Frailty prevalence and associated factors in the elderly in Southern Brazil, 2014

Farías-Antúnez, Simone; Fassa, Anaclaudia Gastal

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Epidemiologia e Serviços de Saúde

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ORIGINAL ARTICLE • Epidemiol. Serv. Saúde 28 (1) • 2019 • https://doi.org/10.5123/S1679-49742019000100008 copy

Frailty prevalence and associated factors in the elderly in Southern Brazil, 2014^* * Article derived from the Master’s Degree dissertation entitled ‘Frailty in the elderly in a South Brazilian city’, defended by Simone Farías-Antúnez at the Federal University of Pelotas Epidemiology Postgraduate Program on November 20th 2014. This study was financed with resources from the Federal University of Pelotas Epidemiology Master’s Degree Research Consortium 2013/14: Academic Excellence Program - Coordination for the Improvement of Higher Level Personnel (PROEX/CAPES) No. 23038.003968/2013-99; Financial Support for Educational or Research Project via the Academic Excellence Program (AUXPE/PROEX) No. 1107/2013.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

to analyze frailty prevalence and associated factors in the elderly in the city of Pelotas, RS, Brazil, in 2014.

Methods:

this was a cross-sectional, population-based study of a sample of individuals aged 60 years old or older; a modified version of the Edmonton Frail Scale was used to assess frailty; prevalence ratios (PR) and their 95% confidence intervals (95%CI) were estimated using Poisson regression.

Results:

frailty prevalence was 13.8% and was higher among individuals aged 75 years or older (PR 4.33 - 95%CI 2.94;6.39), those of the female gender (PR 1.46 - 95%CI 1.06;2.03) and those living without a partner (PR 1.54 - 95%CI 1.16;2.04); epilepsy (PR 3.58 - 95%CI 2.19;5.85), ischemia (PR 2.56 - 95%CI 2.00;3.28), and heart failure (PR 2.48 - 95%CI 1.92;3.19) were the morbidities most highly associated with frailty.

Conclusion:

frailty was associated with older individuals, the female gender, those living without a partner and those affected by multiple morbidities.

Keywords:
Aged; Cross-Sectional Studies; Frailty; Frail Elderly; Epidemiology; Health of the Elderly

Characteristics	n	%
Sex (n=1,399)
Male	515	36.8
Female	884	63.2
Age range (in full years) (n=1,398)
60-64	387	27.7
65-69	350	25.0
70-74	265	19.0
≥75	396	28.3
Race/skin color (n=1,398)
White	1.170	83.7
Other	228	16.3
Marital status (1,398)
Has a partner	743	53.1
Does not have a partner	655	46.9
Family income (in BRL) (n=1,315)^a
Up to R$724.00	139	10.6
R$724.01 - R$2,172.00	563	42.9
R$2,172.01 - R$3,620.00	278	21.1
R$3,620.01 - R$7,240.00	195	14.8
R$7,241.01 or more	140	10.6
Economic status^b (ABEP^c) (n=1,333)
A/B	470	35.2
C	701	52.6
D/E	162	12.2
Schooling (in completed years of study) (n=1,390)
None	189	13.6
1-3	323	23.2
4-7	431	31.0
8-11	140	10.1
≥12	307	22.1
Morbidities^d (n=1,391)
None	146	10.5
1-3	892	64.1
≥4	353	25.4
Tobacco smoking (n=1,398)
No	756	54.1
Yes	176	12.6
Former smoker	466	33.3
CAGE^e (n=1,391)
Negative	1.377	99.0
Positive	14	1.0
Physical activity (IPAQ^f) (n=1,353)
Insufficiently active	1.104	81.6
Active	249	18.4
Frailty (n=1,399)
Not frail	973	69.5
Vulnerable	233	16.7
Mild frailty	120	8.6
Moderate frailty	56	4.0
Severe frailty	17	1.2

Independent variable	Frailty
	Not frail	Vulnerable	Mild	Moderate	Severe
	n (%)	n (%)	n (%)	n (%)	n (%)
Sex (n=1,399)
Male	403 (78.2)	66 (12.8)	26 (5.1)	13 (2.5)	7 (1.4)
Female	570 (64.5)	167 (18.9)	94(10.6)	43 (4.9)	10 (1.1)
Age range (in full years) (n=1,398)
60-64	314 (81.2)	52 (13.4)	14 (3.6)	7 (1.8)	0 (0.0)
65-69	264 (75.4)	51 (14.6)	26 (7.4)	7 (2.0)	2 (0.6)
70-74	198 (74.7)	37 (13.9)	20 (7.6)	8 (3.0)	2 (0.8)
≥75	196 (49.5)	93 (23.5)	60(15.1)	34 (8.6)	13(3.3)
Marital status (n=1,398)
Has a partner	571 (76.8)	107 (14.4)	40 (5.4)	17 (2.3)	8 (1.1)
Does not have a partner	401 (61.2)	126 (19.2)	80(12.2)	39 (6.0)	9 (1.4)
Schooling (in completed years of study) (n=1,390)
None	90 (47.7)	49 (25.9)	32(16.9)	14 (7.4)	4 (2.1)
1-3	206 (63.8)	61 (18.9)	33(10.2)	17 (5.2)	6 (1.9)
4-7	300 (69.6)	77 (17.8)	33 (7.7)	15 (3.5)	6 (1.4)
8-11	111 (79.3)	18 (12.9)	6 (4.3)	5 (3.5)	0 (0.0)
≥12	260 (84.7)	25 (8.2)	16 (5.2)	5 (1.6)	1 (0.3)
Morbidities^a (n=1,391)
None	131 (89.7)	9 (6.2)	5 (3.4)	1 (0.7)	0 (0.0)
1-3	690 (77.3)	123 (13.8)	56 (6.3)	16 (1.8)	7 (0.8)
≥4	148 (41.9)	101 (28.6)	58(16.4)	38(10.8)	8 (2.3)
Physical activity (IPAQ^b) (n=1,353)
Insufficiently active	743 (67.3)	204 (18.5)	98 (8.9)	45 (4.1)	14 (1.2)
Active	216 (86.8)	23 (9.2)	9 (3.6)	1 (0.4)	0 (0.0)
Total	973 (69.5)	233 (16.7)	120 (8.6)	56 (4.0)	17 (1.2)

