Maycon Sousa Pegorari

Factors associated with the frailty syndrome in elderly individuals living in the urban area

OBJECTIVE: to identify the occurrence and factors associated with pre-frailty and frailty conditions among elderly individuals. METHODS: this cross-sectional, observational and analytical household survey was conducted with 958 elderly individuals living in the urban area. The Brazilian version of the Functional Assessment Questionnaire and Multidimensional Scales (Depression, Katz and Lawton brief geriatric versions) were used, together with the Phenotype of Frailty developed by Fried. Descriptive analysis was performed along with a bivariate and multinomial logistic regression model (p<0.05). RESULTS: a total of 313 (32.7%) non-frail elderly individuals were found in addition to 522 (55.4%) pre-frail and 128 (12.8%) frail individuals. Factors associated with pre-frailty and frailty, respectively, included: being 70├ 79 years old and 80 years old or older; using 1├ 4 medications and 5 or more; greater number of morbidities, functional disability for instrumental activities of daily life, and negative self-perception. The absence of a partner was associated with pre-frailty while hospitalization in the last year, functional disability for basic activities of daily life and indication of depression were associated with frailty. CONCLUSION: pre-frailty and frailty conditions presented a percentage higher than that reported by Brazilian studies and are associated with health-related variables. These variables can be prevented with interventions directed to the health of elderly individuals.OBJETIVO: identificar la ocurrencia y los factores asociados a las condiciones de prefragilidad y fragilidad en ancianos. METODOS: encuesta domiciliar transversal, observacional y analitica realizada en 958 ancianos residentes en una area urbana. Se utilizaron: Cuestionario Brasileno de Evaluacion Funcional y Multidimensional, Escalas (Depresion Geriatrica Abreviada, Katz y Lawton) y Fenotipo de Fragilidad de Fried. Se realizaron los siguientes analisis: descriptivo, bivariado y modelo de regresion logistica multinomial (p<0,05). RESULTADOS: se constato la ocurrencia de 313 (32,7%) ancianos no fragiles, 522 (55,4%) prefragiles y 128 (12,8%) fragiles; se consolidaron a los factores asociados a la prefragilidad y fragilidad, respectivamente: a los intervalos de edad de 70 a 79 anos y 80 anos o mas; al uso de 1 a 4 medicamentos y 5 o mas; al mayor numero de enfermedades, a la incapacidad funcional para actividades instrumentales de la vida diaria; y a la percepcion de salud negativa. La ausencia de companero permanecio asociada a la prefragilidad, en cuanto que la fragilidad se asocio a la hospitalizacion en el ultimo ano, a la incapacidad funcional para actividades basicas de la vida diaria y al indicativo de depresion. CONCLUSION: las condiciones de prefragilidad y fragilidad presentaron un porcentaje de ocurrencia superior a estudios brasilenos y estuvieron asociadas a variables relacionadas a la salud, siendo estas capaces de recibir acciones preventivas y de intervencion dirigidas a mejorar la salud de los ancianos

Cardiovascular risk factors associated with frailty syndrome among hospitalized elderly people: a cross-sectional study

CONTEXT AND OBJECTIVE: Identification of frailty syndrome and its relationship with cardiovascular risk factors among hospitalized elderly people is important, since this may contribute towards broadening of knowledge regarding this association within tertiary-level services. This study aimed to evaluate the cardiovascular risk factors associated with frailty syndrome among hospitalized elderly people. DESIGN AND SETTING: Observational cross-sectional study in a public teaching hospital. METHODS: The participants were elderly patients admitted to clinical and surgical wards. The cardiovascular risk factors assessed were: body mass index (BMI), waist circumference, systemic arterial hypertension (SAH), blood glucose, total cholesterol, high-density lipoproteins (HDL), low-density lipoproteins (LDL) and triglycerides. To identify frailty syndrome, the method proposed by Fried was used. The data were analyzed through descriptive statistics, chi-square test (P < 0.10) and multinomial logistic regression (P < 0.05). RESULTS: A total of 205 individuals were evaluated. It was found that 26.3% (n = 54) of the elderly people were frail, 51.7% (n = 106) were pre-frail and 22% (n = 45) were non-frail. The preliminary bivariate analysis (P < 0.10) for the regression model showed that frailty was associated with BMI (P = 0.016), LDL cholesterol (P = 0.028) and triglycerides (P = 0.093). However, in the final multivariate model, only overweight remained associated with the pre-frail condition (odds ratio, OR = 0.44; 95% confidence interval, CI = 0.20-0.98; P = 0.045). CONCLUSION: States of frailty were highly present in the hospital environment. The pre-frail condition was inversely associated with overweight.

