Frailty syndrome among the elderly and its associated factors: a structural equation modeling analysis

Authors

  • Isabela Celano Corrochel Universidade Federal do Triângulo Mineiro - UFTM
  • Nayara Gomes Nunes Oliveira Universidade Federal do Triângulo Mineiro - UFTM
  • Gianna Fiori Marchiori Universidade Federal do Triângulo Mineiro - UFTM
  • Sara Franco Diniz Heitor Universidade Federal do Triângulo Mineiro - UFTM
  • Flavia Aparecida Dias Marmo Universidade Federal do Triângulo Mineiro - UFTM
  • Darlene Mara dos Santos Tavares Universidade Federal do Triângulo Mineiro - UFTM

DOI:

https://doi.org/10.11606/issn.2317-0190.v28i4a190872

Keywords:

Frail Elderly, Nutritional Status, Models, Statistical

Abstract

Objective: Analyze the frailty syndrome and its associated factors among the community-dwelling elderly. Method: A cross-sectional study with 1.601 elderlies living in the urban area of the Health Macro-region of the Southern Triangle of Minas Gerais – Brazil divided into two groups: pre-frail/frail (n= 1.200) and non-frail (n= 401). Validated questionnaires were used for data collection. Descriptive and trajectory analyzes were conducted (p<0.05). Results: Older age (p<0.001), a low education level (p<0.001), the highest number of morbidities (p<0.001), high risk for metabolic complications (p= 0.006), and inadequate calf and brachial circumferences were directly associated with pre-frailty/frailty (p<0.001 and p= 0.028, respectively). Indirect associations with pre-frailty were found between males mediated by inadequate calf circumference measurement (β= -0.01), females mediated by the highest number of morbidities and the high risk for metabolic complications (β= 0.04 and β= 0.03, respectively, and the body mass index mediated by the highest number of morbidities (β= 0.03). Conclusion: Older age, low education level, multimorbidity, and inadequate measurements of waist, calf, and brachial circumferences are features that must be considered when designing health care strategies for the elderly aiming to delay the onset of frailty syndrome or minimize its consequences.

Downloads

Download data is not yet available.

References

Projeção da população das unidades federação por sexo e grupos de idade: 2000-2030 [base de dados na Internet]. Brasília: DATASUS; 2020. [citado 2021 set 22]. Disponível em: https://tabnet.datasus.gov.br/cgi/deftohtm.exe?ibge/cnv/projpopuf.def

Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146-56. Doi: http://dx.doi.org/10.1093/gerona/56.3.m146

Tavares D, Corrêa TA, Dias F, Ferreira PC, Pegorari M. Frailty syndrome and socioeconomic and health characteristics among older adults. Colombia Médica. 2017;48(3):126-31. Doi: https://doi.org/10.25100/cm.v48i3.1978

Duarte YAO, Nunes DP, Andrade FB, Corona LP, Brito TRP, Santos JLF, et al. Fragilidade em idosos no município de São Paulo: prevalência e fatores associados. Rev Bras Epidemiol. 2018;21:e180021. Doi: https://doi.org/10.1590/1980-549720180021.supl.2

Lopes AMK, Nunes NGO, Pegorari MS, Tavares DMS, Rodrigues MCS, Bolina AF. Evidence of association between the use of drugs and community-dwelling older people frailty: a cross-sectional study. Sao Paulo Med J. 2020;138(6):465-74. Doi: https://doi.org/10.1590/1516-3180.2020.0205.r1.06082020

Thompson MQ, Theou O, Yu S, Adams RJ, Tucker GR, Visvanathan R. Frailty prevalence and factors associated with the Frailty Phenotype and Frailty Index: Findings from the North West Adelaide Health Study. Australas J Ageing. 2018;37(2):120-126. Doi: https://dx.doi.org/10.1111/ajag.12487

Pérez-Ros P, Vila-Candel R, López-Hernández L, Martínez-Arnau FM. Nutritional status and risk factors for frailty in community-dwelling older people: a cross-sectional study. Nutrients. 2020;12(4):1041. Doi: https://dx.doi.org/10.3390/nu12041041

Hanlon P, Nicholl BI, Jani BD, Lee D, McQueenie R, Mair FS. Frailty and pre-frailty in middle-aged and older adults and its association with multimorbidity and mortality: a prospective analysis of 493 737 UK Biobank participants. Lancet Public Health. 2018;3(7):e323-e332. Doi: https://dx.doi.org/10.1016/S2468-2667(18)30091-4

