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1.
Säo Paulo med. j ; 140(3): 406-411, May-June 2022. tab
Article in English | LILACS | ID: biblio-1377398

ABSTRACT

ABSTRACT BACKGROUND: Frailty is consensually understood to be a clinical syndrome in which minimal stressors can lead to negative outcomes such as hospitalization, early institutionalization, falls, functional loss and death. Frailty is more prevalent among patients with chronic kidney disease (CKD), and those on dialysis are the frailest. Depression contributes towards putting patients with CKD into the frailty cycle. OBJECTIVE: To assess frailty and its relationship with depression among patients with CKD undergoing hemodialysis. DESIGN AND SETTING: Observational and quantitative cross-sectional study conducted in a renal therapy unit, located in the interior of the state of São Paulo, Brazil. METHODS: This investigation took place in 2019, among 80 patients. The following instruments were applied: a sociodemographic, economic and health condition characterization and the Subjective Frailty Assessment (SFA) and Patient Health Questionnaire-9 (PHQ-9). RESULTS: Among the patients, there was higher prevalence of females, individuals with a steady partner and retirees, and their mean age was 59.63 (± 15.14) years. There was high prevalence of physical frailty (73.8%) and depression (93.7%). Depression was associated with frailty, such that patients with depression were 9.8 times more likely to be frail than were patients without depression (odds ratio, OR = 9.80; 95% confidence interval, CI, 1.93-49.79). CONCLUSION: Based on the proposed objective and the results achieved, it can be concluded that depression was associated with the presence of frailty among patients with CKD on hemodialysis.


Subject(s)
Humans , Female , Aged , Renal Insufficiency, Chronic/complications , Renal Insufficiency, Chronic/therapy , Frailty/epidemiology , Brazil/epidemiology , Cross-Sectional Studies , Frail Elderly , Renal Dialysis , Depression/etiology , Depression/epidemiology , Middle Aged
2.
Säo Paulo med. j ; 140(3): 356-365, May-June 2022. tab, graf
Article in English | LILACS | ID: biblio-1377379

ABSTRACT

ABSTRACT CONTEXT: Dyspnea is a symptom present in several chronic diseases commonly seen among older adults. Since individuals with dyspnea tend to stay at rest, with consequently reduced levels of physical activity, they are likely to be at greater risk of developing frailty, especially at older ages. DESIGN AND SETTING: Cross-sectional study at community level, Brazil. OBJECTIVE: To analyze the relationships between self-reported dyspnea, health conditions and frailty status in a sample of community-dwelling older adults. METHOD: Secondary data from the follow-up of the Frailty in Brazilian Elderly (FIBRA) study, involving 415 community-dwelling older adults (mean age: 80.3 ± 4.68 years), were used. The variables analyzed were sociodemographic characteristics, reported dyspnea, clinical data and frailty phenotype. Associations between dyspnea and other variables (age, sex, education and body mass index) were verified through the crude (c) and adjusted (a) odds ratios. RESULTS: The prevalence of dyspnea in the entire sample was 21.0%. Dyspnea was more present in individuals with pulmonary diseases, heart disease, cancer and depression. Older adults with multimorbidities (adjusted odds ratio, ORa = 2.91; 95% confidence interval, CI = 1.41-5.99) and polypharmacy (ORa = 2.02; 95% CI = 1.15-3.54) were more likely to have dyspnea. Those who reported dyspnea were 2.54 times more likely to be frail (ORa = 2.54; 95% CI = 1.08-5.97), and fatigue was their most prevalent phenotype component. CONCLUSION: Dyspnea was associated with different diseases, multimorbidities, polypharmacy and frailty. Recognizing the factors associated with dyspnea may contribute to its early identification and prevention of its negative outcomes among older adults.


Subject(s)
Humans , Aged , Frailty/epidemiology , Brazil/epidemiology , Geriatric Assessment , Cross-Sectional Studies , Frail Elderly , Dyspnea/epidemiology , Independent Living , Self Report
3.
Fisioter. Bras ; 22(6): 809-823, Fevereiro 7, 2022.
Article in Portuguese | LILACS | ID: biblio-1358267

ABSTRACT

A Síndrome da Fragilidade (SF) é a resposta do organismo do idoso frente ao aumento da vulnerabilidade a estressores que redundam em diminuição das reservas fisiológicas e desregulação de múltiplos sistemas. Aspectos sociais e emocionais podem potencializar essa vulnerabilidade, sendo a institucionalização do idoso um agente potencializador desse quadro. Objetivo: Estimar a prevalência da SF e caracterizar o perfil clínico e epidemiológico dos idosos institucionalizados de Pindamonhangaba/SP. Métodos: Trata-se de um estudo observacional transversal descritivo. Para tanto, foram incluídos 31 idosos de ambos os sexos, residentes em duas Instituições de Longa Permanência para Idosos (ILPI) do município de Pindamonhangaba/SP. A SF avalia: perda de peso não intencional, autorrelato de exaustão ou fadiga, diminuição da força muscular pela força de preensão palmar, lentidão na marcha e baixo nível de atividade física. Resultados: A prevalência da SF em idosos institucionalizados foi de 67,4%. Considerando os cinco itens que compõe a SF, a perda de peso não intencional esteve presente em 61,9% dos idosos, o autorrelato de exaustão ou fadiga em 66,6%, o baixo nível de atividade física em 66,6%, a lentidão na marcha em 71,4% e a diminuição da força de preensão palmar em 95,2%. A maior prevalência de idosos frágeis esteve entre os homens (41,9%), e as morbidades mais comuns foram: depressão (32,3%), hipertensão arterial sistêmica (38,7%), sintomas musculoesqueléticos (67,7%), alterações no equilíbrio (74,2%) e características sugestivas de alterações cognitivas (83,9%). Conclusão: A prevalência da SF entre os idosos do estudo foi alta com predomínio no sexo masculino. Destacou-se no perfil clínico, também, a alta prevalência, as características sugestivas de alterações cognitivas, a alteração do equilíbrio e risco de quedas e o sobrepeso ou obesidade. (AU)


