Relationship of Frailty Markers and Socioeconomic Status to Incidence of Depressive Symptoms in a Community Cohort

A predictive nomogram among hypertension old population from the community: A cross-sectional study

BACKGROUND

Frailty presents a significant challenge for aging adults, with a multitude of factors needing consideration. Despite this, there is a lack of research on predicting frailty in the old population with hypertension.

AIM

This study aims to create and validate a nomogram model for the old population with hypertension, to predict frailty and gain valuable insights into its prevalence and determinants.

METHOD

Data for this study were extracted from the "Psychology and Behavior Investigation of Chinese Residents (PBICR) in 2022 (PBICR-2022)", with information on frailty and related factors obtained through self-reported questionnaires. Frailty was assessed using the Fatigue, Resistance, Ambulation, Illnesses, and Loss of Weight (FRAIL) scale. The independent variables encompassed sociodemographic, physiological, psychological, and family health factors. A total of 1135 participants aged over 60 with hypertension were included in the study. Univariate and stepwise binary logistic regression analyses were conducted to identify the relationship between frailty and multiple risk factors and to establish the frailty risk prediction nomogram.

RESULTS

The prevalence of social frailty was found to be 30.91%. The final model included the degree of hypertension, history of falling in the past 3 months, Brief Illness Perception Questionnaire score, depression levels, and Family Health Scale score. The model exhibited good accuracy in the testing set, with an area under the ROC curve of 0.984 (95% CI: 0.978, 0.990).

CONCLUSION

These findings suggest that the prediction model effectively estimated the prevalence of frailty in the older population with hypertension from community and identified associated factors. The model demonstrated good performance and holds potential for further study on the management of frailty.

A dynamic online nomogram for predicting the heterogeneity trajectories of frailty among elderly gastric cancer survivors

BACKGROUND

Frailty is very common among older people with gastric cancer and seriously affects their prognosis. The development of frailty is continuous and dynamic, increasing the difficulty and burden of care.

OBJECTIVES

The aims of this study were to delineate the developmental trajectory of frailty in older people with gastric cancer 1 year after surgery, identify heterogeneous frailty trajectories, and further explore their predictors to construct a nomogram for prediction.

DESIGN

We conducted a prospective longitudinal observation study. Clinical evaluation and data collection were performed at discharge, and at 1, 3, 6, and 12 months.

SETTING AND PARTICIPANTS

This study was conducted in a tertiary hospital and 381 gastric cancer patients over 60 years who underwent radical gastrectomy completed the 1-year follow-up.

METHODS

A growth mixture model (GMM) was used to delineate the frailty trajectories, and identify heterogeneous trajectories. A regression model was performed to determine their predictors and further construct a nomogram based on the predictors. Bootstrap with 1000 resamples was used for internal validation of nomogram, a receiver operating characteristic (ROC) curve to evaluate discrimination, calibration curves to evaluate calibration and decision curve analysis (DCA) to evaluate the clinical value.

RESULTS

GMM identified three classes of frailty trajectories: "frailty improving", "frailty persisting" and "frailty deteriorating". The latter two were referred to as heterogeneous frailty trajectories. Regression analysis showed 8 independent predictors of heterogeneous frailty trajectories and a nomogram was constructed based on these predictors. The area under ROC curve (AUC) of the nomogram was 0.731 (95 % CI = 0.679-0.781), the calibration curves demonstrated that probabilities predicted by the nomogram agreed well with the actual observation with a mean absolute error of 0.025, and the DCA of nomogram indicated that the net benefits were higher than that of the other eight single factors.

CONCLUSIONS

Older gastric cancer patients have heterogeneous frailty trajectories of poor prognosis during one-year postoperative survival. Therefore, early assessment to predict the occurrence of heterogeneous frailty trajectories is essential to improve the outcomes of elderly gastric cancer patients. Scientific and effective frailty interventions should be further explored in the future to improve the prognosis of older gastric cancer patients.

