Validity of the short physical performance battery for screening for frailty syndrome among older people in the Brazilian Amazon region. A cross-sectional study

Autores

Palavras-chave:

Aging, Physical functional performance, Frailty, Reproducibility of results

Resumo

BACKGROUND: Environmental and population characteristics seem to influence the variation in cut- off points of the Short Physical Performance Battery (SPPB) for diagnosing frailty syndrome among older adults. OBJECTIVE: To verify the validity of the SPPB for screening for frailty syndrome among older adults in the Amazonian context. DESIGN AND SETTING: Cross-sectional population-based study on older adults in the urban area of Coari (AM), Brazil. METHODS: In total, 264 older adults (60 years of age or over) were included. Frailty syndrome was defined using the Fried phenotype criteria. The SPPB cutoff points were compared in relation to frailty and validity measurements were calculated for the test. RESULTS: A strong association between poor physical performance and frailty was identified (P < 0.001). The cutoff point of 6 demonstrated the best validity measurements for frailty in the sample studied (sen- sitivity: 0.28; specificity: 0.94; accuracy: 0.88; area under the receiver operating characteristic curve, AUC- ROC: 0.61; likelihood ratio, LR+: 4.44; LR-: 0.77; prevalence: 8.3%; post-test probability, PTP+: 0.32; PTP-: 0.07), with emphasis on high specificity and the positive likelihood ratio value. CONCLUSION: The SPPB was shown to be useful for screening frail older adults in the Amazon region. The score of 6 demonstrated the best cutoff point for this population. This could be used in healthcare services for diagnostic screening for frailty among older people within the Amazonian context.

Downloads

Não há dados estatísticos.

Biografia do Autor

Laila Lira Guimarães Rocco, Universidade Federal do Amazonas

MSc. Physiotherapist, Postgraduate Program on Health, Society and Endemics in the Amazon, Universidade Federal do Amazonas (UFAM), Manaus (AM), Brazil.

Tiótrefis Gomes Fernandes, Universidade Federal do Amazonas

PhD. Professor, School of Physical Education and Physiotherapy, Universidade Federal do Amazonas (UFAM), Manaus (AM), Brazil.

Referências

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-M156. PMID: 11253156; doi: 10.1093/gerona/56.3.m146.

Bouillon K, Kivimaki M, Hamer M, et al. Measures of frailty in population-based studies: an overview. BMC Geriatr. 2013;13:64. PMID: 23786540; doi: 10.1186/1471-2318-13-64.

Pritchard JM, Kennedy CC, Karampatos S, et al. Measuring frailty in clinical practice: A comparison of physical frailty assessment methods in a geriatric out-patient clinic. BMC Geriatr. 2017;17(1):264. PMID: 29132301; doi: 10.1186/s12877-017-0623-0.

Lourenço RA, Moreira VG, Mello RGB de, et al. Consenso brasileiro de fragilidade em idosos: conceitos, epidemiologia e instrumentos de avaliação [Brazilian consensus on frailty in older people: concepts, epidemiology and evaluation instruments]. Geriatr Gerontol Aging. 2018;12(2):121-35. doi: 10.5327/Z2447-211520181800023.

Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G. Untangling the Concepts of Disability, Frailty, and Comorbidity: Implications for Improved Targeting and Care. Journals Gerontol Ser A Biol Sci Med Sci. 2004;59(3):255-63. PMID: 15031310; doi: 10.1093/gerona/59.3.m255.

Cesari M, Onder G, Russo A, et al. Comorbidity and physical function: Results from the aging and longevity study in the Sirente geographic area (iISIRENTE Study). Gerontology. 2006;52(1):24-32. PMID: 16439821; doi: 10.1159/000089822.

Guralnik JM, Ferrucci L, Simonsick EM, Salive ME, Wallace RB. Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. N Engl J Med. 1995;332(9):556-61. PMID: 7838189; doi: 10.1056/NEJM199503023320902.

da Câmara SMA, Alvarado BE, Guralnik JM, Guerra RO, Maciel AC. Using the Short Physical Performance Battery to screen for frailty in young-old adults with distinct socioeconomic conditions. Geriatr Gerontol Int. 2013;13(2):421-8. PMID: 22882512; doi: 10.1111/j.1447-0594.2012.00920.x.

Abizanda P, Romero L, Sánchez-Jurado PM, et al. Association between Functional Assessment Instruments and Frailty in Older Adults: The FRADEA Study. J Frailty Aging. 2012;162-8. PMID: 27093316; doi: 10.14283/jfa.2012.25.

Mello MJC. Análise da bateria de testes “Short Physical Performance Battery” de acordo com a classificação de fragilidade em idosos da comunidade - Estudo FIBRA [thesis]. Campinas: Universidade Estadual de Campinas (UNICAMP); 2015. Available from: http://repositorio.unicamp.br/jspui/handle/REPOSIP/312940. Accessed in 2020 (Sep 15).

Ferrucci L, Penninx BW, Leveille SG, et al. Characteristics of nondisabled older persons who perform poorly in objective tests of lower extremity function. J Am Geriatr Soc. 2000;48(9):1102-10. PMID: 10983911; doi: 10.1111/j.1532-5415.2000.tb04787.x.

Nakano MM. Versão brasileira da Short Physical Performance Battery - SPPB: adaptação cultural e estudo da confiabilidade [thesis]. Campinas: Universidade Estadual de Campinas (UNICAMP); 2007. Available from: http://www.repositorio.unicamp.br/handle/REPOSIP/252485. Accessed in 2020 (Sep 15).

