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

Abstract

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. RESUMO CONTEXTO E OBJETIVO:A identificação da síndrome de fragilidade em idosos hospitalizados em interface com fatores de risco cardiovascular é relevante, pois pode contribuir para a ampliação do conhecimento sobre essa relação no nível de serviço terciário. Este estudo objetivou avaliar os fatores de risco cardiovascular associados à síndrome de fragilidade em idosos hospitalizados. TIPO DE ESTUDO E LOCAL: Estudo observacional transversal em hospital público de ensino. MÉTODOS: Participaram idosos internados nas clínicas médica e cirúrgica. Os fatores de risco cardiovascular avaliados foram: índice de massa corporal (IMC), circunferência abdominal, hipertensão arterial sistêmica (HAS), glicemia, colesterol total, lipoproteínas de alta densidade (HDL), lipoproteínas de baixa densidade (LDL) e triglicérides. Para identificar a síndrome de fragilidade, utilizou-se o método proposto por Fried. Os dados foram analisados por estatística descritiva, teste qui-quadrado (P < 0,10) e regressão logística multinomial (P < 0,05). RESULTADOS: Foram incluídos 205 indivíduos. Constatou-se que 26,3% (n = 54) dos idosos eram frágeis, 51,7% (n = 106) pré-frágeis e 22% (n = 45) não frágeis. A análise bivariada preliminar (P < 0,10) para o modelo de regressão indicou associações da fragilidade com as variáveis IMC (P = 0,016), col...

Factors associated with the social, individual and programmatic vulnerability of older adults living at home

“…It is important to emphasize that the aging process may lead to greater predisposition to develop physical frailty (11) . There was an expressive percentage of physical frailty in the present study, with 16.0% of older adults being frail, and more than half (52.2%) were pre-frail.…”

“…The frailty process is understood as the reduction of reserves and resistance to stressors due to cumulative declines in several systems, which cause greater susceptibility to adverse outcomes (19) . Some scholars consider aging itself a condition of vulnerability (11) .…”

“…The older adults were evaluated according to the vulnerability level of the sector in which they reside, and the variable recategorized in low, medium and high/very high social vulnerability. Individual vulnerability was assessed by five criteria of the frailty phenotype, namely: unintentional weight loss, decreased muscle strength, slow walking speed, low physical activity level and self-reported exhaustion and/or fatigue (6) , as described in a previous study (11) . Based on this evaluation, older adults who presented three or more of these criteria were considered frail, one or two as pre-frail and all negative tests as not frail (6) .…”

Towards a unified and standardized definition of the frailty phenotype

“…Tavares et al investigated the association between frailty and cardiovascular risk factors in 205 patients at a tertiary-level hospital. 5 Using Fried's definition of frailty, 26% of the sample were frail, 52% were pre-frail and only 22% were non-frail. The cutoffs for weakness and slowness were based on the original description of Fried et al 2 In addition, Tavares et al used the International Physical Activity Questionnaire (IPAQ) to measure physical activity level, while this was defined in accordance with the Minnesota Leisure Time Activities Questionnaire in the original study by Fried et al 2 In the study by Tavares et al, the only cardiovascular risk factor associated with frailty was overweight, which was more prevalent among pre-frail patients.…”

From screening-driven medicine to symptom-driven medicine

“…* 3 If, on the one hand, the medical-industrial complex relating to cardiovascular diseases has enough power to equilibrate this dispute, on the other hand, health conditions with little or no support exist. These conditions relate to the burden of morbidity with low lethality rates.The current issue of the Journal presents original articles addressing low-back pain, 3,4 frailty, [5][6][7] ankylosis spondylitis 8 and knee osteoarthritis. 9 The constant decline in age-adjusted mortality rates for all causes including chronic diseases, combined with the increasing size of the elderly population, is bringing up a new agenda for medical and public health research.…”