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Barra RP, de Moraes EN, Lemos MMDV, Bonati PCDR, Castro JFM, Jardim AA. Frailty and spatialization of older adults in the city of Uberlândia with IVCF-20. Rev Saude Publica 2024; 57Suppl 3:9s. [PMID: 38629673 PMCID: PMC11037899 DOI: 10.11606/s1518-8787.2023057005273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 10/27/2023] [Indexed: 04/19/2024] Open
Abstract
OBJECTIVE To describe the functional clinical profile of elderly people linked to primary health care, using the Functional Clinical Vulnerability Index (IVCF-20) and to spatialize those with the greatest functional decline by primary health care units in the municipality of Uberlândia, in the state of Minas Gerais (MG), in the year 2022. METHODS A cross-sectional study with secondary data from the Municipal Health Department of Uberlândia-MG. The variables were compared using Student's t-test, Mann Whitney test, Pearson's chi-square, and multinomial logistic regression to obtain the independent effect of each variable. The significance level adopted was 5% (p < 0.05). The georeferenced database in ArcGIS® was used. RESULTS 47,182 older adults were evaluated with a mean age of 70.3 years (60 to 113 years), 27,138 of whom were women (57.52%), with a clear predominance of low-risk or robust older adults (69.40%). However, 11.09% are high-risk older adults and 19.52% are at risk of frailty. Older men had independently lower odds of moderate and high risk compared to older women (OR = 0.53; p < 0.001). A high prevalence of polypharmacy was observed, 21.40% of the older adult population, particularly in frail older adults, with a prevalence of 63.08%. There was a greater distribution of frail older adults around the central region of the municipality and in health units with a larger coverage area. The IVCF-20 made it possible to screen frailty in primary health care. CONCLUSION The instrument is capable of stratifying the risk of older adults in health care networks through primary health care, enabling the application of individualized preventive, promotional, palliative, or rehabilitative interventions, according to the clinical functional stratum of the older adult and the compromised functional domains. Risk stratification and spatial distribution of the frailest older adults can be a good strategy for qualifying health professionals with the aim of maximizing the autonomy and independence of the older adults.
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Affiliation(s)
- Rubia Pereira Barra
- Centro Colaborador Planificação da Atenção à Saúde UberlândiaConselho Nacional de Secretários de SaúdeUberlândiaMGBrazilCentro Colaborador Planificação da Atenção à Saúde Uberlândia. Conselho Nacional de Secretários de Saúde. Uberlândia, MG, Brazil
| | - Edgar Nunes de Moraes
- Universidade Federal de Minas GeraisFaculdade de MedicinaDepartamento de Clínica MédicaBelo HorizonteMGBrazilUniversidade Federal de Minas Gerais. Faculdade de Medicina. Departamento de Clínica Médica. Belo Horizonte, MG, Brazil
| | | | - Poliana Castro de Resende Bonati
- Universidade de São PauloEscola de Enfermagem de Ribeirão PretoRibeirão PretoSPBrasilUniversidade de São Paulo. Escola de Enfermagem de Ribeirão Preto. Ribeirão Preto, SP, Brasil
| | - José Flávio Morais Castro
- Pontifica Universidade Católica de Minas GeraisPrograma de Pós-Graduação em GeografiaBelo HorizonteMGBrazilPontifica Universidade Católica de Minas Gerais. Programa de Pós-Graduação em Geografia. Belo Horizonte, MG, Brazil
| | - André Augusto Jardim
- Secretaria Municipal de SaúdeCoordenação de Saúde do IdosoUberlândiaMGBrasilSecretaria Municipal de Saúde. Coordenação de Saúde do Idoso. Uberlândia, MG, Brasil
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Hernandes ECR, Aliberti MJR, Guerra RO, Ferriolli E, Perracini MR. Intrinsic capacity and hospitalization among older adults: a nationally representative cross-sectional study. Eur Geriatr Med 2024:10.1007/s41999-024-00933-y. [PMID: 38491314 DOI: 10.1007/s41999-024-00933-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 01/04/2024] [Indexed: 03/18/2024]
Abstract
