Frailty syndrome in Brazilian older people: a population based study

Guedes, Rita de Cássia; Dias, Rosangela; Neri, Anita Liberalesso; Ferriolli, Eduardo; Lourenço, Roberto Alves; Lustosa, Lygia Paccini

doi:10.1590/1413-81232020255.21582018

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Sumário

TEMAS LIVRES • Ciênc. saúde coletiva 25 (5) • May 2020 • https://doi.org/10.1590/1413-81232020255.21582018 copy

Frailty syndrome in Brazilian older people: a population based study

Síndrome de fragilidade em idosos brasileiros: um estudo de base populacional

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This article aims to categorize elderly non-frail (NF), pre-frail (PF) and frail (FF) as to fast and slow gait speed. Compare NF, PF and FF, and analyze associations between fast or slow gait speed with clinical, functional and mental factors. 5,501 elderly (65 years or over; to the Frailty in Brazilian Older People Study), classified as NF, PF and FF (Fried´s frailty phenotype) and, in relation to fast gait speed (≥ 0.8m/s) and slow (< 0.8m/s). Age, sex, body mass index, muscular strength, advanced, instrumental and basic activities of daily living, falls, fear of falling and depressive symptoms were evaluated. Logistic regression analysis investigated associations between variables. The proportion of the slow elderly increased with fragility (NF = 12.39%, PF = 37.56%, FF = 88.83%, p < 0.01). Be woman, performance in activities of daily living, muscle strength and fall were associated with fragility syndrome. The association between frailty and adverse health outcomes reinforces its primacy as an indicator of the functional health of the elderly. Functional capacity, muscular strength, and falls should be evaluated considering their potential for reversibility.

Key words
Aged; Gait; Elderly health; Frail elderly

Characteristics	Total Sample (N=5501)	Non Frail (N=2034) 37,0%	Pre-Frail (N=2822) 51,3%	Frail (N=645) 11,7%	p-value
Age, years (SD)	73.01 (6.17)	72.10 (5.83)	73.36 (6.17)	76.71 (7.18)^* * frail x pre-frail; ^£ £ frail x non frail;	<0.01
Sex					<0.01
Male, n (%)	1862 (33.80)	750 (36.90)	937 (33.20)	177 (27.40)
Female, n (%)	3639 (66.20)	1284 (63.10)	1885 (66.80)	468 (72.60)
Falls in previous year, n (%)	1667 (30.30)	498 (24.10)	828 (29.36)	341 (55.44)	<0.01
Number of falls (SD)	1.30 (0.9)	0.30 (1.12)	1.33 (0.98) ^¥ ¥ pre frail x non frail.	2.54 (1.51)^* * frail x pre-frail; ^£ £ frail x non frail;	0.01
BMI (kg/m²) (SD)	26.87 (5.29)	26.80 (4.71)	27.00 (5.02)	26.82 (6.14)	0.07
HGS (kgf) (SD)	22.90 (8.37)	29.72 (8.33)	24.37 (9.30) ^¥ ¥ pre frail x non frail.	14.63 (7.48)^* * frail x pre-frail; ^£ £ frail x non frail;	<0.01
AADL (SD)	3.25 (3.87)	2.73 (1.81)	3.04 (2.05)	3.99 (2.47)^£ £ frail x non frail;	<0.01
IADL (SD)	19.14 (2.31)	20.70 (1.29)	19.59 (2.09)	17.14 (3.56)^£ £ frail x non frail;	<0.01
BADL (SD)	0.20 (0.67)	0.10 (0.32)	0.13 (0.35)	0.37 (0.90)^* * frail x pre-frail; ^£ £ frail x non frail;	<0.01
FES-I - Brasil (SD)	28.41 (7.32)	23.54 (8.41)	26.88 (9.98)	34.81 (11.58)^* * frail x pre-frail; ^£ £ frail x non frail;	<0.01
GDS (SD)	7.65 (1.94)	7.20 (1.70)	7.61 (2.01)	8.15 (2.12)^£ £ frail x non frail;	<0.01
GS categorized					<0.01
Slow (<0,8 m/s), n (%)	1885 (34.26)	252 (12.39)	1060 (37.56)	573 (88.83)
Fast (≥0,8 m/s), n (%)	3616 (65.74)	1782 (87.61)	1762 (62.44)	72 (11.17)
GS (m/s) (SD)	1.0 (0.69)	1.06 (0.22)	0.87 (0.25) ^¥ ¥ pre frail x non frail.	0.53 (0.22)^* * frail x pre-frail; ^£ £ frail x non frail;	<0.01

Variables	OR	(IC95%)	p-Value
Age	0.84	(0.79 - 0.89)	<0.01^* * Significant difference. OR > 1 are associated with increased probability of GS be greater than 0.8m/s.
Female	1.58	(1.36 - 1.96)	0.01^* * Significant difference. OR > 1 are associated with increased probability of GS be greater than 0.8m/s.
BMI	0.84	(0.79 - 0.90)	<0.01^* * Significant difference. OR > 1 are associated with increased probability of GS be greater than 0.8m/s.
HGS	1.29	(1.20 - 1.39)	<0.01^* * Significant difference. OR > 1 are associated with increased probability of GS be greater than 0.8m/s.
IADL	1.36	(1.22 - 1.52)	<0.01^* * Significant difference. OR > 1 are associated with increased probability of GS be greater than 0.8m/s.
FES-I Brasil	0.81	(0.77 - 0.86)	<0.01^* * Significant difference. OR > 1 are associated with increased probability of GS be greater than 0.8m/s.

Variables	OR	(IC 95%)	p-Value
Female	1.44	(1.30 - 1.65)	<0.01^* * Significant difference. OR > 1 are associated with increased probability of GS be greater than 0.8m/s.
HGS	1.37	(1.32 - 1.42)	<0.01^* * Significant difference. OR > 1 are associated with increased probability of GS be greater than 0.8m/s.
IADL	1.13	(1.03 - 1.23)	0.01^* * Significant difference. OR > 1 are associated with increased probability of GS be greater than 0.8m/s.
FES-I Brasil	0.75	(0.73 - 0.78)	<0.01^* * Significant difference. OR > 1 are associated with increased probability of GS be greater than 0.8m/s.

Variables	OR	(IC95%)	p-Value
HGS	1.48	(1.24 - 1.54)	<0.01^* * Significant difference. OR > 1 are associated with increased probability of GS be greater than 0.8m/s.
Falls	2.31	(2.01 - 2.99)	0.03^* * Significant difference. OR > 1 are associated with increased probability of GS be greater than 0.8m/s.
BADL	0.32	(0.14 - 0.75)	0.01^* * Significant difference. OR > 1 are associated with increased probability of GS be greater than 0.8m/s.
FES-I Brasil	0.58	(0.68 - 0.91)	0.01^* * Significant difference. OR > 1 are associated with increased probability of GS be greater than 0.8m/s.
GDS	0.71	(0.52 - 0.96)	0.03^* * Significant difference. OR > 1 are associated with increased probability of GS be greater than 0.8m/s.

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[1] Collaborations

RC Guedes, R Dias and LP Lustosa were responsible for the conception, writing, statistical analysis, revision and final approval. AL Neri, E Ferriolli and RA Lourenço were responsible for the conception, research, methodology and final approval.