Subject(s)
Aged , Aged, 80 and over , Exercise , Depression , Muscle Strength , Homes for the Aged , Hypertension , Frail Elderly , Frailty
4.
Fisioter. Bras ; 23(1): 51-61, Fev 11, 2022.
Article in Portuguese | LILACS | ID: biblio-1358401

ABSTRACT

Introdução: A tontura é uma queixa comum em idosos. Esse sintoma causa instabilidade no equilíbrio corporal e pode afetar a vida do idoso de forma ampla. Objetivo: Verificar a associação entre tontura e fragilidade em idosos. Métodos: Estudo transversal realizado a partir da triagem de setecentos prontuários do ambulatório de fisioterapia. Foram selecionados idosos ≥ 60 anos, de ambos os sexos, residentes na região administrativa sudoeste de Brasília com informações no prontuário a respeito das variáveis tontura e fragilidade. Resultados: Participaram do estudo 383 idosos. 76,2% do idosos eram do sexo feminino, 55,1% com idade > 80 anos, 43,9% com renda entre 2 e 3 salários mínimos, 53,3% com ensino fundamental incompleto e a prevalência de tontura foi de 57,7%. Houve associação significativa entre tontura e as variáveis: fragilidade (OR: 3,59 IC 95%), risco de queda (OR: 9,81 IC: 95%) e episódio de queda (OR:15,35 IC: 95%). Conclusão: A tontura associou-se às variáveis: fragilidade, risco de queda e episódio de queda em idosos. Os dados sugerem a importância de compreender a tontura de forma ampliada e a necessidade de uma abordagem multifatorial e multidisciplinar. (AU)


Subject(s)
Aged, 80 and over , Physical Therapy Modalities , Dizziness , Frailty , Accidental Falls , Aged , Frail Elderly
5.
Fisioter. Bras ; 23(1): 73-79, Fev 11, 2022.
Article in Portuguese | LILACS | ID: biblio-1358411

ABSTRACT

Introdução: A anemia aplásica (AA) é uma condição clínica considerada rara que se desenvolve a partir da disfunção hematopoiética da medula óssea. O tratamento indicado é o transplante de células tronco hematopoiéticas (TCHP). Objetivo: Descrever o caso clínico e as estratégias utilizadas pela fisioterapia durante o processo de reabilitação física. Métodos: Trata-se de estudo de caso, realizado com paciente do sexo feminino, 34 anos de idade e diagnóstico de AA severa. Após avaliação clínica foi indicado o TCHP alogênico de um doador aparentado que apresentou compatibilidade histo-imunológica. O tempo total de internação hospitalar foi de 35 dias. Os objetivos da reabilitação física foram o de manter a ventilação pulmonar, prevenir o acúmulo de secreção, minimizar a progressão da fadiga, perda de força e resistência muscular. Resultados: A estratégia utilizada para contornar a extrema fragilidade hematológica e as implicações clínicas decorrentes evitou perda expressiva no desempenho no teste de caminhada de seis minutos (-10%) ao final da internação. Conclusão: Foi um verdadeiro desafio a implementação da reabilitação física durante o TCHP para o tratamento da AA, mas a estratégia adotada demonstrou-se segura, bem tolerada e suficiente para evitar maiores prejuízos no estado funcional. (AU)


Subject(s)
Female , Adult , Therapeutics , Bone Marrow , Physical Therapy Modalities , Health Strategies , Cell Transplantation , Fatigue , Walk Test , Frailty , Anemia, Aplastic
6.
Aquichan ; 22(1): e2218, ene. 26, 2022.
Article in English, Portuguese | LILACS, BDENF, COLNAL | ID: biblio-1353841

ABSTRACT

Objective: to evaluate the experiences of sexuality and its correlation with frailty among older adults. Materials and methods: cross-sectional study carried out with a total of 250 older adults living in the Northeast of Brazil. They answered three instruments to obtain biosociodemographic, sexuality and frailty data. The analysis was performed using Spearman correlation, Mann-Whitney and Kruskal-Wallis test with 95% confidence interval. Results: sexual intercourse was negatively correlated with reduced strength (ρ = -0.263; p < 0.001) and walking speed (ρ = -0.201; p = 0.001) and positively correlated with reported fatigue (ρ = 0.149; p = 0.018). Affective relationships were negatively correlated with reduced strength (ρ = -0.254; p < 0.001) and walking speed (ρ = -0.207; p = 0.001) and positively correlated with reported fatigue (ρ = 0.207; p = 0.001). Finally, physical and social adversities were positively correlated with reduced strength (ρ = 0.279; p < 0.001), reduced walking speed (ρ = 0.261; p < 0.001) and low physical activity (ρ = 0.140; p = 0.034), in addition to being negatively correlated with reported fatigue (ρ = -0.171; p = 0.009). Conclusion: it was found that the sexuality of older adults is better experienced in affective relationships and weak positive and negative correlations between sexuality and frailty.


Objetivo: avaliar as vivências da sexualidade e sua correlação com a fragilidade entre idosos. Materiais e métodos: estudo seccional realizado com 250 idosos residentes no Nordeste do Brasil. Os idosos responderam a três instrumentos para a obtenção dos dados biossociodemográfico, da sexualidade e da fragilidade. A análise foi realizada com a correlação de Spearman, teste de Mann-Whitney e Kruskal-Wallis com intervalo de confiança de 95 %. Resultados: o ato sexual se correlacionou negativamente à redução da força (ρ = -0,263; p < 0,001) e da velocidade de caminhada (ρ = -0,201; p = 0,001) e positivamente à fadiga relatada (ρ = 0,149; p = 0,018). As relações afetivas se correlacionaram negativamente à redução da força (ρ = -0,254; p < 0,001) e da velocidade de caminhada (ρ = -0,207; p = 0,001) e positivamente à fadiga relatada (ρ = 0,207; p = 0,001). Por fim, as adversidades física e social se correlacionaram positivamente à redução da força (ρ = 0,279; p < 0,001), à redução da velocidade de caminhada (ρ = 0,261; p < 0,001) e à baixa atividade física (ρ = 0,140; p = 0,034), além de se correlacionar negativamente com a fadiga relatada (ρ = -0,171; p = 0,009). Conclusões: constatou-se que a sexualidade dos idosos é vivenciada de melhor forma nas relações afetivas e correlações positivas e negativas de fraca magnitude entre a sexualidade e a fragilidade.