PURPOSE Monitoring intrinsic capacity (IC) in community-dwelling older people can be potentially used to alert for adverse health outcomes. However, whether there is an association between IC and hospitalization has yet to be fully explored. This study aimed to investigate the association of the IC composite measure and its 5 domains with hospitalization in the previous year and length of hospital stay. METHODS We conducted cross-sectional analyses using data from a representative sample of community-dwelling adults (≥ 65 years). We assessed the IC domains (vitality, locomotor, cognitive, sensory, and psychological) using validated self-reported information and performance tests. We calculated standardized estimated scores (z scores) for IC composite measure and domains and conducted multivariate logistic and ordinal regressions. The primary outcomes were hospitalizations in the previous year and length of hospital stay. RESULTS In a sample of 5354 participants (mean age = 73 ± 6 years), we found that participants with high IC composite z scores were less likely to have experienced hospitalization in the previous year (OR = 0.51; 95% CI = 0.44-0.58). Among those who were hospitalized, high IC scores were associated with short stays (OR = 0.87; 95% CI = 0.80-0.95). Cognitive and psychological domains were associated with hospitalizations, and the locomotor domain was related to length of hospital stay. The vitality domain was associated with both outcomes. CONCLUSION IC as a composite measure was associated with previous hospitalizations and length of stay. IC can help clinicians identify older people prone to adverse outcomes, prompting preventive integrated care interventions.
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Affiliation(s)
- Elisângela Cristina Ramos Hernandes
- Masters' and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, Rua Cesáreo Galeno, 448, Tatuapé, São Paulo, 03071-000, Brazil
| | - Márlon Juliano Romero Aliberti
- Laboratorio de Investigaçao Medica em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clinicas, Disciplina de Geriatria, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- Research Institute, Hospital Sirio-Libanes, São Paulo, Brazil
| | - Ricardo Oliveira Guerra
- Department of Physiotherapy, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Eduardo Ferriolli
- Laboratorio de Investigaçao Medica em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clinicas, Disciplina de Geriatria, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Monica Rodrigues Perracini
- Masters' and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, Rua Cesáreo Galeno, 448, Tatuapé, São Paulo, 03071-000, Brazil.
- Master's and Doctoral Programs in Gerontology, Faculty of Medical Sciences, Universidade Estadual de Campinas, Campinas, Brazil.
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Santos PHS, Dos Santos L, Fernandes MH, Brito TA, Munaro HLR, Carneiro JAO. Factors associated with frailty syndrome in older adults with three- and four-criteria clustering. Geriatr Nurs 2023; 51:121-128. [PMID: 36940506 DOI: 10.1016/j.gerinurse.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/02/2023] [Accepted: 03/03/2023] [Indexed: 03/23/2023]
Abstract
This study aimed to identify the main clusters of diagnostic criteria pertaining to frailty syndrome as well as the factors associated with the occurrence of frailty without diagnostic criteria clusters and with clusters of three and four criteria. This is a cross-sectional study, carried out with 216 older adults. In order to determine the dependent variable, a combination of the following criteria for frailty syndrome diagnostic criteria was used: unintentional weight loss, exhaustion, muscle weakness, a low level of physical activity, and a slow gait speed. There were different clusters of Frailty Syndrome diagnostic criteria and were associated with Frailty with clustering of three criteria, age group ≥80 years and negative self-perception of health and Frailty with clustering of four criteria, age group ≥80 years and polypharmacy use. Age, self-perception of health, and polypharmacy can be assessed to target different intervention plans in the frail older adult population.
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Affiliation(s)
- Patrícia Honório Silva Santos
- PhD in Health Sciences, Postgraduate Program in Nursing and Health, State University of Southwest Bahia, José Moreira Sobrinho Street, Jequiezinho., Jequié, Bahia CEP 45206-190, Brazil.