Status de fragilidade entre idosos com indicativo de depressão segundo o sexo

Objectives To describe the socioeconomic variables of elderly indicative of depression by gender, verify the association between frailty status and sex, and describe the component of the phenotype of frailty among older adults impacted more indicative of pre-frail and frail depression. Methods An observational, cross-sectional, analytical, conducted with 418 elderly residents indicative of depression in Uberaba-MG. We used the Geriatric Depression Scale Short and Phenotype of Frailty Fried. We used descriptive and Chi-square test (p < 0.05) analysis. Results It was found that among elderly indicative of depression, 27.8% and 51.7% were fragile pre-frail. The frailty status was not associated with gender (p = 0.910). Among the pre-frail, components most impacted phenotype were self-reported exhaustion/fatigue for women and decreased muscle strength for men. In fragile, prevailed decreased muscle strength for both sexes. Conclusion Through the findings of this study, it is concluded that though there was no association between the syndrome of frailty and sex, the identification of components of the phenotype of frailty most impacted can promote multidisciplinary care, considering the specificities of the groups. Early diagnosis helps to establish conducts and disease prevention.

Qualidade de vida e autoestima de idosos na comunidade

This study sought to investigate the association between the scores for quality of life (QoL) and self-esteem among the elderly in an urban community. A cross-sectional, quantitative and analytical household survey was conducted with 1,691 elderly persons resident in an urban area in a county in Minas Gerais state. The World Health Organization Quality of Life BREF (WHOQOL-BREF), the World Health Organization Quality of Life OLD (WHOQOL-OLD) questionnaires and the Rosenberg Self-Esteem Scale were used in this study. A descriptive statistical analysis and a linear regression model (p < 0.05) were conducted. The results revealed that the social relationships domain (71.19) and the topic of death and dying (74.30) had the highest mean scores among the elderly; while the lowest mean scores were the environment domain (60.39) and the topic of social participation (63.06). The self-esteem scores showed an average of 9.36 ± 4.09. Associations were evident for the lower scores of quality of life in all the WHOQOL-BREF domains and WHOQOL-OLD aspects (except death and dying) with lower levels of self-esteem (p <0.001). The results provide data that contribute to a better understanding of the aspects that influence the QoL of the elderly due to reduced self-esteem, thus providing information for the development of health strategies.This study sought to investigate the association between the scores for quality of life (QoL) and self-esteem among the elderly in an urban community. A cross-sectional, quantitative and analytical household survey was conducted with 1,691 elderly persons resident in an urban area in a county in Minas Gerais state. The World Health Organization Quality of Life BREF (WHOQOL-BREF), the World Health Organization Quality of Life OLD (WHOQOL-OLD) questionnaires and the Rosenberg Self-Esteem Scale were used in this study. A descriptive statistical analysis and a linear regression model (p < 0.05) were conducted. The results revealed that the social relationships domain (71.19) and the topic of death and dying (74.30) had the highest mean scores among the elderly; while the lowest mean scores were the environment domain (60.39) and the topic of social participation (63.06). The self-esteem scores showed an average of 9.36 ± 4.09. Associations were evident for the lower scores of quality of life in all the WHOQOL-BREF domains and WHOQOL-OLD aspects (except death and dying) with lower levels of self-esteem (p <0.001). The results provide data that contribute to a better understanding of the aspects that influence the QoL of the elderly due to reduced self-esteem, thus providing information for the development of health strategies.

Time Spent Sitting Is Associated with Changes in Biomarkers of Frailty in Hospitalized Older Adults: A Cross Sectional Study

Background: Sedentary behavior has gained prominence in the literature as a risk factor for health and mortality independent of physical activity level; however, little is known about the relationship of sedentary behavior with frailty in older adults. The aim of this study was to investigate if time spent sitting can be used as a discriminator of frailty in older hospitalized persons. Methods: The study included 162 hospitalized inpatients aged ≥60 years. Blood samples were taken for analyzing leukocyte counts and serum concentrations of C-reactive protein (CRP). Participants also answered a questionnaire about time spent sitting. Frailty was determined from a combination of CRP concentration and leukocyte count. Receiver operating characteristic (ROC) curves were constructed to analyse the predictive power and cut-points for time spent sitting and the presence of frailty. Results: The areas under the ROC curves indicated that time spent sitting was an independent indicator of frailty (area under curve >0.6). The cut-off points for time spent sitting as an indicator of frailty were >257 min/day for men and >330 min/day for women. Conclusions: Time spent sitting is associated with biomarkers of frailty in persons aged ≥60 years, indicating a need for interventions aimed at reducing sedentary behavior in this age group.