Monteil D, Walrand S, Vannier-Nitenberg C, Van Oost B, Bonnefoy M. The Relationship between frailty, obesity and social deprivation in non-institutionalized elderly people. J Nutr Health Aging. 2020;24(8):821-6. Doi: https://dx.doi.org/10.1007/s12603-020-1465-6

Farías-Antúnez S, Fassa AG. Prevalência e fatores associados à fragilidade em população idosa do Sul do Brasil, 2014. Epidemiol Serv Saúde. 2019;28(1):e2017405. Doi: https://doi.org/10.5123/S1679-49742019000100008

Carneiro JA, Cardoso RR, Durães MS, Guedes MCA, Santos FL, Costa FMD, et al. Frailty in the elderly: prevalence and associated factors. Rev Bras Enferm. 2017;70(4):747-52. Doi: https://dx.doi.org/10.1590/0034-7167-2016-0633

Cruz DTD, Vieira MT, Bastos RR, Leite ICG. Fatores associados à fragilidade em uma população de idosos da comunidade. Rev Saúde Pública. 2017;51:106. Doi: https://doi.org/10.11606/S1518-8787.2017051007098

Vetrano DL, Palmer K, Marengoni A, Marzetti E, Lattanzio F, Roller-Wirnsberger R, et al. Frailty and multimorbidity: a systematic review and meta-analysis. J Gerontol A Biol Sci Med Sci. 2019;74(5):659-66. Doi: https://dx.doi.org/10.1093/gerona/gly110

Onder G, Vetrano DL, Marengoni A, Bell JS, Johnell K, Palmer K; Optimising Pharmacotherapy through Pharmacoepidemiology Network (OPPEN). Accounting for frailty when treating chronic diseases. Eur J Intern Med. 2018;56:49-52. Doi: https://dx.doi.org/10.1016/j.ejim.2018.02.021

Closs VE, Rosemberg LS, Ettrich BG, Gomes I, Schwanke CHA. Medidas antropométricas em idosos assistidos na atenção básica e sua associação com gênero, idade e síndrome da fragilidade: dados do EMI-SUS. Sci Med. 2015;25(3):ID21176. Doi: https://doi.org/10.15448/1980-6108.2015.3.21176

Liao Q, Zheng Z, Xiu S, Chan P. Waist circumference is a better predictor of risk for frailty than BMI in the community-dwelling elderly in Beijing. Aging Clin Exp Res. 2018;30(11):1319-25. Doi: https://dx.doi.org/10.1007/s40520-018-0933-x

Mello AC, Carvalho MS, Alves LC, Gomes VP, Engstrom EM. Consumo alimentar e antropometria relacionados à síndrome de fragilidade em idosos residentes em comunidade de baixa renda de um grande centro urbano. Cad Saude Publica. 2017;33(8):e00188815. Doi: https://dx.doi.org/10.1590/0102-311X00188815

Marôco J. Análise de equações estruturais: fundamentos teóricos, software & aplicações. 2 ed. Perô Pinheiro: Report Number; 2014.

Bertolucci PH, Brucki SM, Campacci SR, Juliano Y. O Mini-Exame do Estado Mental em uma população geral. Impacto da escolaridade. Arq Neuropsiquiatr. 1994;52(1):1-7. Doi: https://doi.org/10.1590/S0004-282X1994000100001

World Health Organization. Physical status: the use and interpretation of antropometry. Geneva: WHO; 1995. [Technical Report Series, 854]. Available from: http://whqlibdoc.who.int/trs/WHO_TRS_854.pdf?ua=1

World Health Organization. Obesity: preventing and managing the global epidemic: report of a WHO consultation. Geneva: WHO; 2000. Available from: https://apps.who.int/iris/handle/10665/42330

Pagotto V, Santos KFD, Malaquias SG, Bachion MM, Silveira EA. Circunferência da panturrilha: validação clínica para avaliação de massa muscular em idosos. Rev Bras Enferm. 2018;71(2):322-28. Doi: https://dx.doi.org/10.1590/0034-7167-2017-0121

Burr ML, Phillips KM. Anthropometric norms in the elderly. Br J Nutr. 1984;51(2):165-9. Doi: https://dx.doi.org/10.1079/bjn19840020

Frisancho AR. Anthropometric standards for the assessment of growth and nutritional status. Ann Arbor: University of Michigam Press; 1990.

