Cardiovascular risk factors associated with frailty syndrome among hospitalized elderly people
a cross-sectional study
Keywords:
Frail elderly, Risk factors, Cardiovascular diseases, Aging, HospitalizationAbstract
CONTEXT AND OBJECTIVE: Identification of frailty syndrome and its relationship with cardiovascular risk factors among hospitalized elderly people is important, since this may contribute towards broadening of knowledge regarding this association within tertiary-level services. This study aimed to evaluate the cardiovascular risk factors associated with frailty syndrome among hospitalized elderly people. DESIGN AND SETTING: Observational cross-sectional study in a public teaching hospital. METHODS: The participants were elderly patients admitted to clinical and surgical wards. The cardiovascular risk factors assessed were: body mass index (BMI), waist circumference, systemic arterial hypertension (SAH), blood glucose, total cholesterol, high-density lipoproteins (HDL), low-density lipoproteins (LDL) and triglycerides. To identify frailty syndrome, the method proposed by Fried was used. The data were analyzed through descriptive statistics, chi-square test (P < 0.10) and multinomial logistic regression (P < 0.05). RESULTS: A total of 205 individuals were evaluated. It was found that 26.3% (n = 54) of the elderly people were frail, 51.7% (n = 106) were pre-frail and 22% (n = 45) were non-frail. The preliminary bivariate analysis (P < 0.10) for the regression model showed that frailty was associated with BMI (P = 0.016), LDL cholesterol (P = 0.028) and triglycerides (P = 0.093). However, in the final multivariate model, only overweight remained associated with the pre-frail condition (odds ratio, OR = 0.44; 95% confidence interval, CI = 0.20-0.98; P = 0.045). CONCLUSION: States of frailty were highly present in the hospital environment. The pre-frail condition was inversely associated with overweight.
Downloads
References
Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146-56.
Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G. Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol A Biol Sci Med Sci. 2004;59(3):255-63.
Hubbard RE, Lang IA, Llewellyn DJ, Rockwood K. Frailty, body mass index, and abdominal obesity in older people. J Gerontol A Biol Sci Med Sci. 2010;65(4):377-81.
Storti LB, Fabrício-Whebe SCC, Kusumota L, Rodrigues RAP, Marques
S. Fragilidade de idosos internados na clínica médica da unidade de emergência de um hospital geral terciário [Frailty of elderly patients admitted to the medical clinic of an emergency unit at a general tertiary hospital]. Texto & Contexto Enferm. 2013;22(2):452-9.
Afilalo J. Frailty in Patients with Cardiovascular Disease: Why, When, and How to Measure. Curr Cardiovasc Risk Rep. 2011;5(5):467-72.
Afilalo J, Karunananthan S, Eisenberg MJ, Alexander KP, Bergman H. Role of frailty in patients with cardiovascular disease. Am J Cardiol. 2009;103(11):1616-21.
Ramsay SE, Arianayagam DS, Whincup PH, et al. Cardiovascular risk profile and frailty in a population-based study of older British men. Heart. 2015;101(8):616-22.
Moretto MC, Alves RMA, Neri AL, Guariento ME. Relação entre estado nutricional e fragilidade em idosos brasileiros [Relationship between nutritional status and frailty in Brazilian elderly]. Rev Soc Bras Clín Méd. 2012;10(4):267-71.
Bastos-Barbosa RG, Ferriolli E, Coelho EB, et al. Association of frailty syndrome in the elderly with higher blood pressure and other cardiovascular risk factors. Am J Hypertens. 2012;25(11):1156-61.
Oliveira DR, Bettinelli LA, Pasqualotti A, et al. Prevalência de síndrome da fragilidade em idosos de uma instituição hospitalar [Prevalence of frailty syndrome in old people in a hospital institution]. Rev Latinoam Enferm. 2013;21(4):898-8.
Ricci NA, Pessoa GS, Ferriolli E, Dias RC, Perracini MR. Frailty and cardiovascular risk in community-dwelling elderly: a population- based study. Clin Interv Aging. 2014;9:1677-85.
Khandelwal D, Goel A, Kumar U, et al. Frailty is associated with longer hospital stay and increased mortality in hospitalized older patients. J Nutr Health Aging. 2012;16(8):732-5.
Purser JL, Kuchibhatla MN, Fillenbaum GG, et al. Identifying frailty in hospitalized older adults with significant coronary artery disease. J Am Geriatr Soc. 2006;54(11):1674-81.
Bertolucci PHF, Brucki SMD, Campacci SR, Juliano Y. O Mini-Exame do Estado Mental em uma população geral: impacto da escolaridade [The Mini-Mental State Examination in an outpatient population: influence of literacy]. Arq Neuropsiquiatr. 1994;52(1):1-7.
Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde. Departamento de Atenção Básica. Envelhecimento e saúde da pessoa idosa. Ministério da Saúde: Brasília; 2007. Available from: http://bvsms.saude.gov.br/bvs/publicacoes/abcad19.pdf. Accessed in 2016 (Jul 5).