CONTRIBUTION OF THE PAPER STATEMENTS

This study constructed a static and dynamic online nomogram with good discrimination and calibration, which can help to screen high-risk patients, implement preoperative risk stratification easily and promote the rational allocation of medical resources greatly.

REGISTRATION

ClinicalTrials.gov (Number: NCT05982899).

TWEETABLE ABSTRACT

Our findings identified three frailty trajectories and constructed a nomogram to implement preoperative risk stratification and improve patient outcomes.

Longitudinal analysis of the mediating role of self-perception of aging in the relationship between frailty and intrinsic capacity: A cross-lagged mediation model

OBJECTIVES

The causal relationship between intrinsic capacity and frailty in older adults, as well as the underlying temporal mechanisms, remained poorly understood. The study aimed to investigate the causal association between intrinsic capacity and frailty while exploring the potential mediating role of self-perception of aging.

MEASUREMENTS

A survey was conducted with a sample of 429 participants who completed measures of intrinsic capacity, self-perception of aging, and frailty at baseline and were followed for one year. The relationships between these variables were assessed using an autoregressive cross-lagged model.

RESULTS

The study found reciprocal associations between intrinsic capacity and frailty (p < 0.01). Furthermore, the results indicated that self-perception of aging partially mediated the effect of frailty at baseline (T1) on intrinsic capacity at one-year follow-up (T2) (β = -0.02, confidence interval: [-0.055, -0.004]). However, the reverse causation was not observed.

CONCLUSIONS AND IMPLICATIONS

This study demonstrates a bidirectional causal relationship between intrinsic capacity and frailty in older adults. Self-perception of aging plays a significant mediating role in this relationship. Older adults with a worse level of frailty should be made aware of the potentially vicious cycle related to self-perception of aging, which can negatively affect their intrinsic capacity. Maintaining a positive self-perception of aging may help preserve physical and psychological reserves, maintain intrinsic capacity, and slow the decline of frailty.

Characterization of social frailty domains and related adverse health outcomes in the Asia-Pacific: a systematic literature review

Background

Frailty is a significant healthcare challenge worldwide, increasing interest in developing more assessment tools covering for frailty. Recently, there has been a growing awareness of a correlation between social variables and frailty in older people. However, there is a lack of understanding of the social domains of frailty and the related adverse outcomes, particularly in the Asia-Pacific settings. This study aimed to characterize the social frailty domains and their health outcomes by overviewing the frailty screening tools in older people living in the Asia-Pacific region.

Methodology

A systematic review, using the PRISMA guideline, was conducted on articles published between 2002 and 2023 from three electronic databases: PubMed, Scopus, and ScienceDirect. A manual search was conducted for the references of the included articles using Google Scholar. Included articles must be in English and were based on empirical evidence published in peer-reviewed journals and focus on the assessment of domains of social frailty in older people aged 60 or over in the Asia-Pacific (East Asia, Southeast Asia, and Oceania).

Result

A total of 31 studies were included in the thematic analysis, from which 16 screening tools measuring six social domains were reviewed. The six domains were: social networks, followed by social activities, social support, financial difficulties, social roles, and socioeconomic, arranged in four categories: social resources, social needs, social behaviors (or social activities), and general resources. The six social domains predicted mortality, physical difficulties, and disability incidence. Other adverse health outcomes were also associated with these social domains, including cognitive disorders, mental illness, and nutritional disorders (n = 5 domains each), dementia (n = 4 domains), and oral frailty, hearing loss, obesity, and chronic pain (n = 3 domains each).

Conclusion

Overall, social frailty is a complex construct with multiple dimensions, including the frailty of social and general resources, social behaviors, and social needs, leading to several health disorders. The findings contribute to understanding the conceptual framework of social frailty in older people and its related health outcomes. Therefore, it could facilitate professionals and researchers to monitor and reduce the risks of adverse health outcomes related to each domain of social frailty, contributing to a better aging process.