Fatores associados à qualidade de vida de idosos comunitários da macrorregião do Triângulo do Sul, Minas Gerais, Brasil

This study sought to establish the socioeconomic and health factors associated with quality of life among the elderly in the community. An analytical study with a cross-sectional and quantitative approach was conducted in 2012 and 2013 with 3430 senior citizens in 24 municipalities in the Southern Triangle Macro-region of the State of Minas Gerais in Brazil. A structured questionnaire was used for socioeconomic and health variables, as well as the Katz scale, the World Health Organization Quality of Life-Bref (WHOQOL-BREF) and the World Health Organization Quality of Life Assessment for Older Adults (WHOQOL-OLD). Descriptive, bivariate statistical analysis was performed and a multiple linear regression model (p < 0.05) was created. Lower quality of life (QoL) scores were found in the environment and autonomy domains associated with advanced age, lack of schooling and income, a negative perception of health and functional disability. The salient key factor was negative health perception. The conclusion drawn was that socioeconomic and health factors were associated with the quality of life of the elderly, highlighting the lowest scores in the environmental domain and from the aspect of autonomy, a key influencing factor being negative health perception.This study sought to establish the socioeconomic and health factors associated with quality of life among the elderly in the community. An analytical study with a cross-sectional and quantitative approach was conducted in 2012 and 2013 with 3430 senior citizens in 24 municipalities in the Southern Triangle Macro-region of the State of Minas Gerais in Brazil. A structured questionnaire was used for socioeconomic and health variables, as well as the Katz scale, the World Health Organization Quality of Life-Bref (WHOQOL-BREF) and the World Health Organization Quality of Life Assessment for Older Adults (WHOQOL-OLD). Descriptive, bivariate statistical analysis was performed and a multiple linear regression model (p < 0.05) was created. Lower quality of life (QoL) scores were found in the environment and autonomy domains associated with advanced age, lack of schooling and income, a negative perception of health and functional disability. The salient key factor was negative health perception. The conclusion drawn was that socioeconomic and health factors were associated with the quality of life of the elderly, highlighting the lowest scores in the environmental domain and from the aspect of autonomy, a key influencing factor being negative health perception.

Fatores associados à síndrome de fragilidade em idosos residentes em área urbana

OBJECTIVE: to identify the occurrence and factors associated with pre-frailty and frailty conditions among elderly individuals. METHODS: this cross-sectional, observational and analytical household survey was conducted with 958 elderly individuals living in the urban area. The Brazilian version of the Functional Assessment Questionnaire and Multidimensional Scales (Depression, Katz and Lawton brief geriatric versions) were used, together with the Phenotype of Frailty developed by Fried. Descriptive analysis was performed along with a bivariate and multinomial logistic regression model (p<0.05). RESULTS: a total of 313 (32.7%) non-frail elderly individuals were found in addition to 522 (55.4%) pre-frail and 128 (12.8%) frail individuals. Factors associated with pre-frailty and frailty, respectively, included: being 70├ 79 years old and 80 years old or older; using 1├ 4 medications and 5 or more; greater number of morbidities, functional disability for instrumental activities of daily life, and negative self-perception. The absence of a partner was associated with pre-frailty while hospitalization in the last year, functional disability for basic activities of daily life and indication of depression were associated with frailty. CONCLUSION: pre-frailty and frailty conditions presented a percentage higher than that reported by Brazilian studies and are associated with health-related variables. These variables can be prevented with interventions directed to the health of elderly individuals.OBJETIVO: identificar la ocurrencia y los factores asociados a las condiciones de prefragilidad y fragilidad en ancianos. METODOS: encuesta domiciliar transversal, observacional y analitica realizada en 958 ancianos residentes en una area urbana. Se utilizaron: Cuestionario Brasileno de Evaluacion Funcional y Multidimensional, Escalas (Depresion Geriatrica Abreviada, Katz y Lawton) y Fenotipo de Fragilidad de Fried. Se realizaron los siguientes analisis: descriptivo, bivariado y modelo de regresion logistica multinomial (p<0,05). RESULTADOS: se constato la ocurrencia de 313 (32,7%) ancianos no fragiles, 522 (55,4%) prefragiles y 128 (12,8%) fragiles; se consolidaron a los factores asociados a la prefragilidad y fragilidad, respectivamente: a los intervalos de edad de 70 a 79 anos y 80 anos o mas; al uso de 1 a 4 medicamentos y 5 o mas; al mayor numero de enfermedades, a la incapacidad funcional para actividades instrumentales de la vida diaria; y a la percepcion de salud negativa. La ausencia de companero permanecio asociada a la prefragilidad, en cuanto que la fragilidad se asocio a la hospitalizacion en el ultimo ano, a la incapacidad funcional para actividades basicas de la vida diaria y al indicativo de depresion. CONCLUSION: las condiciones de prefragilidad y fragilidad presentaron un porcentaje de ocurrencia superior a estudios brasilenos y estuvieron asociadas a variables relacionadas a la salud, siendo estas capaces de recibir acciones preventivas y de intervencion dirigidas a mejorar la salud de los ancianos