Ministério do Planejamento, Orçamento e Gestão Instituto Brasileiro de Geografia e Estatística - IBGE. Censo demográfico 2010: Aglomerados subnormais - informações territoriais. Rio Janeiro: IBGE; 2010. Available from: https://biblioteca.ibge.gov.br/visualizacao/periodicos/552/cd_2010_agsn_if.pdf. Accessed in 2020 (Sep 15).

Gama ASM, Fernandes TG, Parente RCP, Secoli SR. Inquérito de saúde em comunidades ribeirinhas do Amazonas, Brasil [A health survey in riverine communities in Amazonas State, Brazil]. Cad Saude Publica. 2018;34(2):e00002817. PMID: 29489939; doi: 10.1590/0102-311X00002817.

Bertolucci PH, Brucki SM, Campacci SR, Juliano Y. O Mini-Exame do Estado Mental em uma população geral: impacto da escolaridade [The Mini-Mental State Examination in a general population: impact of educational status]. Arq Neuropsiquiatr. 1994;52(1):1-7. PMID: 8002795.

Freire Junior RC, Fernandes TG, Borges GF, Guerra RO, de Abreu DCC. Factors associated with low levels of physical activity among elderly residents in a small urban area in the interior of the Brazilian Amazon. Arch Gerontol Geriatr. 2018;75:37-43. PMID: 29180130; doi: 10.1016/j. archger.2017.11.007.

Fernandes TG, Silva KR, Guerra RO, et al. Influence of the Amazonian context on the frailty of older adults: A population-based study [published online ahead of print, 2020 Jun 23]. Arch Gerontol Geriatr. 2020;104162. PMID: 32624196; doi: 10.1016/j.archger.2020.104162.

Andrade JM, Duarte YAO, Alves LC, et al. Perfil da fragilidade em adultos mais velhos brasileiros: ELSI-Brasil [Frailty profile in Brazilian older adults: ELSI-Brazil]. Rev Saude Publica. 2018;52Suppl 2(Suppl 2):17s. PMID: 30379282; doi: 10.11606/S1518-8787.2018052000616.

Mello A de C, 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 Saude Publica. 2014;30(6):1143-68. PMID: 25099040; doi: 10.1590/0102-311X00148213.

Fhon JRS, Rodrigues RAP, Santos JLF, et al. Fatores associados à fragilidade em idosos: estudo longitudinal [Factors associated with frailty in older adults: a longitudinal study]. Rev Saude Publica. 2018;52:74. PMID: 30066813; doi: 10.11606/S1518-8787.2018052000497.

Verghese J, Xue X. Identifying frailty in high functioning older adults with normal mobility. Age Ageing. 2010;39(3):382-5. PMID: 20051607; doi: 10.1093/ageing/afp226.

Andrade AN, Fernandes MGM, da Nóbrega MML, Garcia TR, Costa KNFM. Análise do conceito fragilidade em idosos. Texto Context - Enferm. 2012;21(4):748–56. doi: 10.1590/S0104-07072012000400004.

Bensenor IM, Lotufo PA. Epidemiologia Abordagem Prática. 2a ed. São Paulo: Sarvier Editora de Livros Medicos Ltda; 2011.

Rockwood K, Theou O, Mitnitski A. What are frailty instruments for? Age Ageing. 2015;44(4):545-7. PMID: 25824236; doi: 10.1093/ageing/afv043.

Patino CM, Ferreira JC. Entendendo os testes diagnósticos: Parte 2 [Understanding diagnostic tests. Part 2]. J Bras Pneumol. 2017;43(6):408. PMID: 29340487; doi: 10.1590/S1806-37562017000000424.

Da Mata FA, Pereira PP, De Andrade KR, et al. Prevalence of frailty in Latin America and the Caribbean: A systematic review and meta-analysis. PLoS ONE. 2016;11(8):e0160019. PMID: 27500953; doi: 10.1371/journal. pone.0160019.

Siriwardhana DD, Hardoon S, Rait G, Weerasinghe MC, Walters KR. Prevalence of frailty and prefrailty among community-dwelling older adults in low-income and middle-income countries: A systematic review and meta-analysis. BMJ Open. 2018;8(3):e018195. PMID: 29496895; doi: 10.1136/bmjopen-2017-018195.

Neri AL, Yassuda MS, Araújo LF, et al. Metodologia e perfil sociodemográfico, cognitivo e de fragilidade de idosos comunitários de sete cidades brasileiras: Estudo FIBRA [Methodology and social, demographic, cognitive, and frailty profiles of community-dwelling elderly from seven Brazilian cities: the FIBRA Study]. Cad Saude Publica. 2013;29(4):778-92. PMID: 23568307; doi: 10.1590/S0102-311X2013000400015.

Downloads

Publicado

2020-12-03

Como Citar

1.
Rocco LLG, Fernandes TG. Validity of the short physical performance battery for screening for frailty syndrome among older people in the Brazilian Amazon region. A cross-sectional study. Sao Paulo Med J [Internet]. 3º de dezembro de 2020 [citado 16º de outubro de 2025];138(6):537-44. Disponível em: https://periodicosapm.emnuvens.com.br/spmj/article/view/537

Edição

Seção

Artigo Original