Effect of overweight/obesity and metabolic syndrome on frailty in middle-aged and older Japanese adults

Background

The potential for developing frailty exists in middle-aged and older adults. While obesity and metabolic syndrome (MetS) increase the risk of frailty in older adults, this relationship remains unclear in middle-aged adults, who are prone to developing lifestyle-related diseases.

Objective

To examine the effect of overweight/obesity and MetS on frailty development in middle-aged and older Japanese adults using real-world data.

Methods

This nationwide cohort study used exhaustive health insurance claims data of 3,958,708 Japanese people from 2015 to 2019 provided by the Japan Health Insurance Association. Participants aged ≥35 and < 70 years who received health checkups in 2015 were included. Multivariate logistic regression was used to assess the effect of body mass index (BMI) and MetS or MetS components (i.e., diabetes, hypertension, and dyslipidemia) in 2015 on frailty risk assessed using the hospital frailty risk score in 2019. Additionally, a subgroup analysis was performed to examine the interaction effects of MetS components and 4-year weight change (%) on frailty risk among participants who were overweight and obese (BMI ≥25 kg/m2).

Results

In 2019, 7204 (0.2%) and 253,671 (6.4%) participants were at high and intermediate frailty risks, respectively. Obesity and MetS were independently associated with intermediate/high frailty risk (odds ratio (OR) 1.36, p < 0.05; OR 1.23, p < 0.05, respectively) and high frailty risk (OR 1.80, p < 0.05; OR 1.37, p < 0.05, respectively) in all participants. Although all MetS components were frailty risk factors, these effects diminished with age in both sexes. Subgroup analysis of patients with diabetes revealed that 5%-10% weight loss was associated with reduced frailty risk in both sexes.

Conclusions

Obesity, MetS, and MetS components were independent frailty risk factors in middle-aged and older Japanese adults. Weight loss of up to 10% over 4 years prevented frailty in patients with diabetes who were overweight and obese.

Depressive symptoms, alone or together with physical comorbidity, are predictive of healthcare use and spending in older adults

OBJECTIVE

Depressive symptoms and physical comorbidity are common health problems in older adults and are both posing increasingly considerable challenges to global healthcare systems. This study investigated the relationships of depressive symptoms, alone or together with physical comorbidity, with healthcare utilization and spending among older adults, as well as examined sex differences.

METHODS

We used data of the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018 and enrolled 6519 participants. Depressive symptoms was operationalized following the Center for Epidemiological Studies Depression Scale and physical comorbidity was assessed according to the presence of 11 physical non-communicable diseases. The relationships of depressive symptoms and comorbidity with healthcare outcomes were examined using mixed-effects regression models.

RESULTS

Compared with the neither depressive symptoms nor physical comorbidity category, older adults classified as depressive symptoms-only, physical comorbidity-only or both conditions were all associated with elevated risks for healthcare use and spending (all OR/IRR > 1; all p < 0.001). Depressive symptoms and physical comorbidity in combination consistently led to higher risks for studied endpoints than either condition alone (outpatient visit: OR = 3.50, outpatient visit number: IRR = 3.39, inpatient visit: OR = 3.35, hospitalization days: IRR = 2.82, catastrophic health expenditure: OR = 1.70; all p-trend < 0.001). Stratification analyses revealed similar relationships irrespective of sex.

CONCLUSION

Depressive symptoms and physical comorbidity are separately and jointly associated with increased healthcare utilization and spending among Chinese older adults. These two conditions in combination lead to highest risks than either condition alone. Early screen for depressive symptoms, alone or together with physical comorbidity, may offer implications for appropriate policy interventions.

The national burden of frailty and disproportionate distribution of its components-the predominance of slow gait speed: a 2018-19 face-to-face epidemiologic assessment representative of population of older Poles

BACKGROUND

The prevalence of frailty and its components may be affected by age, diseases and geriatric deficits. However, the current operational definition of frailty assigns equal weight to the five components of frailty.

AIMS

To perform a population-based assessment of physical frailty, its prevalence, and distribution of its components across different age, disease and deficit spectrum.