Objetivo: evaluar las vivencias de la sexualidad y su correlación con la fragilidad entre ancianos. Materiales y métodos: estudio seccional realizado con 250 ancianos habitantes en el noreste de Brasil. Los ancianos contestaron tres instrumentos para obtener datos biosociodemográfico, la sexualidad y la fragilidad. Se realizó el análisis con base en la correlación de Spearman, prueba de Mann-Whitney y Kruskal-Wallis con intervalo de confianza del 95 %. Resultados: el acto sexual se correlacionó negativamente con la reducción de la fuerza (ρ = -0,263; p < 0,001) y de la velocidad de marcha (ρ = -0,201; p = 0,001) y positivamente a la fadiga relatada (ρ = 0,149; p = 0,018). Las relaciones afectivas se correlacionaron negativamente a la reducción de la fuerza (ρ = -0,254; p < 0,001) y de la velocidad de marcha (ρ = -0,207; p = 0,001) y positivamente a la fadiga relatada (ρ = 0,207; p = 0,001). Por fin, las adversidades física y social se correlacionaron positivamente a la reducción de la fuerza (ρ = 0,279; p < 0,001), a la reducción de la velocidad de marcha (ρ = 0,261; p < 0,001) y a la baja actividad física (ρ = 0,140; p = 0,034), además de correlacionar negativamente con la fadiga relatada (ρ = -0,171; p = 0,009). Conclusiones: se encontró que la sexualidad de los ancianos se vivencia de mejor manera en las relaciones afectivas y correlaciones positivas y negativas de magnitud débil entre la sexualidad y la fragilidad.


Subject(s)
Public Health , Health of the Elderly , Comprehensive Health Care , Sexuality , Frailty
7.
Article in Chinese | WPRIM | ID: wpr-928688

ABSTRACT

OBJECTIVE@#To compare the efficacy and safety of different chemotherapy regimens in elderly multiple myeloma (MM) patients with different Frailty scores.@*METHODS@#The clinical data of elderly patients with MM were retrospectively analyzed, including age, treatment regimen, efficacy, adverse reactions, and the Frailty score included in the activity of daily living score, the instrumental activity of daily living scale and the Charlson comorbidity index. The patients were divided into fit group, mediate fit group and frail group according to the scoring standard. The treatment efficiency and adverse reaction rates of elderly MM with different physical conditions treated by different chemotherapy regimens were analyzed.@*RESULTS@#Among the 70 patients, the effective rates of the patients in fit group, the mediate fit group, and the frail group were 79.5%, 81%, and 40%, and the effective rates of the fit patients in double and triple groups were 54.5% and 89.3%, 70% and 90.9% for mediate fit patients, 42.9% and 33.3% for frail patients, the triple regimen in fit patients showed obvious advantages, and the difference showed statistically significant (P<0.05), while the efficacy for mediate patients and frail patients showed no significant difference. During the induction of bortezomib, the incidence of adverse reactions for the patients in the triple group (78.6%) was higher than 67.9% in the double group, and the difference showed no statistically significant (P>0.05).There was no significant difference in the 1-year overall survival rate of the patients and with molecular genetic abnormalities among each groups.@*CONCLUSION@#The therapeutic effect is related to the patient's physical condition. For patients with healthy physique, the triple regimen should be used first. For patients with weak physical constitution, the chemotherapy regimen with low drug toxicity should be selected for safety.


Subject(s)
Aged , Bortezomib , Frailty , Humans , Multiple Myeloma/drug therapy , Retrospective Studies
8.
Article in English | WPRIM | ID: wpr-927464

ABSTRACT

INTRODUCTION@#Adults aged ≥60 years contribute to disproportionately higher visits to the emergency departments (ED). We performed a systematic review to examine the reasons why older persons visit the ED in Singapore.@*METHODS@#We searched Medline, Embase and Scopus from January 2000 to December 2021 for studies reporting on ED utilisation by older adults in Singapore, and included studies that investigated determinants of ED utilisation. Statistically significant determinants and their effect sizes were extracted. Determinants of ED utilisation were organised using Andersen and Newman's model. Quality of studies was evaluated using Newcastle Ottawa Scale and Critical Appraisal Skills Programme.@*RESULTS@#The search yielded 138 articles, of which 7 were used for analysis. Among the significant individual determinants were predisposing (staying in public rental housing, religiosity, loneliness, poorer coping), enabling (caregiver distress from behavioural and psychological symptoms of dementia) and health factors (multimorbidity in patients with dementia, frailty, primary care visit in last 6 months, better treatment adherence). The 7 included studies are of moderate quality and none of them employed conceptual frameworks to organise determinants of ED utilisation.@*CONCLUSION@#The major determinants of ED utilisation by older adults in Singapore were largely individual factors. Evaluation of societal determinants of ED utilisation was lacking in the included studies. There is a need for a more holistic examination of determinants of ED utilisation locally based on conceptual models of health seeking behaviours.


