Prevalence and Associated Factors of Frailty Syndrome in Older Cancer Patients in Itaguaí, Rio de Janeiro, Brazil

Carvalho, Danielle Aparecida de; Magalhães, Marcos Vinícius de Carvalho; Evangelista, Tatiana Zoio; Martucci, Renata Brum; Thuler, Luiz Claudio Santos

doi:10.32635/2176-9745.RBC.2025v71n3.5155

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Original Article • Rev. Bras. Cancerol. 71 (3) • 2025 • https://doi.org/10.32635/2176-9745.RBC.2025v71n3.5155EN linkcopy

Prevalence and Associated Factors of Frailty Syndrome in Older Cancer Patients in Itaguaí, Rio de Janeiro, Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Introduction: Frailty syndrome in older adults (FSOA) reflects vulnerability to adverse outcomes such as functional decline, falls, and hospitalizations, associated with comorbidities, cognition, and aging.

Objective: To screen for FSOA in older adults diagnosed with cancer between 2017 and 2021, residing in Itaguaí, Rio de Janeiro.

Method: A cross-sectional observational study using the self-reported FSOA screening tool. Sociodemographic and clinical data were collected during home visits using a specific instrument, in addition to the Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS-15), handgrip strength (HGS), calf circumference (CC), weight, and height measurements.

Results: A total of 279 older adults were analyzed. The age range was 60 to 95 years, with a 69.5 (± 6.2) years mean. Participants were predominantly men with prostate cancer and women with breast cancer. 79.9% of patients could not be located for interviews, primarily due to death (41.9% of cases). Among the 56 older adults included in the frailty study, reduced HGS was observed in 35.7%, depressive symptoms in 26.8%, cognitive decline in 32.1%, and reduced muscle mass in 14.3%. FSOA was observed in 39.3% of participants, associated with factors such as sedentary lifestyle, chronic pain, history of falls, low handgrip strength, and depressive symptoms.

Conclusion: The high prevalence of FSOA and its associated factors highlight the need for interventions to improve the quality of life and autonomy of these individuals.

Key words:
Frailty/diagnosis; Frail Elderly; Neoplasms/epidemiology; Surveys and Questionnaires; Mass Screening

Variables	n	%
Sex
Male	29	51.8
Female	27	48.2
Age (years)
Mean (±SD)	69.5 (± 6.2)	-
Education
Illiterate	7	12.5
1-4 years	19	33.9
5-8 years	14	25.0
9 years or more	16	28.6
Total family income
Up to 1 minimum wage	28	50.0
More than 1 to 3 minimum wages	3	5.4
More than 3 minimum wages	25	44.6
Current occupation
Retired	14	25.0
Home activities	33	58.9
Active	9	16.1
Family network
Lives alone	17	30.4
With spouse	20	35.7
Lives with family	19	33.9
Smoking
Yes	7	12.5
Ex-smoker	25	44.6
Never smoked	24	42.9
Alcohol use
Yes	13	23.2
Ex-user	20	35.7
Never used	23	41.1
Physical activities
Yes	9	16.1
No	47	83.9
History of falls
Yes	25	44.6
No	31	55.4
Chronic pain
Yes	25	44.6
No	31	55.4
History of hospitalizations
Yes	16	28.6
No	40	71.4
Comorbidities
SAH	20	35.7
DM	4	7.1
SAH and DM	14	25.0
None	18	32.1
Impairment
Yes	5	8.9
No	51	91.1
Health self-perception
Negative	26	46.4
Positive	30	53.6
Body mass index
Low weight	7	12.5
Eutrophic	23	41.1
Overweight	26	46.4
Polypharmacy
5 or more medications	13	23.2
1 to 4 medications	37	66.1
No medications	6	10.7
Handgrip strength
Reduced	20	35.7
No changes	36	64.3
Depression symptoms (GDS-15)
Yes	15	26.8
No	41	73.2
Cognitive Impairment (MMSE)
Yes	18	32.1
No	38	67.9
Calf circumference
Muscle mass loss	13	23.2
No changes	43	76.8
Total	56	100

