Body composition and frailty profiles in Brazilian older people: Frailty in Brazilian Older People Study-FIBRA-BR

Ferriolli, Eduardo; Pessanha, Fernanda Pinheiro Amador dos Santos; Moreira, Virgílio Garcia; Dias, Rosângela Corrêa; Néri, Anita Liberalesso; Lourenço, Roberto Alves

doi:10.1016/j.archger.2017.03.008

Cited by 46 publications

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References 36 publications

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“…The similar results were reported in other studies. 10,22 Liao et al 23 further found that abdominal obesity is more closely associated with incidence of frailty than general obesity in the elders. Consistently, in the present study, we found that high waist circumference and body fat mass in elder inpatients were risk factors for frailty.…”

Section: Discussionmentioning

confidence: 98%

“…9 The relationship between body composition and frailty is complex and unclear. Ferriolli et al 10 found that elder Brazilian subjects with elevated waist circumference presented a higher risk of frailty. Falsarella et al 11 found that frail elder people have the characteristics of lower muscle mass, lower bone mass and higher fat percentage.…”

Section: Introductionmentioning

confidence: 99%

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<p>Association Between Body Composition and Frailty in Elder Inpatients</p>

Xu¹,

Zhang²,

Shen³

et al. 2020

CIA

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Purpose: The study aimed to investigate the association between body composition and frailty in elder inpatients. Patients and Methods: This is a cross-sectional study including 656 elder inpatients (275 females and 381 males) aged ≥65 years, from department of geriatrics of Zhejiang Hospital between January 2018 and March 2019. Sociodemographic, health-related data and anthropometric measurements were evaluated. Body composition was assessed by bioimpedance analysis (BIA), mainly including skeletal muscle mass, body fat mass, total body water, fat-free mass,percent body fat, basal metabolic rate. Frailty was assessed by Clinical Frailty Scale (CFS). Univariate logistic regression was used to analyze the association between body composition and frailty. Results: Frailty was present in 43.9% of the participants. Frail inpatients showed higher waist circumference, body fat mass and percent body fat, non-frail inpatients showed greater upper arm circumference, calf circumference, skeletal muscle mass, total body water, fat-free mass and basal metabolic rate. Subjects with underweight (body mass index (BMI)<18.5 kg/m 2 ; odds ratio (OR), 95% confidence interval (CI)=4.146 (1.286-13.368) P=0.017) and those with high waist circumference (OR 95% CI=1.428 (0.584-3.491) P<0.001), body fat mass (OR, 95% CI=1.143 (0.892-1.315) P<0.001) presented a higher risk of frailty compared to normal subjects. Skeletal muscle mass (OR; 95% CI=0.159 (0.064-0.396) P<0.001) was a protective factor for frailty. Conclusion: Frailty in elder Chinese inpatients was characterized by a body composition phenotype with underweight, high waist circumference, low skeletal muscle mass and high body fat mass. Underweight, abdominal obesity and sarcopenic obesity may, therefore, be targets for intervention of frailty.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

<p>Association Between Body Composition and Frailty in Elder Inpatients</p>

Xu¹,

Zhang²,

Shen³

et al. 2020

CIA

View full text Add to dashboard Cite

show abstract

“…Além dessa definição, atualmente outros autores vêm defendendo a hipótese de que o desenvolvimento da fragilidade seja baseado principalmente na tríade de alterações causais relacionadas à sarcopenia, desregulação neuroendócrina e disfunção imunológica (FRIED et al, 2001;SANTOS-EGGIMANN et al, 2009;FERRIOLLI et al, 2017).…”

Section: O Conceito De Fragilidadeunclassified

“…As causas da fragilidade não estão completamente elucidadas e a frequente relação com eventos agudos, doenças crônicas e incapacidade funcional dificulta a detecção de alterações fisiológicas que possam estar estritamente relacionadas à síndrome (FERRIOLLI et al, 2017).…”

Section: O Conceito De Fragilidadeunclassified

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Avaliação da fragilidade em indivíduos submetidos à cirurgia cardíaca