Subject(s)
Aged , Aged, 80 and over , Emergency Service, Hospital , Frailty , Health Behavior , Humans , Middle Aged , Singapore
9.
Fisioter. Mov. (Online) ; 35: e35103, 2022. tab
Article in English | LILACS | ID: biblio-1364860

ABSTRACT

Abstract Introduction: Sex is one of the demographic characteristics that better differentiates the independence of the elderly, despite this distinction not being consensual. Objective: To know the differences in functioning associated with sex in elderly people aged ≥ 65 years according to the International Classification of Functioning, Disability, and Health (ICF). Methods: This was an analytical and cross-sectional observational study with a sample of 451 subjects. The instruments were a sociodemographic questionnaire identical to a ICF checklist and the Biopsychosocial Assessment Method. The student t, Mann-Whitney, chi-square, and Spearman correlation tests were used considering p < 0.05. Results: The average age was between 79.5 ± 7.5 years with a female prevalence (62.1%). Of the 43 variables studied, sex differences were found in 17 (39.5%). In the personal factors, women showed greater vulnerability in conjugality (p ≤ 0.001), cohabitation (p = 0.037), and economic income (p = 0.002). Nonetheless, they showed healthier behaviors in all health-related habits. As for environmental factors and body functions, greater fragility was once again observed in women: the need for assistive devices (p ≤ 0.001) and urinary incontinence (p = 0.021). In activities/participation, differences were found in mobility, where women experienced more restrictions, whereas men were more dependent on washing/drying clothes in domestic life (p = 0.022). Conclusion: Women are more unprotected in social and economic areas, while men showed more vulnerability in habits related to health. These differences are linked to demographic issues related to longevity, cultural differences, and socialization, and differences regarding activities/participation tend to dilute between sexes.


Resumo Introdução: O sexo é das caraterísticas demográficas que mais diferencia a independência dos idosos, apesar dessa distinção não ser consensual. Objetivo: Conhecer as diferenças da funcionalidade associadas ao sexo, de acordo com a Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) em idosos com idade ≥ 65 anos. Métodos: Estudo observacional, analítico e transversal com uma amostra de 451 indivíduos. Os instrumentos utilizados foram um questionário sociodemográfico idêntico à checklist da CIF e o Método de Avaliação Biopsicossocial. Utilizaram-se os testes de T-Student, Mann-Whitney, Qui-Quadrado e Correlação de Spearman, considerando-se p < 0,05. Resultados: A média de idade foi de 79,5 ± 7,5 anos, observando-se uma prevalência feminina (62,1%). Das 43 variáveis estudadas, foram encontradas diferenças entre os sexos em 17 (39,5%). Nos fatores pessoais, as mulheres apresentaram maior vulnerabilidade na conjugalidade (p ≤ 0,001), na coabitação (p = 0,037) e no rendimento econômico (p = 0,002). Em todos os hábitos relacionados com a saúde, contudo, revelaram comportamentos mais saudáveis. Nos fatores ambientais e nas funções do corpo, observou-se novamente maior fragilidade nas mulheres: na necessidade de dispositivos de auxílio (p ≤ 0,001) e na incontinência urinária (p = 0,021). Nas atividades/participação, as mulheres apresentaram maior restrição na mobilidade e os homens na vida doméstica (lavar/secar roupa p = 0,022). Conclusão: As mulheres apresentam-se mais desprotegidas nas dimensões social e econômica, enquanto os homens manifestam hábitos de saúde mais vulneráveis. Estas diferenças estão ligadas às questões demográficas de longevidade e às diferenças culturais e de socialização. As diferenças nos domínios das atividades/participação tendem a diluir-se entre os sexos.


Subject(s)
Humans , Male , Female , Aged , International Classification of Functioning, Disability and Health , Frailty , Life Style , Sex , Habits , Longevity
10.
Acta Paul. Enferm. (Online) ; 35: eAPE039009234, 2022. tab, graf
Article in Portuguese | LILACS, BDENF | ID: biblio-1374000

ABSTRACT

Resumo Objetivo Identificar a prevalência da fragilidade em idosos e o nível de funcionalidade familiar e analisar a associação dessas variáveis com características sociodemográficas e com o acesso aos serviços de saúde de idosos vinculados à Atenção Domiciliar tipo 1 da Atenção Primária à Saúde. Métodos Estudo transversal analítico, realizado por meio de visitas domiciliares, de outubro de 2018 a abril de 2019, com 124 idosos de 60 anos ou mais, vinculados à Atenção Domiciliar tipo 1 de um distrito sanitário de Porto Alegre. Utilizaram-se a Escala de Fragilidade de Edmonton, o APGAR da família e o questionário de dados sociodemográficos e de acesso ao serviço de saúde. Aplicaram-se o teste t de Student, o teste de Mann-Whitney, o teste do qui-quadrado, o teste exato de Fisher e o modelo de regressão de Poisson na análise estatística. Foi considerado como valor significativo p<0,05. Resultados A prevalência de fragilidade foi de 75%, e 84,7% dos idosos apresentaram bom nível de funcionalidade familiar. A fragilidade apresentou associação estatisticamente significativa, com maior faixa etária (p=0,009), elevado número médio de morbidades (p=0,027), presença de cuidador (p<0,001), não morar sozinho (p<0,001), défice cognitivo (p<0,001) e com forma de atendimento exclusivamente domiciliar (p<0,001). A funcionalidade familiar não apresentou associação estatisticamente significativa com as variáveis em estudo. Conclusão Houve alta prevalência de fragilidade e de boa funcionalidade familiar. Apenas a fragilidade esteve associada significativamente com algumas das variáveis em estudo. Conhecer essa população específica é imprescindível para que intervenções possam ser desenvolvidas, garantindo acesso aos serviços de saúde.


