ABSTRACT
OBJECTIVE: Verify the prevalence of frailty and its associated factors in institutionalized older people. METHODS: Cross-sectional study carried out in 10 nursing homes in Natal (Brazil), between October/2013 and January/2014. All institutionalized older people 60+ that were not hospitalized, in terminal state, coma or under palliative care were included in the study. The dependent variable of the study was the presence/absence of frailty, classified according to the following criteria: severe cognitive decline and/or impossibility of independent walking or being bedridden. The 5 criteria (muscular weakness, unintentional weight loss, low physical activity level, slowness and exhaustion) of Fried et al. were considered for those with preserved cognitive and walking capacity. The chi-square test or Fisher's test and logistic regression were used for bivariate and multiple analysis, respectively. Sociodemographic, institution-related and health-related variables were also included. RESULTS: Of the 321 participating older people, 80.1% were considered frail, 16.8% pre-frail and 3.1% non-frail. The final model demonstrated association of frailty with age (OR=2.67; 95%CI 1.39-5.14; p=0.003), presence of chronic diseases (OR=10.27; 95%CI 3.42-30.90; p<0.001), systemic arterial hypertension (OR=0.11; 95%CI 0.05-0.27; p<0.001) and institutionalization due to lack of caregiver (OR=2.55; 95%CI 1.36-4.76; p=0.003) adjusted by sex and type of institution. DISCUSSION: Frailty was highly prevalent in institutionalized older people and its association with multi-factor aspects suggested that action of health services and government representations could aid in the prevention or delay of frailty onset, improving the life quality of older people.
ABSTRACT
BACKGROUND AND PURPOSE: Although functional assessments and programs to prevent activity limitations are fundamental for efficient geriatric evaluations and interventions, these procedures have not been satisfactorily explored at nursing homes in Brazil. Literature is scarce on the evaluation of disability in Brazilian institutionalized older people. METHODS: A cross-sectional study was conducted in 10 nursing homes in the city of Natal (Northeast Brazil). Sociodemographic and health data were collected and activity limitations were assessed by the Katz Index. RESULTS AND DISCUSSION: The prevalence of activity limitations was 72.9% (95% confidence interval: 67.8-77.5) and the most affected activity was "bathing" (71.6%), followed by "dressing" (65.4%) and "toileting" (62.0%). The final model revealed associations with private (for-profit) institutions (odds ratio [OR] = 3.33; P < .001), age ≥ 83 years (OR = 2.34; P = .003), institutionalization due to lack of caregiver (OR = 1.80; P = .033), and presence of osteoporosis (OR = 2.94; P = .045), adjusted by sex. CONCLUSIONS: Activity limitations affected almost 73% of institutionalized older people in this sample and were associated with private nursing homes, age, osteoporosis, and institutionalization due to lack of caregiver. Activity limitations exact high socioeconomic impacts and affect the quality of life of older people. The results obtained herein emphasized the importance of planning strategies for their prevention and treatment, directed to reduce the prevalence of this health issue.
