Prevalence and factors associated with frailty in an older population from the city of Rio de Janeiro, Brazil: the FIBRA-RJ Study

Abstract

OBJECTIVE:Frailty syndrome can be defined as a state of vulnerability to stressors resulting from a decrease in functional reserve across multiple systems and compromising an individual's capacity to maintain homeostasis. The purpose of this study was to determine the prevalence of frailty and its association with social and demographic factors, functional capacity, cognitive status and self-reported comorbidities in a sample of community-dwelling older individuals who are clients of a healthcare plan.METHODS:We evaluated 847 individuals aged 65 years or older who lived in the northern area of the city of Rio de Janeiro, Brazil. The subjects were selected by inverse random sampling and stratified by gender and age. To diagnose frailty, we used the scale proposed by the Cardiovascular Health Study, which consisted of the following items: low gait speed, grip strength reduction, feeling of exhaustion, low physical activity and weight loss. The data were collected between 2009 and 2010, and the frailty prevalence was calculated as the proportion of individuals who scored positive for three or more of the five items listed above. To verify the association between frailty and risk factors, we applied a logistic regression analysis.RESULTS:The prevalence of frailty syndrome was 9.1% (95% confidence interval [CI], 7.3-11.3); 43.6% (95% CI, 40.3-47) of the individuals were considered robust, and 47.3% (95% CI 43.8-50.8) were considered pre-frail (p<0.001). The frail individuals tended to be older (odds ratio [OR] 13.2, 95% CI, 8.7-20) and have lower education levels (OR 2.1, 95% CI, 1-4.6), lower cognitive performance (OR 0.76, 95% CI, 0.73-0.79) and reduced health perception (OR 65.8, 95% CI, 39.1-110.8). Frail individuals also had a greater number of comorbidities (OR 6.6, 95% CI, 4.4-9.9) and worse functional capacity (OR 3.8, 95% CI, 2.9-5).CONCLUSION: The prevalence of frailty was similar to that seen in other international studies and was significantly associated with educational level, cognition, comorbidities, functional capacity, perception of health and old age.

Evaluation of frailty, functional capacity and quality of life of the elderly in geriatric outpatient clinic of a university hospital

“…Moreira and Lourenço 20 argued that only a history of three or more falls, which define the elderly individual as a faller, is directly linked to frailty, which may explain the lack of an association here, as in addition to the rate of falls being low, 80% of these elderly individuals had a history of only one fall. This study was limited by the exclusion of elderly people with cognitive impairment, which is considered a factor for the development of the syndrome of frailty.…”

“…9 The elderly persons interviewed in the present study had at least one comorbidity, mainly visual disorders, SAH, insomnia and OA. SAH and OA are among the chronic diseases associated with pain and/or FR= frail elderly persons; PF= pre-frail elderly persons; NF= non-frail elderly persons loss of function most commonly involved with the occurrence of frailty, 19 with heart, kidney and liver failure, cancer, diabetes mellitus, chronic obstructive pulmonary disease, stroke and atherosclerosis, 20 less cited in the present study.…”

“…One study found a prevalence of 20,0% among elderly persons in Paraíba 21 , while another identified a prevalence of 31,0% in Rio Grande do Sul 9 and another described 9.1% of people having the condition in Rio de Janeiro. 20 This indicates that frailty can vary greatly among the Brazilian population, perhaps due to cultural diversity and living habits, including diet and physical activity, which are important protective factors against frailty. 22 However, these factors were not the object of this analysis.…”

Prevalência e fatores associados à fragilidade em idosos não institucionalizados

“…In Peru (20) , there was no association between frailty and old age and falls in the prior year. In Brazil, researchers from Rio de Janeiro also found an association of frailty with advanced age, the presence of morbidities, and lower educational level (21) . A study performed in Ribeirão Preto (SP) showed that there was a greater chance of falling among the frail elderly, using EFS to diagnose the condition (22) .…”

Frailty prevalence and related factors in the older adult—FrailTURK Project

“…In our study the sociodemographic factors associated with frailty were identified as age, female gender, low education status (literate), being a housewife, and living with the family. In the literature, especially age and female gender stand out as determining factors in frailty (Heuberger 2011;Jürschik et al 2012;Castell et al 2013;Hoover et al 2013;Kobayashi et al 2013;Moreira and Lourenço 2013;González-Vaca et al 2014;Runzer-Colmenares et al 2014). On the other hand, Oliveira et al (2013) did not report age and female gender as influential factors.…”