Resumen Objetivo Identificar la prevalencia de la fragilidad en adultos mayores y el nivel de funcionalidad familiar y analizar la asociación de esas variables con características sociodemográficas y con el acceso a los servicios de salud de adultos mayores vinculados a la Atención Domiciliaria tipo 1 de la Atención Primaria a la Salud. Métodos Estudio transversal analítico, realizado por medio de visitas domiciliarias, de octubre de 2018 a abril de 2019, con 124 adultos mayores de 60 años o más, vinculados a la Atención Domiciliaria tipo 1 de un distrito sanitario de Porto Alegre. Se utilizó la Escala de Fragilidad de Edmonton, el APGAR de la familia y el cuestionario de datos sociodemográficos y de acceso al servicio de salud. Se aplicaron la prueba t de Student, la prueba de Mann-Whitney, la prueba chi cuadrado, y la prueba exacta de Fisher y el modelo de regresión de Poisson en el análisis estadístico. Se consideró valor significante p<0,05. Resultados La prevalencia de fragilidad fue de 75 % y el 84,7 % de los adultos mayores presentaron un buen nivel de funcionalidad familiar. La fragilidad presentó una asociación estadísticamente significante, con mayor grupo de edad (p=0,009), elevado número promedio de morbilidades (p=0,027), presencia de cuidador (p<0,001), no vivir solo (p<0,001), déficit cognitivo (p<0,001) y con forma de atención exclusivamente domiciliaria (p<0,001). La funcionalidad familiar no presentó asociación estadísticamente significante con las variables en estudio. Conclusión Hubo una alta prevalencia de fragilidad y de buena funcionalidad familiar. Apenas la fragilidad estuvo asociada significantemente con algunas de las variables en estudio. Conocer a esa población específica es imprescindible para que se puedan desarrollar intervenciones, garantizando el acceso a los servicios de salud.


Abstract Objective To identify frailty prevalence and family functionality level in older people and analyze the association of these variables with sociodemographic characteristics and with access to health care services for older people linked to Home Care type 1 in Primary Health Care. Methods This is an analytical cross-sectional study, carried out through home care visits, from October 2018 to April 2019, with 124 older people aged 60 years or older, linked to Home Care type 1 in a health district in Porto Alegre. The Edmonton Frail Scale, the family APGAR and the sociodemographic data and access to health care service questionnaire were used. Student's t test, Mann-Whitney test, chi-square test, Fisher's exact test and Poisson regression model were applied in the statistical analysis. A significant value p<0.05 was considered. Results Frailty prevalence was 75%, and 84.7% of the older adults had a good family functionality level. Frailty had a statistically significant association, with a higher age group (p=0.009), a high average number of morbidities (p=0.027), presence of a caregiver (p<0.001), not living alone (p<0.001), cognitive decline (p<0.001) and exclusively home care (p<0.001). Family functionality did not show a statistically significant association with the variables under study. Conclusion There was a high frailty prevalence and good family functionality. Only frailty was significantly associated with some of the variables under study. Knowing this specific population is essential so that interventions can be developed, ensuring access to health care services.


Subject(s)
Humans , Middle Aged , Aged , Aged, 80 and over , Family , Morbidity , Frail Elderly , Frailty , Functional Status , House Calls , Cross-Sectional Studies , Surveys and Questionnaires
11.
Article in Portuguese | LILACS | ID: biblio-1353025

ABSTRACT

Fundamentos: Idosos que vivem na comunidade são propensos a desenvolver fragilidade, considerada como um estado clinicamente identificável que aumenta a vulnerabilidade a resultados adversos e prediz incapacidade e mortalidade na população idosa. Objetivo: Identificar a prevalência e fatores associados à fragilidade em idosos que vivem em uma comunidade. Método: Trata-se de um inquérito domiciliar transversal e analítico, de abordagem quantitativa realizado com 854 idosos que vivem na comunidade. A fragilidade foi mensurada pela Edmonton Frail Scale (EFS). A associação entre fragilidade e variáveis sociodemográficas e de condições clínicas foi mensurada pela análise múltipla por regressão logística. Resultados: A prevalência de fragilidade encontrada neste estudo foi de 12,3% (IC95%: 10,1 a 14,5). O modelo de regressão logística mostrou que as variáveis estatisticamente associadas à fragilidade foram: queda recorrente, uso de dispositivo para auxílio à marcha, polifarmácia, autopercepção ruim de saúde, dependência nas atividades básicas e instrumentais de vida diária. Conclusão: A prevalência de fragilidade em idosos foi baixa em comparação a outros estudos nacionais que empregaram a EFS. Os resultados indicaram múltiplos fatores associados à fragilidade modificáveis. Assim, a investigação da síndrome da fragilidade bem como dos seus fatores relacionados passíveis de prevenção são ações a serem incluídas na prática clínica. (AU)


Foundations: Elderly people living in the community are prone to developing frailty, considered as a clinically identifiable state that increases vulnerability to adverse events and predicts disability and mortality in the elderly population. Objective: To identify the prevalence and factors associated with frailty in the elderly living in the community. Materials and method: This is a cross-sectional and analytical household survey with a quantitative approach conducted with 854 elderly people living in the community. Frailty was measured by Edmonton Frail Scale (EFS). The association between frailty and sociodemographic and clinical condition variables was measured by multiple analysis using logistic regression. Results: The prevalence of frailty found in this study was 12.3% (95% CI: 10.1 to 14.5). The logistic regression model showed that the variables statistically associated with frailty were: recurrent fall, use of walking aids, polypharmacy, poor self-rated health, dependence on basic and instrumental activities of daily living. Conclusion: The prevalence of frailty in the elderly was low compared to other national studies that employed the SAI. Results indicated potentially modifiable factors associated with frailty. Thus, the investigation of frailty syndrome and its related preventable factors are actions to be included in clinical practice. (AU)


Subject(s)
Humans , Aged , Aged, 80 and over , Activities of Daily Living , Prevalence , Frail Elderly , Disease Prevention , Health Vulnerability , Frailty , Gait , Homes for the Aged , Methods
12.
Rev. argent. cir ; 113(4): 471-476, dic. 2021. graf
Article in Spanish | LILACS, BINACIS | ID: biblio-1356957

ABSTRACT

RESUMEN La traqueobroncomalacia es una enfermedad de la vía aérea central caracterizada por una debilidad de la pared, con disminución dinámica de la luz de la tráquea y grandes bronquios principalmente durante la espiración. Genera síntomas crónicos que pueden evolucionar hasta la falla respiratoria grave, frecuentemente diagnosticados de forma errónea como asma o enfermedad pulmonar obstructiva crónica (EPOC). Presentamos el caso de una paciente femenina de 70 años, con antecedente de artritis reumatoide y múltiples internaciones por cuadros respiratorios infecciosos en los 3 años previos.


