Frailty in older adults in the city of São Paulo: Prevalence and associated factors

Duarte, Yeda Aparecida de Oliveira; Nunes, Daniella Pires; Andrade, Fabíola Bof de; Corona, Ligiana Pires; Brito, Tábatta Renata Pereira de; Santos, Jair Lício Ferreira dos; Lebrão, Maria Lúcia

Acessibilidade / Reportar erro

Brasil

Revista Brasileira de Epidemiologia

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

ORIGINAL ARTICLE • Rev. bras. epidemiol. 21 (Suppl 02) • 2018 • https://doi.org/10.1590/1980-549720180021.supl.2 copy

Frailty in older adults in the city of São Paulo: Prevalence and associated factors

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT:

Introduction:

Frailty is a preventable and reversible syndrome characterized by a cumulative decline of physiological systems, causing greater vulnerability to adverse conditions.

Objective:

To describe the prevalence of frailty among older adults and analyze its associated factors and progression.

Method:

This is a longitudinal study that used the Health, Well-being, and Aging Study (Saúde, Bem-Estar e Envelhecimento - SABE) database of 2006 and 2010. Five components identified the frailty syndrome: weight loss; fatigue; decreased strength, low physical activity, and reduced walking speed. Older adults were classified as “pre-frail” (1-2 components) and “frail” (3 or more). We used a hierarchical multiple multinomial regression to analyze associated factors.

Results:

Out of the total number of older adults (n = 1,399), 8.5% were frail, and the associated factors were age, functional impairment, cognitive decline, hospitalization, and multimorbidity. In four years, 3.3% of non-frail and 14.7% of pre-frail older adults became frail.

Conclusion:

Identifying the prevalence of frailty and its associated factors can help to implement adequate interventions early to improve the quality of life of older adults.

Keywords:
Aged. Aged; 80 and over. Frail elderly

	Total sample (n = 1,399)	No cognitive decline (n = 1,185)	Cognitive decline (n = 214)	p-value
Low physical activity
No	80.0	83.0	49.3	0,000
Yes	20.0	17.0	50.7	0,000
Handgrip strength
Normal	74.8	79.2	30.6	0,000
Decreased	25.2	20.8	69.4	0,000
Walking speed
Normal	83.0	86.9	45.0	0,000
Reduced	17.0	13.1	55.0	0,000
Weight loss
No	92.2	92.7	88.0	0.080
Yes	7.8	7.3	12.0	0.080
Fatigue
No	86.8	88.3	68.0	0.0000
Yes	13.2	11.7	32.0	0.0000
Number of components
0	50.0	53.7	14.5	0.0000
1	28.7	29.6	20.8
2	12.8	11.4	25.8
3	6.9	4.8	27.2
4	1.3	0.5	9.3
5	0.3	0.0	2.4
Frailty categories
No	50.0	53.7	14.5	0.0000
Pre-frail	41.5	41.0	46.6
Frail	8.5	5.3	38.9
Total	100.0	100.0	100.0

Variables	Age group (years)				p- value
	60 to 69	70 to 79	80 to 89	90 and older
	%	%	%	%
Sociodemographic, economic, and health characteristics
Gender (female)	56.5	61.9	66.3	77.9	0.012
Marital status (without partner)	32.9	50.9	69.2	92.5
Perceived income insufficiency (Yes)	58.2	52.4	44.1	50.4	0.029
Lives alone (Yes)	10.0	15.8	25.0	11.7	0.000
Multimorbidity (Yes)	49.1	66.2	65.2	57.1	0.000
Depression symptoms (Yes)	14.1	13.5	17.9	7.7	0.463
Difficulty with at least 1 ADL^† (Yes)	7.4	15.2	34.4	66.4	0.000
Difficulty with at least 1 IADL^‡ (Yes)	35.4	53.1	76.4	92.7	0.000
Fell in the past year (Yes)	25.0	31.8	38.5	32.4	0.002
Hospitalized in the past year (Yes)	6.7	11.8	18.2	27.2	0.000
Frailty
Low physical activity (Yes)	12.7	23.7	45.8	70.6	0.000
Decreased handgrip strength (Yes)	18.6	27.4	51.8	82.3	0.000
Reduced walking speed (Yes)	10.4	16.7	49.0	75.8	0.000
Weight loss (Yes)	6.4	9.5	11.2	4.6	0.076
Fatigue (Yes)	11.9	13.9	20.3	12.6	0.020
Categories
Non-frail	58.6	44.7	20.4	8.5	0.000
Pre-frail	37.3	46.9	51.6	35.6
Frail	4.1	8.4	28.0	55.9
Total	58.9	30.0	9.6	1.5

Variables	Frailty categories			p-value
	Non-frail	Pre-frail	Frail
	%	%	%
Gender
Male	51.8	41.5	6.7	0.268
Female	48.7	41.6	9.7	0.268
Marital status
With partner	53.7	40.2	6.1	0.002
Without partner	44.9	43.4	11.7	0.002
Schooling (years)
Illiterate	35.0	49.6	15.4	0.000
1-3	47.1	42.5	10.4
4-7	53.3	40.5	6.2
8 or more	59.2	35.7	5.1
Lives alone
No	51.1	40.3	8.6	0.139
Yes	43.2	49.3	7.5	0.139
Multimorbidity
No	60.6	35.4	4.0	0.000
Yes	41.5	46.4	12.1	0.000
Depression symptoms
No	57.8	38.4	3.7	0.000
Yes	25.2	61.0	13.8	0.000
Difficulty with at least 1 ADL†
No	56.0	39.7	4.3	0.000
Yes	10.1	53.9	36.0	0.000
Difficulty with at least 1 IADL‡
No	62.2	33.3	1.5	0.000
Yes	31.8	51.4	16.8	0.000
Fell in the past year
No	54.5	37.8	7.7	0.000
Yes	38.5	51.0	10.5	0.000
Hospitalized in the past year
No	52.6	40.8	6.6	0.000
Yes	25.0	48.7	26.3	0.000
Total	50.0	41.5	8.5

Variables	aRRR	95%CI	p-value
Pre-frail*
Age (80 years or older)	2.77	1.87 - 4.12	0.000
Perceived income insufficiency	1.47	1.07 - 2.02	0.016
Difficulty with at least 1 ADL†	3.20	1.81 - 5.66	0.000
Difficulty with at least 1 IADL‡	1.87	1.32 - 2.64	0.001
Cognitive decline	2.10	1.11 - 3.98	0.023
Fell in the past year	1.56	1.15 - 2.13	0.005
Hospitalized in the past year	2.05	1.13 - 3.71	0.019
Frail**
Age (80 years or older)	5.35	2.54 - 11.24	0.000
Difficulty with at least 1 ADL^†	8.97	4.41 - 18.22	0.000
Difficulty with at least 1 IADL^‡	5.70	1.45 - 22.37	0.013
Cognitive decline	7.37	3.41 - 15.91	0.000
Hospitalized in the past year	3.68	1.89 - 7.16	0.000
Reported multimorbidity	2.70	1.34 - 5.40	0.006

Associação Brasileira de Saúde Coletiva Av. Dr. Arnaldo, 715 - 2º andar - sl. 3 - Cerqueira César, 01246-904 São Paulo SP Brasil , Tel./FAX: +55 11 3085-5411 - São Paulo - SP - Brazil
E-mail: revbrepi@usp.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Corresponding author: Yeda Aparecida de Oliveira Duarte. Núcleo de Apoio à Pesquisa SABE. Avenida Dr. Arnaldo, 715, CEP: 01246-904, São Paulo, SP, Brasil. E-mail: yedaenf@usp.br