Bottura¹

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Frailty syndrome, defined as the reduction of energy reserve and resistance to stressors, associated with late indication of some surgical procedures, results in a higher occurrence of risk situations for the patients with heart disease, with a greater predisposition to the development of postoperative complications, which are related to an increase in cases of hospital readmission and high length of stay. In order to improve postoperative management and our assessment of severity, prevention and risk stratification, preoperative physiotherapy uses functional tests that translate the patient's actual physical and pulmonary condition, allowing the identification of potentially risk factors. As a way of evaluating the prevalence of frailty in population for cardiac surgery, the association of functional tests with frailty, and peri and postoperative morbidity and mortality, we evaluated the candidates for cardiac surgery according to five criteria proposed by Fried: loss of weight, depression, low handgrip strength, low level of physical activity and reduction of walking speed, as well as lung capacity (manovacuometry, ventilometry and peak flow), effort tolerance (6MWT) and cognitive function (MMSE). After surgery, information was collected regarding the surgical procedure and postoperative recovery and then, subjects were divided into two groups: fragile and nonfragile and subdivided according to the age group in the elderly and not elderly. We evaluated 100 individuals, being 59 valvopaths and 41 coronary disease; 13% were considered nonfragile, 70% pre-fragile and 17% fragile; the maximum inspiratory pressure was significantly lower in the fragile individuals (52 ± 21 vs 75 ± 33 in non-fragile, p = 0.044), as well as the handgrip strength (31 ± 11 vs. 22 ± 8, p = 0.007); 11 patients died after the procedure (7.2% non-fragile versus 29.4% fragile individuals; p = 0.019). From the results found, we can conclude that the prevalence of frailty in cardiac surgery patients was high, even among individuals not considered elderly, and, in addition, fragile individuals had lower handgrip strength, lower vital capacity and lower inspiratory pressures and expiratory rates than those observed in non-fragile patients, as well as higher in-hospital mortality.

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Body mass index, frailty, and outcomes in heart failure with preserved ejection fraction

Li,

Wang,

Hua

et al. 2023

ESC Heart Failure

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AimsRelationship between body mass index (BMI), frailty, and clinical adverse events remains unclear in patients with heart failure (HF) with preserved ejection fraction (HFpEF) in different patient populations. We aimed to compare the association of BMI, frailty, and clinical adverse events between a US cohort from the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) study and a Chinese cohort from the Heart Failure Registry of Patient Outcomes (HERO) study.Methods and resultsWe used data of 1715 participants enrolled from America in the TOPCAT study and 1487 patients with HFpEF in the Chinese registry study, the HERO. We evaluated the relationship between BMI and frailty using multivariate restricted cubic spline logistic regression. Association between frailty and BMI categories and primary outcomes including HF hospitalization, aborted sudden death, and cardiovascular death, all‐cause mortality, and HF hospitalization were analysed by Cox proportional hazards models. The patients' mean age was 72 ± 11 years for both study populations, with 50% and 46% female for the TOPCAT study and the HERO study, respectively. Patients in the TOPCAT study had a higher mean BMI (33.9 vs. 24 kg/m2), with 72.3% vs. 52.9% defined as moderately to severely frail (frailty index > 0.3). In the TOPCAT study, risk of frailty rose as BMI increased, but not in the HERO study. Patients with frailty were at significant higher risk for the primary composite outcomes [hazard ratio (HR) 1.84 (95% confidence interval: 1.46–2.32)], all‐cause mortality [HR 1.73 (1.34–2.25)], and HF hospitalization [HR 1.83 (1.40–2.40)] in the TOPCAT study. The corresponding numbers in the HERO study were 1.26 (1.01–1.57), 2.21 (1.45–3.35), and 1.15 (0.81–1.37), respectively. The association of frailty with clinical outcomes did not vary with BMI categories in the two studies.ConclusionsBMI distribution and association between BMI and frailty risk were different between the two study populations. Frailty was associated with clinical adverse events and this association was consistent across different BMI categories in both studies.

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Body composition and frailty profiles in Brazilian older people: Frailty in Brazilian Older People Study-FIBRA-BR

Cited by 46 publications

References 36 publications

<p>Association Between Body Composition and Frailty in Elder Inpatients</p>

<p>Association Between Body Composition and Frailty in Elder Inpatients</p>

Avaliação da fragilidade em indivíduos submetidos à cirurgia cardíaca

Body mass index, frailty, and outcomes in heart failure with preserved ejection fraction

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