ABSTRACT Tracheobroncomalacia is a disease of the central airway due to weakness of the wall with dynamic narrowing of the lumen of the trachea and mainstem bronchi during exhalation. It produces chronic symptoms that can progress to severe respiratory failure, often misdiagnosed as asthma or chronic obstructive pulmonary disease (COPD). We report the case of a 70-year-old female patient with a history of rheumatoid arthritis and multiple hospitalizations for recurrent respiratory infections over the past 3 years.


Subject(s)
Humans , Female , Aged , Tracheobronchomalacia , Tracheomalacia , Respiratory Insufficiency , Asthma , Signs and Symptoms , Trachea , Bronchi , Exhalation , Tracheobronchomalacia/complications , Frailty
13.
Säo Paulo med. j ; 139(6): 570-575, Nov.-Dec. 2021. tab
Article in English | LILACS | ID: biblio-1352297

ABSTRACT

ABSTRACT BACKGROUND: The population with chronic kidney disease (CKD) is more predisposed to early development of frailty. Although the concept of frailty is well established from a physical point of view, it is not an exclusively physical syndrome. It can be characterized as an interaction of physical, psychological and social factors. OBJECTIVE: To ascertain the relationship between frailty, social support and family functionality among CKD patients undergoing hemodialysis. DESIGN AND SETTING: Correlational, cross-sectional and quantitative study conducted at a service in the interior of the state of São Paulo. METHODS: This study included 80 patients with CKD who were on hemodialysis. The participants were interviewed individually, with application of the following instruments: sociodemographic and economic characterization, Tilburg Frailty Indicator, Medical Outcomes Study and Family APGAR. Females and white ethnicity predominated among the participants, and their mean age was 59.63 ± 15.14 years. RESULTS: There was high prevalence of frailty (93.8%). Although there was a difference in scores for the dimensions of social support between the frail group and the non-frail group, only family functionality reached a statistically relevant difference. There was a significant correlation between physical frailty, social support and family functionality. CONCLUSIONS: Presence of frailty is related to the social support and family functionality of patients with CKD undergoing hemodialysis.


Subject(s)
Humans , Female , Adult , Aged , Frailty/epidemiology , Social Support , Brazil/epidemiology , Geriatric Assessment , Cross-Sectional Studies , Frail Elderly , Renal Dialysis , Middle Aged
14.
Rev. Hosp. Ital. B. Aires (2004) ; 41(4): 176-179, dic. 2021. graf, ilus, tab
Article in Spanish | LILACS, BINACIS, UNISALUD | ID: biblio-1366810

ABSTRACT

En la medida en que el crecimiento poblacional continúe en aumento, la cantidad de adultos mayores que sufran patología oncológica será cada vez mayor. Esta población, por su heterogeneidad y su comorbilidad diferente de la del adulto joven, requiere un manejo más específico e individualizado. La realización de una valoración geriátrica integral y el trabajo multidisciplinario, colaborarán en la toma de decisiones con el fin de priorizar la calidad de vida de cada paciente en particular y optimizar el manejo de los pacientes vulnerables. (AU)


As the population grows, there will be more cancer diagnoses in the elderly population. This group, due to its heterogeneity and comorbidities different from those of young adults, requires a specific and individualized assessment. The geriatric assessment and multidisciplinary work, together, would help in decision-making in order to prioritize the quality of life of each patient and optimize management of the vulnerable patients.Key words: elderly, geriatric assessment, frailty, cancer, sarcopenia, abilities of daily living. (AU)


Subject(s)
Humans , Aged , Aged, 80 and over , Geriatric Assessment/methods , Sarcopenia/diagnosis , Frailty/diagnosis , Functional Status , Neoplasms , Quality of Life , Health of the Elderly , Risk Factors , Frail Elderly
15.
Int. j. cardiovasc. sci. (Impr.) ; 34(5,supl.1): 78-86, Nov. 2021. tab, graf
Article in English | LILACS | ID: biblio-1346350

ABSTRACT

Abstract Background There is no consensus among tools for assessing frailty. Objective To evaluate the prevalence of frailty according to different tools in patients referred for elective valve cardiac surgery. Methods This is a cross-sectional study. All patients were ≥ 18 years of age, clinically stable. The following patients were excluded: those unable to perform the tests because of physical, cognitive, or neurological limitations; those requiring non elective/emergency procedures or hemodynamic instability. During the preoperative cardiology visit, frailty was assessed by the Short Physical Performance Battery (SPPB), the Frailty Deficit Index (FDI), handgrip strength, and gait speed 3m. For the entire analysis, the statistical significance was set at 5%. Results Our cohort consisted of 258 subjects. From the total cohort, 201 were ≤ 70 years of age (77.9%), the predominant etiology according to rheumatic disease (50.7% vs 8.8%; p=0.000) with double mitral lesion (24.9% vs 0%; p=0.000). Frailty was present in 32.9% according SPPB, 29.1% with reduced muscular strength. and 8.9% with FDI. Handgrip strength was weaker in elderly patients (26.7 vs 23.6; p=0.051) and gait speed was lower in the younger group, in which 36% were considered frail (36% vs 14%; p=0.002). Variables associated with frailty were age ≥ 70 years, female gender, aortic stenosis, and regurgitation. Conclusion Frailty in adult patients who will have elective heart valve surgery is present even in the younger groups, although the older group with comorbidities are more frail. Frailty was more clearly shown by the SPPB than by the FDI and handgrip tests.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Aortic Valve Stenosis/surgery , Frail Elderly , Frailty/diagnosis , Heart Valves/surgery , Rheumatic Diseases , Prevalence , Cross-Sectional Studies , Preoperative Period , Walking Speed , Frailty/epidemiology , Gait Analysis , Cardiac Surgical Procedures
16.
Ciênc. Saúde Colet ; 26(supl.3): 5089-5098, Oct. 2021. tab, graf
Article in English | LILACS | ID: biblio-1345723

