Implications of self-reported fragility on the quality of life of older adults: a cross-sectional study

Souza Júnior, Edison Vitório de; Cruz, Diego Pires; Silva, Cristiane dos Santos; Rosa, Randson Souza; Siqueira, Lais Reis; Sawada, Namie Okino

doi:10.1590/1980-220X-REEUSP-2021-0040

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ORIGINAL ARTICLE • Rev. esc. enferm. USP 55 • 2021 • https://doi.org/10.1590/1980-220X-REEUSP-2021-0040 copy

Implications of self-reported fragility on the quality of life of older adults: a cross-sectional study

Implicaciones de la fragilidad auto declarada en la calidad de vida de adultos mayores: estudio transversal

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To analyze the association between self-reported fragility and quality of life in older adults.

Method:

Cross-sectional study carried out with Brazilian older adults between July and October 2020. Three instruments were applied to obtain bio sociodemographic, frailty data and quality of life. Data were analyzed using the Kruskal-Wallis test, Pearson correlation and multivariate linear regression, adopting a 95% confidence interval (p < 0.05).

Results:

A total of 662 older adults participated. All facets of quality of life were significantly and negatively correlated with reduced strength, reduced walking speed, low physical activity, and reported fatigue, with the exception of weight loss. In the regression analysis, different frailty components were associated with quality of life, but all had a negative relationship.

Conclusion:

Self-reported frailty has a negative relationship with quality of life, that is, the increase in the frailty scale implies a reduction of different magnitudes in the quality of life of older adults.

DESCRIPTORS
Frail Elderly; Quality of Life; Geriatric Nursing; Health of the Elderly; Family Health Strategy

FRAILTY
Variables	Non-frail		Pre-frail		Frail
	N	%	n	%	n	%
Gender
Male	66	17.2	159	41.5	158	41.3
Female	32	11.6	106	38.3	139	50.2
Other	0	0.0	0	0.0	2	100
Marital status
Married	63	15.0	168	40.0	189	45.0
Stable union	17	14.5	47	40.2	53	45.3
Regular partner	18	14.4	50	40.0	57	45.6
Religion
Catholic	56	15.6	146	40.6	158	43.9
Protestant	10	11.2	34	38.2	45	50.6
Spiritism	15	18.8	34	42.5	31	38.8
African origins	2	16.7	2	16.7	8	66.7
No religion	9	14.5	31	50.0	22	35.5
Others	6	10.2	18	30.5	35	59.3
Living with their children
Yes	19	10.7	68	38.2	91	51.1
No	73	16.3	185	41.2	191	42.5
Have no children	6	17.1	12	34.3	17	48.6
Ethnicity
White	65	14.5	186	41.6	196	43.8
Yellow	3	21.4	3	21.4	8	57.1
Black	4	12.5	11	34.4	17	53.1
Brown	25	15.8	61	38.6	72	45.6
Indigenous	1	16.7	3	50.0	2	33.3
Does not know	0	0.0	1	20.0	4	80.0
Brazilian region
North	3	9.4	16	50.0	13	40.6
Northeast	22	18.0	47	38.5	53	43.4
Midwest	8	17.0	18	38.3	21	44.7
Southeast	45	15.2	117	39.4	135	45.5
South	20	12.1	67	40.9	77	47.0
Education
Primary	2	3.6	20	36.4	33	60.0
Elementary I	8	15.4	19	36.5	25	48.1
Elementary II	5	14.3	16	45.7	14	40.0
High school	42	17.3	88	36.2	113	46.5
Higher education	41	14.9	122	44.2	113	40.9
No education	0	0.0	0	0.0	1	100