| | - Lucas Dos Santos
- Master in Health Sciences, Postgraduate Program in Nursing and Health, State University of Southwest Bahia, José Moreira Sobrinho Street, Jequiezinho., Jequié, Bahia CEP 45206-190, Brazil
| | - Marcos Henrique Fernandes
- PhD in Health Sciences, Postgraduate Program in Nursing and Health, State University of Southwest Bahia, José Moreira Sobrinho Street, Jequiezinho., Jequié, Bahia CEP 45206-190, Brazil
| | - Thaís Alves Brito
- Master in Health Sciences, State University of Southwest Bahia, José Moreira Sobrinho Street, SN, Jequiezinho., Jequié, Bahia CEP 45206-190, Brazil
| | - Hector Luiz Rodrigues Munaro
- PhD in Physical Education, Postgraduate Program in Physical Education, State University of Southwest Bahia, José Moreira Sobrinho Street, Jequiezinho., Jequié, Bahia CEP 45206-190, Brazil
| | - José Ailton Oliveira Carneiro
- PhD in Health Science, Postgraduate Program in Nursing and Health, State University of Southwest Bahia, José Moreira Sobrinho Street, Jequiezinho., Jequié, Bahia CEP 45206-190, Brazil
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Qin Y, Hao X, Lv M, Zhao X, Wu S, Li K. A global perspective on risk factors for frailty in community-dwelling older adults: A systematic review and meta-analysis. Arch Gerontol Geriatr 2023; 105:104844. [PMID: 36335672 DOI: 10.1016/j.archger.2022.104844] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 10/16/2022] [Accepted: 10/17/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Frailty has become an important determinant of a series of adverse health outcomes. We explored the risk factors for frailty in older adults in the community from a global perspective and explore whether there are ethnic differences in these risk factors. METHODS The systematic review and meta-analysis (PROSPERO registration number: CRD42022323342) was searched using six electronic databases, including PubMed, Embase, the Cochrane Library, Web of Science, PsycINFO (EBSCO) and CINAHL (EBSCO) from inception to October 2021. We assessed study eligibility by inclusion and excluded criteria. Cohort studies included were assessed according to the Newcastle-Ottawa Scale. Cross-sectional studies were assessed by the bias risk evaluation standard recommended by the Agency for Health care Research and Quality. The results were reported by a narrative synthesis and pooled analyses. Statistical analyses were performed in Review Manager 5.3 software. RESULTS We reviewed 10870 studies, and 62 studies were included. The results showed a significant association between multidomain risk factors and the frailty of global older adults, including demographic factors, health-related factors, and physical factors. Marital status, depression, risk of malnutrition, history of falls and disease-related symptoms are also risk factors for frailty among older people in Asia. CONCLUSION Multiple domain factors were associated with frailty among older people around the world. Compared with the rest of the world, Asian populations are exposed to more risk factors for frailty. Therefore, health care providers should consider the characteristics of risk factors for frailty in this region when formulating intervention measures related to frailty.
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Affiliation(s)
- Yuan Qin
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, Jilin 130021, China
| | - Xiaonan Hao
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, Jilin 130021, China
| | - Miaohua Lv
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, Jilin 130021, China
| | - Xuetong Zhao
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, Jilin 130021, China
| | - Shuang Wu
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, Jilin 130021, China
| | - Kun Li
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, Jilin 130021, China.
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Faria ADCA, Martins MMFPDS, Aguilera JAL, Ribeiro OMPL, Silva JMAVD. Construction and validation of a rehabilitation nursing program for fragile elderly. Rev Bras Enferm 2022; 75Suppl 4:e20210562. [DOI: 10.1590/0034-7167-2021-0562] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 12/15/2021] [Indexed: 12/14/2022] Open
Abstract
ABSTRACT Objective: To build a rehabilitation nursing program to be implemented in the homes of frail elderly people and validate it by rehabilitation nurses. Methods: This is a qualitative, exploratory study, divided into two stages. The first corresponded to an integrative literature review that supported the construction of the program. The second consisted of the program content validity stage, through a focus group, in May 2021. Results: Nine experts participated in the construction and content validation of the rehabilitation nursing program for frail elderly. Two focus groups were carried out, and the final version of the program included training in life activities and particularly self-care, strength, balance, coordination and joint mobility. Final considerations: The program reached content validity, with a minimum set of characteristics that it must integrate, now requiring application in Primary Health Care for clinical validation.