ABSTRACT

Abstract This article aims to investigate whether difficulty in taking medication is associated with stroke among older adults with Systemic Arterial Hypertension (SAH) and to explore their association with living arrangements. Cross-sectional study was based on 3,502 older adults with SAH from the four universities pole of Frailty in Brazilian Older People (Fibra) Study, Brazil, including 14 municipalities of the five Brazilian regions. We used the medical diagnosis of stroke and difficulty in taking medications (self-reported difficulty and financial difficulty affording prescribed medications). Multivariate analysis was performed using logistic regression. Differently from women, older men with SAH, which report difficulty in taking medication (unintentional non-adherence), have higher odds of stroke. When stratified by living arrangements, those living with a partner have even higher odds of stroke compared to those without difficulty in taking medication and living alone. None association was found for difficulty affording prescribed medication for both men and women. Unintentional difficulty in taking medication plays a role in SAH treatment among men. Primary care strategies for controlling blood pressure should not be focus only on patients but targeting spouses as well.


Resumo O objetivo deste artigo é investigar se a dificuldade em tomar medicamentos está associada ao acidente vascular encefálico (AVE) entre idosos com hipertensão arterial sistêmica (HAS) e explorar esta associação com arranjos familiares. Estudo seccional baseado em 3.502 idosos com HAS dos quatro polos do Estudo Fibra, Brasil, incluindo 14 cidades das cinco regiões brasileiras. Foi usado o diagnóstico médico de AVE e a dificuldade em tomar medicamentos (dificuldade autorrelatada e dificuldade financeira). Utilizou-se a regressão logística na análise multivariada. Diferentemente das mulheres, homens com HAS que relataram dificuldade em tomar medicamentos (não adesão não intencional) apresentam maior chance de ter AVE. Quando estratificado por arranjos familiares, homens que moravam com o cônjuge apresentaram chance ainda maior de ter AVE, quando comparados com aqueles sem dificuldade em tomar medicamentos e que vivem sozinhos. Nenhuma associação foi encontrada para dificuldade financeira, tanto para mulheres quanto para homens. Dificuldades não intencionais em tomar medicamentos têm um papel importante no controle da HAS entre homens. Estratégias de controle da pressão arterial realizadas na atenção primária não devem focar apenas nos pacientes, mas nos cônjuges destes pacientes.


Subject(s)
Humans , Male , Female , Aged , Stroke/epidemiology , Frailty , Hypertension/epidemiology , Blood Pressure , Cross-Sectional Studies , Medication Adherence
17.
Int. j. med. surg. sci. (Print) ; 8(3): 1-11, sept. 2021. tab
Article in Spanish | LILACS | ID: biblio-1292479

ABSTRACT

El síndrome de fragilidad se caracteriza por una mayor vulnerabilidad y riesgo de deterioro funcional y cognitivo ante un mínimo estrés, siendo la demencia una de las principales causas de discapacidad y dependencia entre los adultos mayores a nivel global, con un impacto físico, psicológico, social y económico no solo en las personas que la padecen, sino también en sus cuidadores. El objetivo de este estudio fue determinar la prevalencia de demencia según fenotipos de fragilidad y estimar la asociación de fragilidad y demencia en adultos mayores. Se tomó como referencia la base de datos del estudio Envejecimiento y Alzheimer (10-66), realizándose una investigación descriptiva de corte transversal, en 2024 adultos mayores de 65 años pertenecientes a siete áreas de salud de La Habana, Cuba. Se efectuó un análisis univariado para los efectos independientes de cada una de las variables y la variable de respuesta o dependiente (demencia) considerando esta asociación significativa cuando (p≤0.001) o por criterio de expertos y un análisis multivariado a través de la Regresión de Poisson. Existió una alta prevalencia de demencia en los sujetos con fragilidad 30,6 %(IC 95 % 22,4 - 39,6), donde la relación entre las mismas mostró una asociación significativa. Las personas frágiles presentaron un riesgo mayor de padecer demencia, con un PR 2.74 (IC 95% 2,29-3,29). La fragilidad se comportó como un factor de riesgo para el desarrollo de demencia.


Frailty syndrome is characterized by a greater vulnerability and risk of functional and cognitive deterioration in the face of minimal stress, with dementia being one of the main causes of disability and dependency among older adults globally, with a physical, psychological, and social impact. and economic not only in the people who suffer from it, but also in their caregivers. The objective of this study was to determine the prevalence of dementia according to frailty phenotypes and to estimate the association of frailty and dementia in older adults. The database of the Aging and Alzheimer study (10-66) was taken as a reference, carrying out a descriptive cross-sectional investigation in 2024 adults over 65 years of age belonging to seven health areas in Havana, Cuba. A univariate analysis was carried out for the independent effects of each of the variables and the response or dependent variable (dementia), considering this significant association when (p≤0.001) or by expert criteria and a multivariate analysis through the regression of Poisson. There was a high prevalence of dementia in subjects with frailty 30.6% (95% CI 22.4 - 39.6), where the relationship between them showed a significant association. Frail people had a higher risk of suffering from dementia, with a PR 2.74 (CI 95% 2.29-3.29). Frailty behaved as a risk factor for the development of dementia.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Frail Elderly , Dementia/epidemiology , Frailty/epidemiology , Epidemiology, Descriptive , Prevalence , Risk Factors , Sex Distribution , Age Distribution , Cuba/epidemiology
18.
Säo Paulo med. j ; 139(4): 319-324, Jul.-Aug. 2021. tab
Article in English | LILACS | ID: biblio-1290246

ABSTRACT

ABSTRACT BACKGROUND: Frailty is a condition that can increase the risk of falls. In addition, foot disorders can negatively influence elderly people, thus affecting their condition of frailty. OBJECTIVE: To determine whether foot pain can influence a greater degree of frailty. DESIGN AND SETTING: Cross-sectional descriptive study conducted at the University of Valencia, Valencia, Spain. METHODS: A sample older than 60 years (n = 52), including 26 healthy subjects and 26 foot pain patients, was recruited. Frailty disability was measured using the 5-Frailty scale and the Edmonton Frailty scale (EFS). RESULTS: There were statistically significant differences in the total EFS score and in most of its subscales, according to the Mann-Whitney U test (P < 0.05). In addition, foot pain patients presented worse scores (higher 5-Frailty scores) than did healthy patients, regarding matched-paired subjects (lower EFS scores). With regard to the rest of the measurements, there were no statistically significant differences (P > 0.05). The highest scores (P < 0.001) were for fatigue on the 5-Frailty scale and the EFS, and for the subscale of independence function in EFS. CONCLUSIONS: These elderly patients presented impairment relating to ambulation and total 5-Frailty score, which seemed to be linked to the presence of frailty syndrome and foot disorders.


