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.
Background
Sarcopenia is a geriatric syndrome associated with negative health outcomes and the use of viable alternative screening tools may help in the diagnosis of this condition. This study aimed to analyze the association of sarcopenia with anthropometric indicators among community-dwelling older adults and to identify cut-off points for such indicators as a discriminant criterion for predicting sarcopenia.
Methods
This was a cross-sectional study conducted on community-dwelling older adults ≥60 years old (n = 411) of both sexes from Macapá, Amapá, Brazil. Socioeconomic, clinical and anthropometric data (arm circumference - AC, waist circumference - WC, calf circumference - CC and body mass index – BMI) were collected using a structured form. Sarcopenia was identified according to the EWGSOP 2 consensus. The association between anthropometric indicators and sarcopenia was performed using logistic regression and cut-off points established from the ROC Curve. Statistical significance was defined as p ≤ 0.05.
Results
Adjusted analysis indicated an independent and inverse association between sarcopenia and the anthropometric indicators: AC (odds ratio, OR: 0.63; 95% confidence interval, 95%CI: 0.53–0.76), CC (OR: 0.73; 95%CI: 0.62–0.85), WC (OR: 0.93; 95%CI: 0.90–0.97) and BMI (OR: 0.64; 95%CI: 0.53–0.76). The following cut-off points for older men and women represented the discriminant criterion for the presence of sarcopenia: WC (≤97 and ≤ 86 cm), CC (≤33 and ≤ 31 cm), AC (≤27 cm) and BMI (≤24.8 kg/m2 and ≤ 24.5 kg/m2) (area under the ROC curve superior to 0.70). BMI and AC were the indicators with the highest ability to discriminate older adults of both sexes with sarcopenia.
Conclusions
An increase of one unit of the indicators can reduce the probability of occurrence of sarcopenia. All indicators were considered to discriminate the occurrence of sarcopenia, with emphasis on BMI and AC, and could be used to screen for this condition among community-dwelling older adults.
Resumo Objetivou-se estimar a incidência de quedas entre os idosos e determinar os fatores preditivos de quedas e quedas recorrentes. Estudo longitudinal (2014-2016) conduzido com 345 idosos da área urbana em Uberaba-MG. Utilizou-se: instrumento estruturado referente aos dados socioeconômicos e à ocorrência de quedas; Escalas de Katz e Lawton e Brody; Short Physical Performance Battery (SPPB) e Falls Efficacy Scale-International (FES-I) Brasil. Procedeu-se à análise de regressão logística multinomial (p < 0,05). A incidência de quedas no período de acompanhamento representou 37,1%, sendo 20% recorrentes e 17,1% em um único evento. O modelo final indicou que o aumento em uma unidade do SPPB diminuiu em aproximadamente 15% e 17%, respectivamente, a chance de quedas e quedas recorrentes. O maior escore da FES-I Brasil associou-se à maior ocorrência de quedas recorrentes. Os resultados encontrados sobre a ocorrência de quedas e quedas recorrentes e sua associação com pior desempenho físico e ao medo de cair fornecem subsídios para ações direcionadas ao monitoramento e controle dos fatores interferentes.
| Objective: To evaluate the impact of frailty on respiratory function in a community-dwelling elderly. Method: 51 community-dwelling elderly were evaluated (mean age of 73±6 years), being 29 men (56.7%) and 22 women (43.3%). We collect the following variables: sociodemographic characteristics, frailty phenotype, pulmonary function test and assessment of the respiratory muscles using an analog manometer. The statistical analysis was performed using the Kolmogorov and Smirnov tests, one-way ANOVA, Paired Student's t-test and Pearson correlation coefficient (p<0.05). Results: There were no statistically significant between-group differences among the frail group (FG=9.8%), pre-frail group (PG=47.1%) and non-frail group (NG=43.1%), in relation to anthropometric, demographic and spirometric data. Regarding to the maximum inspiratory and expiratory pressures (MIP and MEP), statistically significant between-group differences were observed among the three groups, being these pressures significantly lower in the FG and PG compared to the NG. With regards to the obtained and predicted values, the FG and PG showed statistically significant difference (p=0.004). The PG showed positive correlations between the MIP and MEP with the values of hand grip strength (r=0.7). The NG showed positive correlation between the MEP and the values of physical activity level (r=0.7). Conclusions: The study demonstrated that maximal respiratory pressures may decrease according to the frailty condition among the nonfrail, pre-frail and frail elderly. Furthermore, it also indicated a positive correlation between inspiratory muscle strength, expiratory muscle strength and hand grip strength in pre-frail elderly. Further investigation with regards to prevention or intervention programs that incorporate actions to minimize the loss of respiratory function are necessary in order to reverse or prevent the progression of the frailty condition.
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