METHODS

From 2018 to 2019, we conducted a face-to-face cross-sectional assessment of a representative sample of older Poles. We obtained data on frailty components, chronic disease burden, and prevalence of particular diseases and geriatric deficits. We calculated weighted population estimates, representative of 8.5 million older Poles, of prevalence of frailty and its components across the disease burden, associated with the particular diseases and the geriatric deficits present.

RESULTS

Of 10,635 screened persons ≥ 60 years, 5987 entered the face-to-face assessment. Data of 5410 have been used for the present analysis. Seventy-two percent of the population are burdened with at least one frailty component. The estimated weighted population prevalence (95% CI) of frailty was 15.9% (14.6-17.1%), and of pre-frailty 55.8% (53.3-58.2%). Slow gait speed predominated across disease burden, specific diseases, geriatric deficits and the age spectrum. Overall, the prevalence of slow gait speed was 56.3% (52.7-60.0%), followed by weakness 26.9% (25.4-28.4%), exhaustion 19.2% (17.6-20.8%), low physical activity 16.5% (14.8-18.3%), and weight loss 9.4% (8.4-10.3%).

CONCLUSIONS

Slow gait speed predominates among the components of frailty in older Poles. This may affect the component-tailored preventive and therapeutic actions to tackle frailty.

The Relationship between Social Frailty and Depressive Symptoms in the Elderly: A Scoping Review

BACKGROUND

Various studies have highlighted the correlation between social frailty and depressive symptoms in the elderly. However, evidence of how these two domains influence each other is not clear. The purpose of this scoping review is to summarize the current literature examining social frailty and depressive symptoms.

METHOD

We conducted a scoping review allowing for the inclusion of multiple methodologies to examine the extent and range of this research topic.

RESULT

The search initially yielded 617 results, 14 of which met the inclusion criteria. Five studies were identified from China, six were identified from Japan, two were identified from Korea, one was identified from Ghana, and one was from Asia. The evidence reviewed indicated that five studies met category 5 criteria, and the others met level 3 criteria. The findings from these studies showed that there is a significant relationship between social frailty and depressive symptoms.

CONCLUSION

This scoping review shows that worse social frailty contributes to a significant degree of depression. Further research on screening social frailty and possible interventions in community and medical settings to prevent the elderly from developing depressive symptoms is needed.

Motor alterations in depression and anxiety disorders: A systematic review and meta-analysis

BACKGROUND

Psychomotor retardation has long been recognized as a major feature of depression, and anxiety disorders have been linked with freeze and flight motor responses. This systematic review and meta-analysis aimed a) to synthesize available evidence of motor alterations comparing individuals with depression and anxiety disorders to healthy individuals and b) to evaluate the effect of experimental manipulations of motor displays within these clinical groups.

METHOD

The databases PubMed and PsycINFO were searched for studies either assessing motor differences between clinical and healthy control groups or manipulating the motor system within a clinical group.

RESULTS

The literature search yielded 87 relevant papers, comprising 82 studies comparing a clinical group to a healthy group and 5 studies investigating motor manipulations within a clinical sample. The results of the meta-analysis (K = 71) indicated a statistically significant combined estimate of differences between healthy and clinical groups (g = 0.38 [0.31, 0.45], adjusted for publication bias g = 0.26 [0.19, 0.33]) of a small size. This effect did not vary according to type of disorder (anxiety vs. depression, p = .468). From a narrative review of experimental studies within clinical groups, four out of five studies reported statistically significant effects of manipulating the motor system on affective outcomes.

DISCUSSION

This synthesis adds to the accumulating empirical evidence of motor alterations in depression and anxiety disorders. Future research will need to investigate how individuals suffering from depression or anxiety disorders could benefit from psychological, behavioral, and physical interventions directly aimed at the motor system.

Smoking Cessation, Weight Gain, and Risk for Type 2 Diabetes: A Prospective Study

Objectives: To examine the association between smoking cessation and risk of type 2 diabetes with emphasis on post-cessation weight gain.