Batistoni SS, Neri AL, Cupertino AP. Validade da escala de depressão do Center for Epidemiological Studies entre idosos brasileiros. Rev Saude Publica. 2007;41(4):598-605. Doi: https://dx.doi.org/10.1590/s0034-89102007000400014

Benedetti TB, Mazo GZ, Barros MVG. Aplicação do questionário internacional de atividades físicas para avaliação do nível de atividades físicas de mulheres idosas: validade concorrente e reprodutibilidade teste-reteste. Rev Bras Cien Mov. 2004;12(1):25-34.

World Health Organization. Global recommendations on physical activity for health. Geneva: WHO; 2010. Available from: https://www.who.int/publications/i/item/9789241599979

Stout MB, Justice JN, Nicklas BJ, Kirkland JL. Physiological aging: links among adipose tissue dysfunction, diabetes, and frailty. Physiology (Bethesda). 2017;32(1):9-19. Doi: https://dx.doi.org/10.1152/physiol.00012.2016

Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet. 2013;381(9868):752-62. Doi: https://dx.doi.org/10.1016/S0140-6736(12)62167-9

Godoy MR, Silva C. Função de produção de saúde para idosos: o caso europeu. J Bras Econ Saúde. 2017;9(1):62-72. Doi: https://dx.doi.org/10.21115/JBES.v9.n1.p62-72

Altin SV, Stock S. Impact of health literacy, accessibility and coordination of care on patient's satisfaction with primary care in Germany. BMC Fam Pract. 2015;16:148. Doi: https://dx.doi.org/10.1186/s12875-015-0372-0

Oscalices MIL, Okuno MFP, Lopes MCBT, Batista REA, Campanharo CRV. Health literacy and adherence to treatment of patients with heart failure. Rev Esc Enferm USP. 2019;53:e03447. Doi: http://dx.doi.org/10.1590/S1980-220X2017039803447

Kim M, Jeong MJ, Yoo J, Song DY, Won CW. Calf Circumference as a Screening Tool for Cognitive Frailty in Community-Dwelling Older Adults: The Korean Frailty and Aging Cohort Study (KFACS). J Clin Med. 2018;7(10):332. Doi: https://dx.doi.org/10.3390/jcm7100332

Santos LP, Gonzalez MC, Orlandi SP, Bielemann RM, Barbosa-Silva TG, Heymsfield SB. New prediction equations to estimate appendicular skeletal muscle mass using calf circumference: results from NHANES 1999-2006. JPEN J Parenter Enteral Nutr. 2019;43(8):998-1007. Doi: https://dx.doi.org/10.1002/jpen.1605

Sousa-Santos AR, Afonso C, Moreira P, Padrão P, Santos A, Borges N, et al. Weakness: the most frequent criterion among pre-frail and frail older Portuguese. Arch Gerontol Geriatr. 2018;74:162-168. Doi: https://dx.doi.org/10.1016/j.archger.2017.10.018

Serra-Prat M, Papiol M, Vico J, Palomera E, Sist X, Cabré M. Factors associated with frailty in community-dwelling elderly population. A cross-sectional study. Eur Geriatr Med. 2016;7(6):531-7. Doi: https://doi.org/10.1016/j.eurger.2016.09.005

Llano PMP, Lange C, Sequeira CADC, Jardim VMDR, Castro DSP, Santos F. Factors associated with frailty syndrome in the rural elderly. Rev Bras Enferm. 2019;72(suppl 2):14-21. Doi: https://dx.doi.org/10.1590/0034-7167-2017-0079

Trevisan C, Veronese N, Maggi S, Baggio G, Toffanello ED, Zambon S, et al. Factors influencing transitions between frailty states in elderly adults: The Progetto Veneto Anziani Longitudinal Study. J Am Geriatr Soc. 2017;65(1):179-84. Doi: https://dx.doi.org/10.1111/jgs.14515

Buch A, Keinan-Boker L, Kis O, Carmeli E, Izkhakov E, Ish-Shalom M, et al. Severe central obesity or diabetes can replace weight loss in the detection of frailty in obese younger elderly - a preliminary study. Clin Interv Aging. 2018;13:1907-1918. Doi: https://dx.doi.org/10.2147/CIA.S176446

Published

2021-12-31

Issue

Section

Original Article

How to Cite

1.
Corrochel IC, Oliveira NGN, Marchiori GF, Heitor SFD, Marmo FAD, Tavares DM dos S. Frailty syndrome among the elderly and its associated factors: a structural equation modeling analysis. Acta Fisiátr. [Internet]. 2021 Dec. 31 [cited 2024 May 19];28(4):251-8. Available from: https://www.revistas.usp.br/actafisiatrica/article/view/190872