QUALITY OF LIFE
	SS	AUT	PPFA	SP	DD	INT	GQoL
Medium posts
Gender
Male	308.99^† †,‡ Bonferroni Post-hoc Test.	335.65	331.13	330.01	343.98	334.87	331.29
Female	362.74^† †,‡ Bonferroni Post-hoc Test.	327.46	333.51	334.76	314.40	327.88	332.51
Other	314.50	96.25	124.50	166.25	309.00	187.75	231.75
p value	*0.002^ * Statistical significance by Kruskal-Wallis H test (p < 0.05).**	0.184	0.300	0.444	0.142	0.497	0.759
Marital status
Married	312.59^† †,‡ Bonferroni Post-hoc Test.	318.52	329.49	323.64	329.76	314.82^† †,‡ Bonferroni Post-hoc Test.	316.78
Stable union	374.92^† †,‡ Bonferroni Post-hoc Test.	351.95	334.19	344.97	344.02	358.01	359.11
Regular partner	354.41	355.96	335.73	345.32	325.62	362.74^† †,‡ Bonferroni Post-hoc Test.	355.11
p value	*0.002^ * Statistical significance by Kruskal-Wallis H test (p < 0.05).**	0.067	0.936	0.373	0.719	*0.010^ * Statistical significance by Kruskal-Wallis H test (p < 0.05).**	*0.033^ * Statistical significance by Kruskal-Wallis H test (p < 0.05).**
Religion
Catholic	328.41	326.00^‡ †,‡ Bonferroni Post-hoc Test.	323.46^‡ †,‡ Bonferroni Post-hoc Test.	327.04	322.48	316.22^‡ †,‡ Bonferroni Post-hoc Test.	319.89^‡ †,‡ Bonferroni Post-hoc Test.
Protestant	295.21	291.21^† †,‡ Bonferroni Post-hoc Test.	307.39^† †,‡ Bonferroni Post-hoc Test.	330.26	345.15	317.12^† †,‡ Bonferroni Post-hoc Test.	307.16^† †,‡ Bonferroni Post-hoc Test.
Spiritism	363.01	402.77^† †,‡ Bonferroni Post-hoc Test. ,^‡ †,‡ Bonferroni Post-hoc Test.	401.24^† †,‡ Bonferroni Post-hoc Test. ,^‡ †,‡ Bonferroni Post-hoc Test.	391.86	341.82	405.80^† †,‡ Bonferroni Post-hoc Test. ,^‡ †,‡ Bonferroni Post-hoc Test.	410.89^† †,‡ Bonferroni Post-hoc Test. ,^‡ †,‡ Bonferroni Post-hoc Test.
African origins	276.00	315.63	279.71	261.54	302.63	338.67	276.92
Others	319.13	321.57	364.89	318.37	355.09	342.03	340.75
No religion	383.38	341.83	301.04	307.32	334.09	333.59	333.16
p value	*0.043^ * Statistical significance by Kruskal-Wallis H test (p < 0.05).**	*0.007^ * Statistical significance by Kruskal-Wallis H test (p < 0.05).**	*0.004^ * Statistical significance by Kruskal-Wallis H test (p < 0.05).**	*0.047^ * Statistical significance by Kruskal-Wallis H test (p < 0.05).**	0.747	*0.008^ * Statistical significance by Kruskal-Wallis H test (p < 0.05).**	*0.003^ * Statistical significance by Kruskal-Wallis H test (p < 0.05).**

QoL facets	Frailty			H	p value
	Non-frail	Pre-frail	Frail
	M_d (IQ)	M_d (IQ)	M_d (IQ)
SS	93.75 (75.00–95.31	81.25 (75.00–93.75)	75.00 (56.25–87.50)	70.154	*<0.001^ * Statistical significance by Kruskal-Wallis H test (p < 0,05).**
AUT	75.00 (62.50–82.81)	68.75 (56.25–75.00)	62.50 (50.00–75.00)	40.469	*<0.001^ * Statistical significance by Kruskal-Wallis H test (p < 0,05).**
PPFA	75.00 (62.50–81.25)	68.75 (56.25–81.25)	62.50 (50.00–75.00)	33.299	*<0.001^ * Statistical significance by Kruskal-Wallis H test (p < 0,05).**
SP	75.00 (68.75–81.25)	75.00 (62.50–81.25)	65.20 (50.00–75.00)	51.061	*<0.001^ * Statistical significance by Kruskal-Wallis H test (p < 0,05).**
DD	81.25 (56.25–93.75)	75.00 (56.25–81.25)	68.75 (43.75–81.25)	26.126	*<0.001^ * Statistical significance by Kruskal-Wallis H test (p < 0,05).**
INT	75.00 (75.00–87.50)	75.00 (68.75–81.25)	75.00 (56.25–75.00)	29.909	*<0.001^ * Statistical significance by Kruskal-Wallis H test (p < 0,05).**
GQoL	77.08 (70.57–83.59)	72.91 (56.54–80.20)	64.58 (55.20–73.95)	85.622	*<0.001^ * Statistical significance by Kruskal-Wallis H test (p < 0,05).**

