Life Course Social and Health Conditions Linked to Frailty in Latin American Older Men and Women

Alvarado, Beatriz; Zunzunégui, Maria-Victoria; Béland, François; Bamvita, Jean‐Marie

doi:10.1093/gerona/63.12.1399

Cited by 277 publications

(296 citation statements)

References 40 publications

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“…2,3,[6][7][8][9][10] Studies conducted both in Brazil and in other countries have reported different prevalence rates, ranging from 6.9% to 40.6% among frail elderly individuals and 46.3% to 60.1% among prefrail individuals. 2,4,[11][12][13][14] In this regard, frailty syndrome should be targeted by earlier investigations and interventions, given its impact on elderly individuals, their families and society as a whole. 1 Despite recent initiatives, there are few Brazilian studies assessing this condition, and interventions that reduce the impact of this syndrome are still insufficient.…”

Section: Introductionmentioning

confidence: 99%

Frailty syndrome in an independent urban population in Brazil (FIBRA study): a cross-sectional populational study

et al. 2016

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CONTEXT AND OBJECTIVE: Frailty is a multifactorial syndrome. The aim of this study was to determine the prevalence and characteristics of frailty syndrome in an elderly urban population. DESIGN AND SETTING: Cross-sectional study carried out at the homes of a randomized sample representing the independent elderly individuals of Ribeirão Preto, Brazil. METHODS: Sociodemographic characteristics, clinical data and criteria of the frailty phenotype were obtained at the subjects' homes; 385 individuals were evaluated. Frailty was defined based on detection of weight loss, exhaustion, weakness, slowness and low physical activity level. Individuals with three or more of these characteristics were classified as frail and those with one or two as pre-frail. Specific cutoff points for weakness, slowness and low physical activity level were calculated. RESULTS: The participants' mean age was 73.9 ± 6.5 years, and 64.7% were women. 12.5% had lost weight over the last year; 20.5% showed exhaustion, 17.1% slowness, 24.4% low physical activity level and 20.5% weakness. 9.1% were considered frail and 49.6% pre-frail. Frail subjects were older, attended more medical visits, had a higher chance of hospitalization within the last 12 months and had more cerebrovascular events, diabetes, neoplasms, osteoporosis and urinary and fecal incontinence. CONCLUSION: In this independent elderly population, there were numerous frail and pre-frail individuals. Frailty syndrome was associated with high morbidity. Cutoff points for weakness, slowness and low physical activity level should be adjusted for the population under study. It is essential to identify frail and pre-frail older individuals for appropriate interventions. RESUMO

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Section: Introductionmentioning

confidence: 99%

Frailty syndrome in an independent urban population in Brazil (FIBRA study): a cross-sectional populational study

et al. 2016

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“…(3) Some scholars have reported that frailty syndrome and the chronic and disabling diseases generated by aging must be properly treated and monitored over the years. (4,5) Among the pathological conditions that have received more attention in recent years, type 2 diabetes mellitus stands out because it is a complex disorder of potential deleterious effects that favors morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

“…(4) The choice of type 2 diabetes mellitus for analysis in this study was due to the high prevalence of the condition among the elderly over 60 years; for its relation to an increased risk of premature death; for its greater association with comorbidities, and especially with major geriatric syndromes, such as the frailty syndrome.…”