Subject(s)
Humans , Aged , Frailty/complications , Frailty/epidemiology , Pain/etiology , Pain/epidemiology , Case-Control Studies , Cross-Sectional Studies , Frail Elderly
19.
Estud. Interdiscip. Psicol ; 12(2): 23-37, maio-ago.2021. Tab
Article in Portuguese | LILACS | ID: biblio-1354065

ABSTRACT

A síndrome de fragilidade é uma condição clínica em que se observa um aumento no estado de vulnerabilidade do indivíduo envolvendo diversos fatores de ordem biopsicossociais. O objetivo foi investigar o desempenho cognitivo, sintomas depressivos e fragilidade entre idosos ribeirinhos amazônicos, bem como a associação entre essas variáveis. Trata-se de um estudo observacional do tipo transversal de abordagem quantitativa realizado no município de Cametá, Pará, Brasil. Participaram do estudo 108 idosos, a coleta de dados foi por meio do fenótipo de fragilidade postulado por Fried et al. (2001) modificado, Miniexame do Estado Mental (MEEM) e Escala de Depressão Geriátrica (EDG-15). Constatou-se que a maioria dos ribeirinhos foram classificados como idosos não frágeis, além disso, o comprometimento cognitivo e a presença de sintomas depressivos consolidaram-se como fatores associados à condição de fragilidade (p = 0.0468 e p = 0.0032). Por fim, destaca-se a importância da gestão da fragilidade em idosos de comunidades tradicionais brasileiras (AU).


The frailty syndrome is a clinical condition in which the individual´s state of vulnerability is increased, involving several biopsychosocial factors. The aim was to investigate the study cognitive performance, depressive symptoms and frailty among elderly riverside Amazonians, as well as the association between these variables. This is an observational cross-sectional study with a quantitative approach carried out in the city of Cametá, Pará, Brazil. 108 elderly people participated in the study. Data collection was performed using the frailty phenotype postulated by Fried et al. (2001) modified, Mini Mental State Examination (MMSE) and Geriatric Depression Scale (GDS-15). It was found that most riverside dwellers were classified as non-frail elderly, in addition, cognitive impairment and the presence of depressive symptoms were consolidated as factors associated with the frail condition (p = 0.0468 and p = 0.0032). Finally, the importance of management failty in the elderly in traditional Brazilian communities is highlighted (AU).


El síndrome de fragilidad es una condición clínica en la que se incrementa el estado de vulnerabilidad del individuo, involucrando varios factores biopsicosociales. El objetivo fue investigar el estudio del rendimiento cognitivo, los síntomas depresivos y la fragilidad en comunidades ancianas ribereñas de la Amazonía, así como la asociación entre estas variables. Se trata de un estudio observacional transversal con enfoque cuantitativo realizado en la ciudad de Cametá, Pará, Brasil. 108 personas mayores participaron en el estudio. La recolección de datos se realizó utilizando el fenotipo de fragilidad postulado por Fried et al. (2001) modificado, Mini Examen del Estado Mental (MMSE) y Escala de Depresión Geriátrica (GDS-15). Se encontró que la mayoría de los ribereños fueron clasificados como ancianos no frágiles, además, el deterioro cognitivo y la presencia de síntomas depresivos se consolidaron como factores asociados a la condición frágil (p = 0.0468 yp = 0.0032). Finalmente, se destaca la importancia de manejar em los ancianos en las comunidades brasileñas tradicionales (AU).


Subject(s)
Humans , Male , Female , Aged , Amazonian Ecosystem , Depression , Efficiency , Frailty , Residence Characteristics
20.
Säo Paulo med. j ; 139(3): 226-233, May-June 2021. tab
Article in English | LILACS | ID: biblio-1252245

ABSTRACT

ABSTRACT BACKGROUND: Existence of an association between sedentary behavior and frailty among older adults has been suggested. However, there is a lack of studies conducted in Brazil, especially in areas of the Amazon region. OBJECTIVE: To analyze the association between frailty syndrome and sedentary behavior among community-dwelling older adults. DESIGN AND SETTING: Cross-sectional study carried out in Macapá, state of Amapá, Brazil. METHODS: Frailty status was assessed using Fried's frailty phenotype, and sedentary behavior was evaluated using two questions concerning time spent in a seated position, from the International Physical Activity Questionnaire (IPAQ). A multinomial logistic regression model was used to verify the association between frailty syndrome and sedentary behavior. RESULTS: The final study sample was made up of 411 older adults with a mean age of 70.14 ± 7.25 years and an average daily duration of sedentary behavior of 2.86 ± 2.53 hours. The prevalence of non-frailty was 28.7%, prevalence of pre-frailty was 58.4% and prevalence of frailty was 12.9%. The adjusted analysis showed that there were independent associations between sedentary behavior and pre-frailty (odds ratio, OR = 1.18; 95% confidence interval, CI: 1.03-1.34) and between sedentary behavior and frailty (OR = 1.20; 95% CI: 1.02-1.40). CONCLUSION: Frailty and pre-frailty status were associated with sedentary behavior among community-dwelling older adults.


Subject(s)
Humans , Middle Aged , Aged , Frailty/epidemiology , Brazil/epidemiology , Geriatric Assessment , Cross-Sectional Studies , Frail Elderly , Sedentary Behavior , Independent Living
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