Rabito EI, Vannucchi GB, Suen VMM, Castilho Neto LL, Marchini JS. Estimativa de peso e altura de pacientes hospitalizados e imobilizados [Weight and height prediction of immobilized patients]. Rev Nutr. 2006;19(6):655-61.
Lipschitz DA. Screening for nutritional status in the elderly. Prim Care. 1994;21(1):55-67.
Sociedade Brasileira de Cardiologia, Sociedade Brasileira de Hipertensão, Sociedade Brasileira de Nefrologia. VI Diretrizes Brasileiras de Hipertensão Arterial. Arq Bras Cardiol. 2010;95(1 Supl. 1).
Xavier HT, Izar MC, Faria Neto JR, et al. V Diretriz Brasileira de Dislipidemias e Prevenção da Aterosclerose. Arq Bras Cardiol. 2013;101(4 Supl. 1).
Sociedade Brasileira de Diabetes. Diretrizes da Sociedade Brasileira de Diabetes 2013-2014. São Paulo: AC Farmacêutica; 2014.
Batistoni SST, Neri AL, Cupertino APFB. Validade da escala de depressão do Center for Epidemiological Studies entre idosos brasileiros [Validity of the Center for Epidemiological Studies Depression Scale among Brazilian elderly]. Rev Saúde Pública. 2007;41(4):598-605.
Benedetti TB, Mazo GZ, Barros MVG. Aplicação do Questionário Internacional de Atividades Físicas para avaliação do nível de atividades físicas de mulheres idosas: validade concorrente e reprodutibilidade teste-reteste [Application of the International Physical Activity Questionnaire (IPAQ) for evaluation of elderly women: concurrent validity and test-retest reprosutibility]. Revista Brasileira de Ciência e Movimento. 2004;12(1):25-33. Available from: https://portalrevistas.ucb.br/index.php/RBCM/article/view/538/562. Accessed in 2016 (Jul 5).
Pate RR, Pratt M, Blair SN, et al. Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA. 1995;273(5):402-7.
Joosten E, Demuynck M, Detroyer E, Milisen K. Prevalence of frailty and its ability to predict in hospital delirium, falls, and 6-month mortality in hospitalized older patients. BMC Geriatr. 2014;14:1.
Kristjansson SR, Rønning B, Hurria A, et al. A comparison of two pre- operative frailty measures in older surgical cancer patients. Journal of Geriatric Oncology. 2012;3(1):1-7. Available from: http://www. geriatriconcology.net/article/S1879-4068(11)00062-2/pdf. Accessed in 2016 (Jul 5).
Mello AC, Engstrom EM, Alves LC. Fatores sociodemográficos e de saúde associados à fragilidade em idosos: uma revisão sistemática de literatura [Health-related and socio-demographic factors associated with frailty in the elderly: a systematic literature review]. Cad. Saúde Pública. 2014;30(6):1-25.
Boxer RS, Kleppinger A, Brindisi J, et al. Effects of dehydroepiandrosterone (DHEA) on cardiovascular risk factors in older women with frailty characteristics. Age Ageing. 2010;39(4):451-8.
Sirola J, Kröger H. Similarities in acquired factors related to postmenopausal osteoporosis and sarcopenia. J Osteoporos. 2011;2011:536735
Chen CY, Wu SC, Chen LJ, Lue BH. The prevalence of subjective frailty and factors associated with frailty in Taiwan. Arch Gerontol Geriatr. 2010;50 Suppl 1:S43-7.
Amaral FLJS, Guerra RO, Nascimento AFF, Maciel ACC. Apoio social e síndrome da fragilidade em idosos residentes na comunidade [Social support and the frailty syndrome among elderly residents in the community]. Ciênc Saúde Coletiva. 2013;18(6):1835-46.
Sheehan KJ, O’Connell MDL, Cunningham C, Crosby L, Kenny RA. The relationship between increased body mass index and frailty on falls in community dwelling older adults. BMC Geriatr. 2013;13:132.
Santos RR, Bicalho MAC, Mota P, Oliveira DR, Morais EN. Obesidade em idosos [Obesity and the elderly]. Rev Méd Minas Gerais. 2013;23(1):64-73.
Mathus-Vliegen EM. Obesity and the elderly. J Clin Gastroenterol. 2012;46(7):533-44.
Cruz-Jentoft AJ, Baeyens JP, Bauer JM, et al. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010;39(4):412-23.
Bouillon K, Kivimäki M, Hamer M, et al. Diabetes risk factors, diabetes risk algorithms, and the prediction of future frailty: the Whitehall II prospective cohort study. J Am Med Dir Assoc. 2013;14(11):851.e1-6.
Paula EA, Paula RB, Costa DMN, Colugnati FAB, Paiva EP. Avaliação do risco cardiovascular em hipertensos [Cardiovascular risk assessment in hypertensive patients]. Rev Latinoam Enferm. 2013;21(3):820-7.