Methods: In total, 8,951 participants from the China Health and Retirement Longitudinal Study at the baseline (2011) were included. Diabetes incidence was accessed at the third survey (2015). Current smokers were treated as the reference and odds ratios (OR) of type 2 diabetes for never smokers, recent, and long-term quitters were computed using multivariable logistic regression. Stratified analysis was further conducted by weight gain after smoking cessation.

Results: There were 712 cases of type 2 diabetes identified. Compared with current smokers, the fully multivariable-adjusted ORs were 1.55 (1.02, 2.36) for recent quitters, 0.88 (0.61, 1.28) for long-term quitters, and 0.75 (0.59, 0.95) for never smokers. Stratified analysis showed recent quitters with weight gain of ≥2.0 kg had a significantly higher odds of type 2 diabetes [2.25 (1.02, 4.95)].

Conclusion: The present study of the Chinese population suggested recent quitters with weight gain of ≥2.0 kg, compared with current smokers, had a significantly increased odds of type 2 diabetes.

Relationship between subjective socioeconomic status and sense of gain of health-care reform and the mediating role of self-rated health: a cross-sectional study in China

BACKGROUND

The sense of gain has gradually become the main evaluation index for the effectiveness of China's deepening reform and is affected by many factors. However, there is no relevant research on the sense of gain of health-care reform (SGHR) and its influencing factors. The purpose of this study was to explore the influence of subjective socioeconomic status (SSS) on SGHR and the mediating role of self-rated health (SRH) between them.

METHODS

Data (25,149 samples total) from China Family Panel Studies (CFPS) in 2018 were included in the analysis. A nonparametric test was used to explore the differences in demographic characteristics of SGHR, and a correlation analysis and mediating effect model were used to explore the influence of SSS on SGHR and the mediating effect of SRH.

RESULTS

Demographic characteristics such as age, urban and rural areas, educational background, marriage and choice of medical treatment had significant differences in the distribution of perceived acquisition of medical reform. SSS, SRH and SGHR are statistically positively correlated with each other. SSS has a positive statistical correlation with SGHR, and may have an indirect effect through SRH.

CONCLUSIONS

SSS is an important predictor of SGHR, and SRH may play a partially mediating role in SGHR.

Gender differences in cognitive reserve: implication for subjective cognitive decline in women

BACKGROUND

Subjective Cognitive Decline (SCD) is a self-experienced decline in cognitive capacity with normal performance on standardized cognitive tests, showing to increase risk of Alzheimer's Disease (AD). Cognitive reserve seems to influence the progression from SCD to Mild Cognitive Impairment (MCI) and to AD. The aim of our study was to investigate gender differences in cognitive reserve evaluating how sex might modulate the role of cognitive reserve on SCD.

METHODS

We included 381 SCD patients who underwent clinical evaluation, neuropsychological assessment, evaluation of premorbid intelligence by the Test di Intelligenza Breve (TIB), cognitive complaints by the Memory Assessment Clinics Questionnaire (MAC-Q), and apolipoprotein E (APOE) genotyping.

RESULTS

The proportion between women and men was significantly different (68.7% [95% CI 63.9-73.4 vs 31.4%, 95% CI 26.6-36.0]). Women were younger than men at onset of SCD and at the baseline visit (p = 0.021), had lower years of education (p = 0.007), lower TIB scores (p < 0.001), and higher MAC-Q scores (p = 0.012). TIB was directly associated with age at onset of SCD in both women and men, while years of education was inversely associated with age at onset only in women. Multivariate analysis showed that sex influences TIB independently from years of education. TIB was directly associated with MAC-Q in men.

CONCLUSIONS

Sex interacts with premorbid intelligence and education level in influencing the age at onset and the severity of SCD. As the effect of education was different between men and women, we speculated that education might act as a minor contributor of cognitive reserve in women.

Combined association of central obesity and depressive symptoms with risk of heart disease: A prospective cohort study

OBJECTIVE

To examine the combined association of central obesity and depressive symptoms with risk of heart disease in a national prospective cohort study of the Chinese population.