Morbidities	%^a	Crude analysis		Adjusted analysis
Morbidities	%^a	PR^b (95%CI^c)	p-value^d	PR^e (95%CI^c)	p-value^d
Arterial hypertension			<0.001		<0.001
No	33.3	1.00		1.00
Yes	66.7	1.80 (1.30;2.48)		1.62 (1.20;2.19)
Diabetes mellitus			<0.001		<0.001
No	76.3	1.00		1.00
Yes	23.7	1.92 (1.51;2.44)		2.04 (1.59;2.67)
Heart problem			<0.001		<0.001
No	68.2	1.00		1.00
Yes	31.8	2.50 (1.95;3.21)		2.04 (1.55;2.67)
Heart failure	<0.001		<0.001
No	89.6	1.00		1.00
Yes	10.4	2.78 (2.14;3.62)		2.48 (1.92;3.19)
Ischemia/stroke			<0.001		<0.001
No	88.7	1.00		1.00
Yes	11.3	3.21 (2.49;4.14)		2.56 (2.00;3.28)
Parkinson’s disease			<0.001		0.007
No	98.6	1.00		1.00
Yes	1.4	2.98 (1.71;5.18)		2.06 (1.22;3.47)
Kidney failure			<0.001		0.005
No	96.0	1.00		1.00
Yes	4.0	2.31 (1.52;3.52)		1.96 (1.23;3.13)
Epilepsy			<0.001		<0.001
No	97.0	1.00		1.00
Yes	3.0	2.47 (1.56;3.90)		3.58 (2.19;5.85)
Osteoporosis			<0.001		<0.001
No	74.8	1.00		1.00
Yes	25.2	2.21 (1.71;2.84)		1.78 (1.38;2.29)
Cancer			0.001		<0.001
No	89.7	1.00		1.00
Yes	10.3	1.73 (1.25;2.40)		1.89 (1.38;2.60)

Independent variable	%^a	Crude analysis		Adjusted analysis
Independent variable	%^a	PR^b (95%CI^c)	p-value^d	PR^b (95%CI^c)	p-value^d
Level 1
Sex			<0.001		0.023
Male	8.9	1.00		1.00
Female	16.6	1.86 (1.36;2.55)		1.46 (1.06;2.03)
Age range (in full years)	<0.001^e		<0.001^e		0,023
60-64	5.4	1.00		1.00
65-69	10.0	1.84 (1.10;3.09)		1.76 (1.05;2.95)
70-74	11.3	2.09 (1.25;3.47)		2.02 (1.21;3.37)
≥75	27.0	4.98 (3.39;7.32)		4.33 (2.94;6.39)
Marital status			<0.001		0.003
Has a partner	8.8	1.00		1.00
Does not have a partner	19.5	2.23 (1.72;2.91)		1.54 (1.16;2.04)
Level 2
Schooling (in completed years of study)	<0.001^e		0.001^e		0,023
None	26.5	3.69 (2.30;5.94)		2.30 (1.43;3.73)
1-3	17.3	2.42 (1.50;3.91)		2.05 (1.31;3.23)
4-7	12.5	1.75 (1.08;2.83)		1.61 (1.04;2.51)
8-11	7.9	1.10 (0.55;2.18)		1.13 (0.59;2.19)
≥12	7.2	1.00		1.00
Level 3
Morbidities ^f			<0.001 ^e		<0.001^e
None	4.1	1.00		1.00
1-3	8.9	2.16 (0.96;4.83)		1.96 (0.89;4.32)
≥4	29.5	7.17 (3.24;15.8)		5.19 (2.32;11.57)
Level 4
Physical activity (IPAQ^g)	<0.001		0.005		0,023
Insufficiently active	14.2	3.54 (1.93;6.50)		2.37 (1.29;4.35)
Active	4.0	1.00		1.00

Secretaria de Vigilância em Saúde e Ambiente - Ministério da Saúde do Brasil SRTVN Quadra 701, Via W5 Norte, Lote D, Edifício P0700, CEP: 70719-040, +55 61 3315-3464, Fax: +55 61 3315-3464 - Brasília - DF - Brazil
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[1] Correspondence: Simone Farías-Antúnez - Rua Marechal Deodoro, No. 1160, 3º piso, Centro, Pelotas, RS, Brazil. Postcode: 96020-220. Caixa Postal 464 E-mail: simonefarias47@gmail.com