Frailty syndrome in an independent urban population in Brazil (FIBRA study): a cross-sectional populational study

ABSTRACT: CONTEXT AND OBJECTIVE: Frailty is a multifactorial syndrome. The aim of this study was to determine the prevalence and characteristics of frailty syndrome in an elderly urban population. DESIGN AND SETTING: Cross-sectional study carried out at the homes of a randomized sample representing the independent elderly individuals of Ribeirão Preto, Brazil. METHODS: Sociodemographic characteristics, clinical data and criteria of the frailty phenotype were obtained at the subjects' homes; 385 individuals were evaluated. Frailty was defined based on detection of weight loss, exhaustion, weakness, slowness and low physical activity level. Individuals with three or more of these characteristics were classified as frail and those with one or two as pre-frail. Specific cutoff points for weakness, slowness and low physical activity level were calculated. RESULTS: The participants' mean age was 73.9 ± 6.5 years, and 64.7% were women. 12.5% had lost weight over the last year; 20.5% showed exhaustion, 17.1% slowness, 24.4% low physical activity level and 20.5% weakness. 9.1% were considered frail and 49.6% pre-frail. Frail subjects were older, attended more medical visits, had a higher chance of hospitalization within the last 12 months and had more cerebrovascular events, diabetes, neoplasms, osteoporosis and urinary and fecal incontinence. CONCLUSION: In this independent elderly population, there were numerous frail and pre-frail individuals. Frailty syndrome was associated with high morbidity. Cutoff points for weakness, slowness and low physical activity level should be adjusted for the population under study. It is essential to identify frail and pre-frail older individuals for appropriate interventions.

摘要：
背景与研究目的：衰弱是一种多因素综合征。本研究旨在明确巴西城市老年人群中衰弱综合征的患病率与特征。
设计与研究场景：本研究为横断面研究，在代表巴西里贝朗普雷图市独立老年人群的随机抽样对象的家中开展。
方法：在研究对象家中收集其社会人口学特征、临床数据以及衰弱表型的相关标准；共评估385名受试者。衰弱的定义基于体重下降、疲惫感、肌力减退、行动迟缓以及低体力活动水平这五项指标。具备三项及以上上述特征的个体被归类为衰弱者，具备一项或两项者则为衰弱前期者。研究还针对肌力减退、行动迟缓及低体力活动水平计算了特定截断值。
结果：受试者的平均年龄为73.9±6.5岁，其中64.7%为女性。12.5%的受试者在过去一年中出现体重下降；20.5%存在疲惫感，17.1%存在行动迟缓，24.4%存在低体力活动水平，20.5%存在肌力减退。9.1%的受试者被判定为衰弱者，49.6%为衰弱前期者。衰弱受试者年龄更大、就医次数更多，在过去12个月内住院的概率更高，且更易发生脑血管事件、罹患糖尿病、肿瘤、骨质疏松症以及尿便失禁。
结论：在该独立老年人群体中，衰弱者与衰弱前期者占比颇高。衰弱综合征与高发病率相关。针对肌力减退、行动迟缓及低体力活动水平的截断值应根据本研究人群进行调整。识别衰弱及衰弱前期的老年个体以开展针对性干预至关重要。