Predictors of Frailty Transitions in Mexican Older Adults.

BACKGROUND: Frailty is a dynamic state in older adults. Current evidence, mostly in high-income countries, found that improving frailty is more likely in mild states (prefrailty). We aimed to determine the probability of frailty transitions and their predictors. METHODS: Participants were adults aged 50 years or over from the Study on Global Ageing and Adult Health in Mexico during 4 waves (2009, 2014, 2017, and 2021). We defined frailty with the frailty phenotype and we used multinomial logistic models to estimate the probabilities of frailty transitions and determine their predictors. RESULTS: For the 3 analyzed periods (2009-2014, 2014-2017, and 2017-2021), transition probabilities from frail to robust were higher for the younger age group (50-59 years) at 0.20, 0.26, and 0.20, and lower for the older age group (≥80 years), 0.03, 0.08 and 0.04. Transitioning from prefrail to robust had probabilities of 0.38, 0.37, and 0.35, for the younger age group, and 0.09, 0.18, and 0.10, for the older age group. The probabilities of transitioning to frail and to death were lower for the younger age group and for the robust at baseline; but higher for the older age group and for the frail at baseline. We identified age, disability, and diabetes as the most significant predictors of frailty transitions. CONCLUSIONS: These findings show that frailty has a dynamic nature and that a significant proportion of prefrail and frail individuals can recover to a robust or prefrail state. They also emphasize that prefrailty should be the focus of interventions.

Association of Newly Diagnosed Hypertension and Polypharmacy with Frailty in a Tertiary Hospital Patients from Maracaibo City, Venezuela.

BACKGROUND: As a syndrome of physiological vulnerability and multifactorial progressive decline tightly related to age, frailty has been associated with several illnesses, and in particular cardiovascular disease. OBJECTIVE: To assess the factors associated with the frailty syndrome in older adults evaluated in the outpatient clinic of a tertiary hospital from Maracaibo city, Venezuela. MATERIALS AND METHODS: An observational, analytical, cross-sectional study was performed on subjects of both genders, over 60 years old that went to the Internal Medicine outpatient clinic of the Hospital General del Sur "Dr. Pedro Iturbe" from Maracaibo city, Venezuela. Sampling was performed via a non-probabilistic, intentional method. For each subject with frailty or pre-frailty, a control subject was selected in a 1:1 ratio according to gender; several risk factors were interrogated. The state of frailty was determined through the FRAIL scale. RESULTS: Of the 201 assessed patients, 49.3% (n=99) were non-frail, 19.9% (n=40) were pre-frail and 30.8% (n=62) were frail. The population's overall age was 68.8±6.8 in non-frails, 69.1±7.7 in pre-frails, and 68.6±7.1 in frails. In the multivariate analysis, subjects with frailty and pre-frailty were most likely to be receiving polypharmacy (OR: 2.36, CI95%: 1.05-5.37; P=0.04) and have hypertension during the study (OR: 10.19, CI95%: 3.86-26.89; P<0.01). CONCLUSION: The newly diagnosed hypertension and presence of polypharmacy were the factors most associated with frailty and pre-frailty in older adults evaluated in a tertiary hospital from Maracaibo city, Venezuela.

Frailty and depressive symptoms in older adults: data from the FIBRA study - UNICAMP

Abstract The relationship between the presence of depression, as measured by total score on the GDS-15 scale, and both pre-frailty and frailty status in community-dwelling elderly was determined. Two thousand four hundred and two elderly residents from seven Brazilian cities (M = 72.3 years, SD = 5.5; 66 % female) were evaluated according to the five criteria comprising the frailty phenotype. Participants answered a self-report inventory of diseases, of performance on advanced and instrumental activities of daily living, and the Geriatric Depression Scale (GDS-15). The number and types of depressive symptoms were found to be higher among frail and pre-frail elderly. Thus, besides variability in depression prevalence among the frailty profiles there were also characteristic depressive symptoms for each profile of the syndrome. (AU)

Costo de la atención médica de pacientes con síndrome de fragilidad vs. pacientes con pre-fragilidad / Cost of patients care with fragility syndrome vs. pre-frailty patients

Introducción: el síndrome clínico de fragilidad se ha relacionado con eventos adversos como caídas, discapacidad, el estado cognitivo, hospitalizaciones e incluso la muerte, implicando con ello un mayor uso de los servicios de salud y de recursos. Objetivo: determinar el costo de la atención médica de pacientes con síndrome de fragilidad vs. pre-fragilidad. Métodos: estudio de costos en pacientes adultos mayores adscritos a tres unidades de medicina familiar que recibieron atención de enero 2011 a mayo de 2013. Se incluyeron expedientes de pacientes adultos mayores. Se integraron dos grupos: frágiles y pre-frágiles. El tamaño de la muestra (n=64) se calculó con la fórmula de promedios para dos poblaciones. La técnica muestral fue aleatoria estratificada, empleando como marco de muestra el listado de pacientes adultos mayores. Se estudiaron características sociodemográficas, de salud, perfil de uso de los servicios de medicina familiar, rayos x y laboratorio, y costos (costo unitario, costo promedio y costo promedio total). El análisis estadístico incluyó promedios y porcentajes. Resultados: la prevalencia de la hipertensión arterial en el grupo de pre-frágiles es 80,7 % y en el grupo frágil 95,5 %. La enfermedad con mayor tiempo de evolución en el grupo de pacientes con pre-fragilidad es la hipertensión arterial con 12,13 años y en el grupo de fragilidad la diabetes con promedio de 15,50. En pacientes frágiles el promedio de glucosa es de 156,67 mg/dl. El costo promedio total en el paciente con fragilidad es de $1 911,02 y en el paciente pre-frágil de $1 802,48. Conclusiones: el costo promedio total en ambos grupos presenta mínima diferencia, y su costo se relaciona con la inclusión del tratamiento de las enfermedades crónicas.

Introduction: the clinical syndrome of frailty has been linked to adverse events such as falls, disability, cognitive status, hospitalization and even death, implying greater use of health services and resources. Objective: determine the care cost of fragility syndrome patients vs. pre-frailty patients. Methods: acost study was conducted on elderly patients assigned to three family medicine units that received attention from January 2011 to May of 2013. Elderly patients' records were included. Two groups were formed: Pre-frail and fragile. The sample size (n = 64) was calculated with the average formula for two populations. The stratified random sampling technique was used as a framework for the list of elderly patients. Socio-demographic characteristics and other variables were studied: health, usage profile of family medicine services, x-rays and lab, and costs (unit cost, average cost and average total cost). Statistical analysis included averages and percentages. Results: the prevalence of hypertension is 80.7% in pre-frail group and 95.5% in the fragile group. Hypertension has the longest history in the pre- fragility group of patients with 12-13 years and diabetes has the longest history in the fragility group with average of 15, 50. In frail patients average glucose is 156.67 mg / dl. The total average cost in patients with fragility is $ 1 911.02 and $ 1 802.48 in pre-frail patients. Conclusions: the total average cost in both groups has minimal difference and its cost is related to the inclusion of treatment of chronic diseases.