METHODS

Data came from 10,722 community-dwelling adults aged over 45 years, from the China Health and Retirement Longitudinal Study during 2011-2018. Central obesity was assessed with waist circumference (WC) in physical examinations (men with a WC of ≥ 90 cm and women with a WC of ≥ 80 cm). Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale (score ≥ 10). Participants were assigned to four groups according to central obesity (yes/no) and depressive symptoms (yes/no). Cox proportional hazard regression was used after adjusting for covariates.

RESULTS

During 7 years of follow-up, we identified 1080 heart disease cases. Compared with people without central obesity and depressive symptoms, the multivariable-adjusted hazard ratios (95% confidence intervals) were 1.39 (1.18, 1.64) for those who had central obesity alone, 1.44 (1.18, 1.77) for those who had depressive symptoms alone, and 1.88 (1.55, 2.30) for those who had both central obesity and depressive symptoms. The combined association in men was more evident than that in women.

CONCLUSIONS

Our study provided evidence that the coexistence of central obesity and depressive symptoms were associated with a substantially increased risk of heart disease compared to those without these two conditions.

Benign prostatic hyperplasia and cardiovascular risk: a prospective study among Chinese men

PURPOSE

To examine the prospective association of BPH with subsequent risk of CVD, including heart disease and stroke.

METHODS

We used data from China Health and Retirement Longitudinal Study of 5242 Chinese men aged 45 years or older. During a follow-up of 7 years, we identified 613 cases of non-fatal CVD, including 417 heart diseases and 254 strokes. Cox proportional hazards models yielded hazard ratios (HRs) relating BPH to CVD, heart disease, and stroke incidence.

RESULTS

Overall, 8.1% of men reported a history of BPH diagnosed by physicians at baseline. As compared with men without a history of BPH, those reporting a history of BPH had an increased risk of developing CVD (multivariable-adjusted HR = 1.43 [1.12, 1.83], heart disease (1.35 [1.00, 1.83]), and stroke (1.50 [1.03, 2.19]). The subgroup analysis by age at baseline (< 60 vs. ≥ 60 years) showed that the associations appeared to be evident among men < 60 years, particularly for CVD (1.82 [1.24, 2.69]) and heart disease (1.72 [1.06, 2.79]). However, interaction tests suggested the associations were not significantly modified by age (P for interaction > 0.10 for all outcomes).

CONCLUSION

In Chinese men, BPH was associated with higher risks of CVD, heart disease and stroke, particularly among men aged < 60 years.

Associations Between Intellectual and Social Activities With Frailty Among Community-Dwelling Older Adults in China: A Prospective Cohort Study

Background: Frailty is one of the most important global health challenges. We aimed to examine the associations between frequency of intellectual and social activities and frailty among community-dwelling older adults in China.

Methods: This is a prospective analysis of older adults (aged ≥60 years) who had intellectual and social activity data and were free of frailty from the national representative China Health and Retirement Longitudinal Study (CHARLS). The exposure was frequency of intellectual and social activities. Frailty was measured by the frailty index (FI) and defined as FI ≥ 0.25. Frailty incidents were followed up for 2 years. We estimated the relative risks (RRs) with 95% confidence intervals (CIs) using log-linear binominal regression adjusting for potential confounders.

Results: We documented 655 frailty cases over the past 2 years. Participants who had frequent intellectual activities had a lower frailty risk compared with participants who did not have intellectual activity (adjusted RR = 0.65, 95%CI = 0.47–0.90). The adjusted RRs were 0.51 (95%CI = 0.33–0.77) for participants who did not have a slip or a fall accident and 1.06 (95%CI = 0.65–1.75) for participants who had experienced slip and fall accidents (P = 0.01 for interaction). Having frequent social activities was not associated with a significant decrease in frailty risk compared with participants who did not have social activity (adjusted RR = 0.93, 95%CI = 0.78–1.12).