Section: Introductionmentioning

confidence: 99%

Síndrome da fragilidade em idosos com diabetes mellitus tipo 2

2015

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Objective: To determine the prevalence of frailty syndrome in elderly patients with type 2 diabetes mellitus. Methods: Cross-sectional study including 30 elderly of both genders, aged 60-79 years, and diagnosed with type 2 diabetes mellitus. The research instruments were validated for Portuguese, included sociodemographic and clinical variables, and criteria for frailty syndrome. The elderly were divided into frail, pre-frail and non-frail. Data were analyzed using descriptive statistics. Results: The prevalence of frailty was 56.7%. The associated factors were the following: female gender (70.6%); widowed (69.2%); white color (58.8%); not working (69.2%); and time since diagnosis of 25-48 months (47.1%). Conclusion:The associated factors such as sociodemographic, economic and time since diagnosis did not affect the prevalence of frailty syndrome in elderly patients with type 2 diabetes mellitus. ResumoObjetivo: Conhecer a prevalência da síndrome da fragilidade e fatores associados em idosos com diabetes mellitus tipo 2. Métodos: Estudo transversal que incluiu 30 idosos, de ambos os sexos, com idades entre 60 a 79 anos e diagnóstico de diabetes mellitus tipo 2. Os instrumentos de pesquisa foram validados para língua portuguesa e incluíram variáveis sociodemográficas, clínicas e critérios para síndrome da fragilidade. Os idosos foram divididos em frágil, pré-frágil e não frágil. Os dados foram analisados por estatística descritiva. Resultados: A prevalência da fragilidade foi de 56,7%. Os fatores associados foram: sexo feminino (70,6%); viúvos (69,2%); cor branca (58,8%); não trabalhar (69,2%); e tempo de diagnóstico de 25 a 48 meses (47,1%). Conclusão: Os fatores associados, tais como, sociodemográficos, econômicos e tempo de diagnóstico não interferiram na prevalência da síndrome da fragilidade em idosos com diabetes mellitus tipo 2.

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“…Recent evidence suggests that biological deficits and specific socio-environmental stressors accumulated early in childhood predict the development of the frailty phenotype (253). There are considerable arguments for a life-course approach(147).…”

Section: Frailty Definitionsmentioning

confidence: 99%

Frailty Assessment in Acute Care

2015

The Gerontologist

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IntroductionFor some people, ageing is associated with the experience of increased co-morbidity, functional impairment, poor resilience and heightened vulnerability to external stressors, resulting in reduced lifespan as well as health-span. This frailty phenomenon poses challenges to health care systems in the form of increased patient complexity and resource utilisation. The acute care setting, characterised by time-pressure and high patient turn-over, is under strain and struggles to recognise and subsequently reliably intervene, to prevent, reverse or halt the decline of this vulnerable cohort. MethodsThis mixed-methods study probes existing evidence and 'real-world' processes with a systematic review of frailty assessments developed or validated in the acute care setting and a survey of contemporaneous clinical practice in London Acute Medical Units. Content validation and understanding of contextual factors for ideal frailty assessment in acute care is explored using Delphi consensus and Focus Group methodology respectively. The resultant model is developed on existing retrospective national Hospital Episode Statistics data, and prospectively tested on observational data in a local Acute Medical Unit setting. ResultsExisting frailty scores are preponderantly biophysical in nature, and have poor predictive power for adverse outcomes in the acute care setting. In clinical practice, single-dimension assessment tools predominate. Frailty syndromes and previous high resource utilisation in the form of a simple, clinically relevant tool useful to the multidisciplinary team gain consensus as optimal assessment for the setting. Retrospective testing of the frailty model displays moderate predictive powers for adverse events (inpatient mortality, emergency readmission and institutionalisation) and prospective testing provides concurrent (Frailty Index, Age, Co-Morbidity) and comparative predictive validity (Frailty Index, Co-Morbidity, 2 admission National Early Warning Score) with existing risk stratification models in this setting. ConclusionsA risk prediction model based on frailty syndromes and previous high resource utilisation is a valid, feasible and useful for the acute care setting.

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Life Course Social and Health Conditions Linked to Frailty in Latin American Older Men and Women

Abstract: Theoretical models to explain gender and social differences in frailty should use a life-course perspective.

Cited by 277 publications

References 40 publications

Frailty syndrome in an independent urban population in Brazil (FIBRA study): a cross-sectional populational study

Frailty syndrome in an independent urban population in Brazil (FIBRA study): a cross-sectional populational study

Síndrome da fragilidade em idosos com diabetes mellitus tipo 2

Frailty Assessment in Acute Care

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