Variables	Non frail		Pre-frail		Frail		p
Sex							0.072
Male	6	46.2	14	66.7	7	31.8
Female	7	53.8	7	33.3	15	68.2
Age (years)							0.160
< 75 years	12	92.3	14	66.7	14	63.6
≥ 75 years	1	7.7	7	33.3	8	36.4
Education							0.431
Illiterate	1	7.7	4	19	2	9.1
1-4 years	3	23.1	7	33.3	9	40.9
5-8 years	3	23.1	7	33.3	4	18.2
9 years or more	6	46.2	3	14.3	7	31.8
Total family income							0.433
Up to 1 minimum wage	4	30.8	11	52.4	10	45.5
More than 1 to 3 minimum wages	9	69.2	8	38.1	11	50
More than 3 minimum wages	0	0	2	9.5	1	4.5
Current occupation							0.518
Retired	2	15.4	6	28.6	6	27.3
Home activities	7	53.8	12	57.1	14	63.6
Active	4	30.8	3	14.3	2	9.1
Family network							0.877
Lives alone	3	23.1	7	33.3	7	31.8
With spouse	4	30.8	8	38.1	8	36.4
Lives with family	6	46.2	6	28.6	7	31.8
Smoking							0.005
Yes	1	7.7	6	26.8	0	0
Ex-smoker	7	53.8	11	52.4	7	31.8
Never smoked	5	38.5	4	19	15	68.2
Alcohol use							0.081
Yes	1	7.7	8	38.1	4	18.2
Ex-user	4	30.8	9	42.9	7	31.8
Never used	8	61.5	4	19	11	50
Physical activities							<0.001
Yes	7	53.8	2	9.5	0	0
No	6	46.2	19	90.5	22	100
History of falls							0.015
Yes	3	23.1	7	33.3	15	68.2
No	10	76.9	14	66.7	7	31.8
Chronic pain							0.017
Yes	4	30.8	6	28.6	15	68.2
No	9	69.2	15	71.4	7	31.8
History of hospitalizations							0.225
Yes	2	15.4	5	23.8	9	40.9
No	11	86.4	16	76.2	13	59.1
Comorbidities							0.225
SAH	6	46.2	7	33.3	7	31.8
DM	0	0	2	9.5	2	9.1
SAH and DM	1	7.7	4	19	9	40.9
None	6	46.2	8	38.1	4	18.2
Impairment							0.365
Yes	0	0	3	14.3	2	9.1
No	13	100	18	85.7	20	90.9
Health self-perception							0.106
Negative	4	30.8	8	38.1	14	63.6
Positive	9	69.2	13	61.9	8	36.4
Body mass index							0.602
Low weight	3	23.1	2	9.5	2	9.1
Eutrophic	6	46.2	9	42.9	8	36.4
Overweight	4	30.8	10	47.6	12	54.5
Polypharmacy							0.37
5 or more medications	2	15.4	3	14.3	1	4.5
1 to 4 medications	9	69.2	15	71.4	13	59.1
No medications	2	15.4	3	14.3	8	36.4
Handgrip strength							0.002
Reduced	0	0	7	33.3	13	59.1
No changes	13	100	14	66.7	9	40.9
Depression symptoms (GDS-15)							0.013
Yes	0	0	5	23.8	10	45.5
No	13	100	16	76.2	12	54.5
Cognitive Impairment (MMSE)							0.249
Yes	2	15.4	9	42.9	7	31.8
No	11	84.6	12	57.1	15	68.2
Calf circumference							0.075
Muscle mass loss	0	0	6	28.6	7	31.8
No changes	13	100	15	71.4	15	68.2
Total	13	23.2	21	37.5	22	39.3	---

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Instituto Nacional de Câncer Rua Marquês de Pombal, 125 - 2º andar, Centro , CEP 20230-240, Tel.: +55 21 3207-6132 - Rio de Janeiro - RJ - Brazil
E-mail: rbc@inca.gov.br

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[TFN4] Captions: GDS-15: 15-item Geriatric Depression Scale; MMSE: Mini Mental State Examination; SAH: Systemic Arterial Hypertension; DM: Diabetes Mellitus; SD: standard deviation. National minimum wage in 2023 R$1,302.00.