Conclusions: This observational study showed that having frequent intellectual activities was associated with a decreased frailty risk. The association was likely to be stronger in participants without a slip or a fall accident. Randomized controlled trials are needed to confirm this observational finding.

Bidirectional Associations between Handgrip Strength and Depressive Symptoms: A Longitudinal Cohort Study

OBJECTIVES

This study aimed to examine the bidirectional associations between handgrip strength and depressive symptoms in a nationally representative sample.

DESIGN

Cohort study with a 4-year follow-up.

SETTING AND PARTICIPANTS

A total of 13,208 participants from the China Health and Retirement Longitudinal Study were included in the analyses.

METHODS

Depressive symptoms were assessed using the 10-item Center for Epidemiological Studies-Depression Scale. Separate generalized estimating equations were used to analyze the cross-sectional and longitudinal associations between handgrip strength and depressive symptoms. Restricted cubic spline models were performed to explore the shape of the dose-response relationship.

RESULTS

Decreased handgrip strength was related to subsequent increased risk of depressive symptoms, such that participants in the lowest quartile of handgrip strength were found to have an approximately 36% increased in their risk of depressive symptoms compared with those in the highest quartile [odds ratio (OR) 1.36, 95% confidence interval (CI) 1.17, 1.58]. There was a linear dose-response relationship between handgrip strength and risk of depressive symptoms (P_nonlinearity = .25), in that a 5-unit increment in handgrip strength may lead to an 11% decrease in the risk of depressive symptoms (OR 0.89, 95% CI 0.85, 0.92). Conversely, depressive symptoms were prospectively associated with subsequent decreased handgrip strength (β = -0.84, 95% CI -1.13, -0.55). An approximatively L-shaped dose-response pattern was found for the association between depressive symptoms level and handgrip strength (P_nonlinearity = .02).

CONCLUSIONS AND IMPLICATIONS

The present study identified bidirectional associations between handgrip strength and depressive symptoms, and the associations were found to have a dose-response pattern. It provides important insights into integrated mental and physical health intervention strategies that simultaneously promote handgrip strength and depressive symptoms.

Marcadores de fragilidade física preditivos de sintomas depressivos em pessoas idosas da atenção primária à saúde

Resumo Objetivo identificar quais os marcadores de fragilidade física predizem os sintomas depressivos (SD) em pessoas idosas assistidas na Atenção Primária à Saúde. Método estudo quantitativo de corte transversal e correlacional desenvolvido em uma Unidade Básica de Saúde em Curitiba, (PR), Brasil, com amostra de 389 pessoas idosas. Coletaram-se os dados de janeiro a outubro de 2019, por meio de questionário sociodemográfico e clínico, escala de depressão (Center for Epidemiological Studies) e testes que compõem o fenótipo da fragilidade física. Para as análises, utilizou-se estatística descritiva, inferencial (qui-quadrado de Pearson), nível de significância de p≤0,05), e regressão logística reportado a estimativa, valor p (teste de Wald). Razão de Prevalência com intervalo de confiança 95%. Resultados das 389 pessoas idosas, 103 (26,5%) apresentaram SD; entre eles 63 (61,2%) eram pré-frágeis, 19 (18,4%) frágeis e 21 (20,4%) não frágeis. Associaram-se aos SD os marcadores fadiga/exaustão (p≤0,001), redução do nível de atividade física (p≤0,001), perda de peso não intencional (p=0,003) e a condição de pré-fragilidade e fragilidade (p≤0,001). O modelo preditivo para os SD incluiu os marcadores fadiga/exaustão (RP: 5,12; IC95%; 3,81-6,87; p<0,0001) e redução do nível de atividade física (RP: 2,16, IC95%; 1,45- 3,22; p<0,0001). Conclusão os marcadores do fenótipo fadiga/exaustão e redução da atividade física são preditores dos SD em pessoas idosas. Esse resultado ressalta a importância e a necessidade da avaliação desses marcadores e da efetividade de ações para o combate ao sedentarismo em pessoas idosas da atenção primária à saúde.