	SS	AUT	PPFA	SP	DD	INT
Weight loss	0.039	0.015	−0.027	−0.018	−0.017	−0.016
Force reduction	−0.319^* * Statistical significance for Pearson correlation (p < 0,01).	−0.177^* * Statistical significance for Pearson correlation (p < 0,01).	−0.219^* * Statistical significance for Pearson correlation (p < 0,01).	−0.262^* * Statistical significance for Pearson correlation (p < 0,01).	−0.176^* * Statistical significance for Pearson correlation (p < 0,01).	−0.194^* * Statistical significance for Pearson correlation (p < 0,01).
Walking speed reduction	−0.275^* * Statistical significance for Pearson correlation (p < 0,01).	−0.209^* * Statistical significance for Pearson correlation (p < 0,01).	−0.169^* * Statistical significance for Pearson correlation (p < 0,01).	−0.193^* * Statistical significance for Pearson correlation (p < 0,01).	−0.142^* * Statistical significance for Pearson correlation (p < 0,01).	−0.187^* * Statistical significance for Pearson correlation (p < 0,01).
Low physical activity	−0.156^* * Statistical significance for Pearson correlation (p < 0,01).	−0.162^* * Statistical significance for Pearson correlation (p < 0,01).	−0.120^* * Statistical significance for Pearson correlation (p < 0,01).	−0.176^* * Statistical significance for Pearson correlation (p < 0,01).	−0.073^* * Statistical significance for Pearson correlation (p < 0,01).	−0.121^* * Statistical significance for Pearson correlation (p < 0,01).
Reported fatigue 1	−0.246^* * Statistical significance for Pearson correlation (p < 0,01).	−0.179^* * Statistical significance for Pearson correlation (p < 0,01).	−0.200^* * Statistical significance for Pearson correlation (p < 0,01).	−0.220^* * Statistical significance for Pearson correlation (p < 0,01).	−0.164^* * Statistical significance for Pearson correlation (p < 0,01).	−0.163^* * Statistical significance for Pearson correlation (p < 0,01).
Reported fatigue 2	−0.259^* * Statistical significance for Pearson correlation (p < 0,01).	−0.183^* * Statistical significance for Pearson correlation (p < 0,01).	−0.201^* * Statistical significance for Pearson correlation (p < 0,01).	−0.185^* * Statistical significance for Pearson correlation (p < 0,01).	−0.207^* * Statistical significance for Pearson correlation (p < 0,01).	−0.165^* * Statistical significance for Pearson correlation (p < 0,01).
Total frailty	−0.357^* * Statistical significance for Pearson correlation (p < 0,01).	−0.261^* * Statistical significance for Pearson correlation (p < 0,01).	−0.261^* * Statistical significance for Pearson correlation (p < 0,01).	−0.304^* * Statistical significance for Pearson correlation (p < 0,01).	−0.220^* * Statistical significance for Pearson correlation (p < 0,01).	−0.239^* * Statistical significance for Pearson correlation (p < 0,01).

	β non-standard	β standard	95%CI	p	Durbin-Watson	R²	RootMSE*
SENSORY SKILLS
Force reduction	−7.07	−0.18	−9.89–−3.50	<0.01	1.92	0.16	17.20
Walking speed reduction	−4.68	−0.12	−7.84–−1.60	<0.01
Reported fatigue 1	−4.72	−0.10	−8.55–−1.17	<0.01
Reported fatigue 2	−6.20	−0.14	−9.73–2.68	<0.01
AUTONOMY
Walking speed reduction	−4.73	−0.13	−7.72–−1.75	<0.01	1.84	0.07	17.73
Low physical activity	−3.32	−0.08	−6.27–−0.222	0.03
Reported fatigue 1	−4.21	−0.09	−7.97–−0.45	0.03
Reported fatigue 2	−4.36	−0.10	−7.97–−0.746	0.02
PAST, PRESENT AND FUTURE ACTIVITIES
Force reduction	−6.06	−0.16	−8.92–−3.21	<0.01	2.01	0.08	17.48
Reported fatigue 1	−4.36	−0.10	−8.07–−0.58	0.02
Reported fatigue 2	−4.7	−0.11	−8.25–−1.15	0.01
SOCIAL PARTICIPATION
Force reduction	−6.33	−0.16	−9.53–−3.21	<0.01	1.95	0.10	18.76
Low physical activity	−4.46	−0.11	−7.66–−1.26	<0.01
Reported fatigue 1	−5.64	−0.12	−9.68–−1.61	<0.01
Reported fatigue 2	−3.87	−0.08	−7.680–−0.054	0.05
DEATH AND DYING
Force reduction	−5.43	−0.11	−9.33–−1.54	<0.01	2.05	0.06	23.84
Reported fatigue 2	−8.70	−0.15	−13.54–−3.86	<0.01	2.05	0.06	23.84
INTIMACY
Force reduction	−4.34	−0.12	−7.659–−1.023	<0.01	1.94	0.06	18.19
Low physical activity	−4.15	−0.11	−7.447–−0.866	<0.01
Reported fatigue 2	−4.79	−0.11	−8.229–−1.370	<0.01

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E-mail: reeusp@usp.br

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[1] Corresponding author: Edison Vitório de Souza Júnior, Av. dos Bandeirantes, 3900, Campus, 14040-902 - Ribeirão Preto, SP, Brazil edison.vitorio@usp.br