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Sousa CRD, Coutinho JFV, Freire Neto JB, Barbosa RGB, Marques MB, Diniz JL. Factors associated with vulnerability and fragility in the elderly: a cross-sectional study. Rev Bras Enferm 2021; 75:e20200399. [PMID: 34614094 DOI: 10.1590/0034-7167-2020-0399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 05/27/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES to assess factors associated with vulnerability and fragility in the elderly. METHODS crosssectional study with 384 elderly people in Fortaleza, Ceará. The Vulnerable Elders Survey and Clinical-Functional Vulnerability Index - 20 were used. Chi-square and Fisher's exact tests were used for associations. In the analysis of the combined influence of risk factors, the stepwise logistic regression and multinomial regression methods were adopted. RESULTS 251 (65.4%) non-vulnerable and 133 (34.6%) vulnerable elders. From the vulnerable elders analyzed, 42 (30.9%) are at high risk for frailty. Factors associated with vulnerability: age, gender, presence of comorbidities, hypertension, diabetes, osteoporosis and use of polypharmacy. There is a 30% increase in the chance of vulnerability for each additional drug. Physical activity reduces the chance of vulnerability by 60%. Factors associated with frailty: educational level; self-perception of health; comorbidities; polypharmacy. CONCLUSIONS it is important to pay attention to the presence of arterial hypertension, osteoporosis, polypharmacy, and encourage the practice of physical activity.
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Mello BHD, Lenardt MH, Moraes DC, Setoguchi LS, Seima MD, Betiolli SE. Cognitive impairment and physical frailty in older adults in secondary health care. Rev Esc Enferm USP 2021; 55:e03687. [PMID: 33886914 DOI: 10.1590/s1980-220x2019029803687] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 09/17/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze the association between cognitive impairment and physical frailty in older adults in secondary health care. METHOD This is a cross-sectional study carried out with people aged ≥ 60 years, assisted at a geriatric and gerontology outpatient clinic. For cognitive screening, the Mini Mental State Examination, the semantic verbal fluency test, and frailty assessment using the physical frailty phenotype were used. The likelihood ratio test was applied to the predictive model. RESULTS 407 older adults participated in the study. Cognitive impairment was observed in 58.5% (n=238) of the sample, being higher in frail (n=66; 75%). A change in the semantic verbal fluency test was identified in 22% (n=90), with a higher prevalence in pre-frail patients (55.5%; n=226). It was identified 2.5 times more chance of a frail older person, when compared to a non-frail one, to have cognitive impairment (95% CI, +0.947 - 0.322). The chance for alteration in the semantic verbal fluency test was 5.4 times higher in frail compared to non-frail ones (95% CI, 1.68 - 0.38). CONCLUSION A relationship was observed between cognitive impairment and physical frailty. Screening for frailty in geriatric nursing practice and the implementation of specific care is recommended.
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Affiliation(s)
- Bruno Henrique de Mello
- Universidade Federal do Paraná, Programa de Pós-Graduação em Enfermagem, Curitiba, PR, Brazil
| | - Maria Helena Lenardt
- Universidade Federal do Paraná, Programa de Pós-Graduação em Enfermagem, Curitiba, PR, Brazil
| | - Dayana Cristina Moraes
- Universidade Federal do Paraná, Programa de Pós-Graduação em Enfermagem, Curitiba, PR, Brazil
| | | | - Marcia Daniele Seima
- Universidade Federal do Paraná, Programa de Pós-Graduação em Enfermagem, Curitiba, PR, Brazil
| | - Susanne Elero Betiolli
- Universidade Federal do Paraná, Programa de Pós-Graduação em Enfermagem, Curitiba, PR, Brazil
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Poor self-perceived health is associated with frailty and prefrailty in urban living older adults: A cross-sectional analysis. Geriatr Nurs 2020; 41:754-760. [DOI: 10.1016/j.gerinurse.2020.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 05/04/2020] [Accepted: 05/06/2020] [Indexed: 11/23/2022]
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de Assis EPS, de Macêdo BG, da Silva TAM, de Paula Dias Rezende P, Vieira ÉLM, Junior ALT, de Figueiredo Antunes CM. Association between Frailty Syndrome and Anemia in Community-Dwelling Elderly. ACTA ACUST UNITED AC 2019. [DOI: 10.4236/aar.2019.85006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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