Respiratory Muscle Strength as a Discriminator of Sarcopenia in Community-Dwelling Elderly: A Cross-Sectional Study

ObjectivesTo compare the values obtained from maximum respiratory pressures (MRP) between sarcopenic and non-sarcopenic elderly; to verify the association of maximum respiratory pressures with sarcopenia and its indicators; and to establish cut-off points for MRP as a discriminator of sarcopenia.DesignCross-sectional study.LocationMacapá, Brazil.ParticipantsCommunity-dwelling elderly ≥ 60 years old, both sexes.MeasuresEvaluation of respiratory muscle strength (maximal inspiratory pressure - MIP and maximal expiratory pressure - MEP) and sarcopenia, according to the European Working Group on Sarcopenia in Older People (EWGSOP), in which the diagnosis of this condition considered the reduction of muscle mass (muscle mass index - MMI) associated with muscle strength reduction (hand grip strength - HGS) and / or impairment in physical performance (gait speed - GS).ResultsThe sample consisted of 383 elderly individuals, with a mean age of 70.02 ± 7.3 years and a prevalence of sarcopenia of 12.53% (n = 48). Sarcopenic individuals presented significantly lower (obtained, obtained versus predicted) mean values for the maximal respiratory pressures compared to the non-sarcopenic elderly, and these were inversely associated with sarcopenia (an increase by 1 cmH2O in MIP and MEP reduced by 5% and 3%, respectively, the probability of sarcopenia). In relation to the association with the sarcopenia indicators, the increase by 1 cmH2O in MIP and MEP decreased, respectively, the probability of decreasing muscle strength (3% and 2%), GS (3% and 4%) and MMI (3 % - MIP). Cut-off points ≤60 cmH2O and ≤50 cmH2O for MEP and ≤55 cmH2O and ≤45 cmH2O for MEP, respectively for elderly men and women, served as a discriminant criterion for the presence of sarcopenia (area under the ROC curve superior to 0.70).ConclusionsElderly patients with sarcopenia had lower MIP and MEP values when compared to non-sarcopenic individuals, and respiratory muscle strength was inversely associated with the diagnosis of sarcopenia and its indicators (HGS, gait speed and MMI). Furthermore, cut-off points for MIP and MEP can be used in clinical practice as discriminators of sarcopenia in community-dwelling elderly.

Frailty Syndrome in Association with Depressive Symptoms and Functional Disability among Hospitalized Elderly

ABSTRACT We sought to examine the frailty association with depression and functional disability in hospitalized older adults. In particular, we compared non-frail, pre-frail, and frail elderly hospitalized individuals. We performed a cross-sectional study with 255 hospitalized Brazilian elderly patients. We used a structured instrument to assess socio-economic data, the Fried frailty phenotype and used morbidity scales (Geriatric Depression; Katz; Lawton and Brody). The adjusted analysis revealed that frail elderly exhibit increased odds ratios (OR) for depressive symptoms (OR = 2.72, 95% CI: 1.12–6.62), disability related to basic activities (OR = 3.50, 95% CI: 1.26–9.60), and instrumental daily living (OR = 2.70, 95% CI: 1.12–6.44). Frailty in hospitalized older adults is associated with depressive symptomatology and functional disability.

Cross-sectional study on the association between frailty and violence against community-dwelling elderly people in Brazil

BACKGROUND The physical, emotional and cognitive limitations that may be present in the aging process, coupled with family unpreparedness, may lead to greater dependence among the elderly. This favors development of frailty syndrome and greater levels of violence against the elderly. The objective here was to analyze the association between violence against the elderly and frailty; and the geographic distribution of violence against the elderly according to the presence of frailty syndrome. DESIGN AND SETTING Cross-sectional study on 705 community-dwelling elderly people in Uberaba (MG), Brazil. METHODS The Fried frailty phenotype and conflict tactics scale were used. Data were analyzed using descriptive statistics, the chi-square test and a logistic regression model. The intensity of the events and the relationship between clusters of violence and frailty status were assessed by means of kernel estimation. RESULTS The adjusted analysis indicated that pre-frailty and frailty were associated with physical and verbal aggression (odds ratio, OR = 1.51; 95% confidence interval, CI: 1.04-2.19; OR = 2.12; 95% CI: 1.29-3.47), frailty was associated with physical aggression (OR = 2.48; 95% CI: 1.25-4.94) and pre-frailty and frailty were associated with verbal aggression (OR = 1.48; 95% CI: 1.03-2.15; OR = 2.15; 95% CI: 1.31-3.52), respectively. Regardless of frailty status and its relationship with violence, clusters of occurrences were larger in similar regions in the southeastern part of the municipality; but superimposition of overlays relating to aggression showed that for frail individuals the clusters were smaller than for non-frail and pre-frail individuals. CONCLUSIONS The condition of frailty was associated with greater chances of violence against the elderly.