Prevalence and factors associated to frailty in institutionalized elderly of Southeastern and Middle-Western Brazil

AIMS: To estimate the prevalence of frailty and identify the associated factors in residents of homes for the aged of Southeast and Middle West regions of Brazil. METHODS: Sectional study with 442 institutionalized elderly in four Brazilian municipalities. Frailty was assessed using the Brazilian version of the Tilburg Frailty Indicator (TFI). The characteristics of the study population were described and the prevalence of frailty was estimated. Means of the total score of TFI and of the scores of its domains were verified. Poisson's regression was applied to explore the observed associations, after adjustment for confounding. RESULTS: The study population was predominantly male (64.3%) and schooled (74.1%) and mean age was 75.0 (9.9) years. Prevalence of frailty was 52.0%. The mean of TFI's total score was 4.9 (2.5) points and the means of domains physical, psychological and social were, respectively, 2.8 (1.7), 1.3 (0.9) and 0.8 (0.8). The following variables were associated with frailty in institutionalized elders: advanced age, illiteracy, comorbidity and polipharmacy. In the multivariate model, only the associations with illiteracy and comorbidity maintained statistical significance (PR=1.28 CI95% 1.07-1.54 and PR=1.48 CI95% 1.21-1.81). CONCLUSIONS: The prevalence of frailty was higher than the observed in two other studies that assessed this condition in institutionalized elders. The identified associations are corroborated by the scientific literature. The TFI is a multidimensional instrument based on an integral concept of frailty and the Brazilian version was adequate to evaluate this condition in institutionalized elders. However, it is important to conduct studies to assess its usefulness in elderly community residents.

目的：评估巴西东南部与中西部地区养老机构老年人的衰弱患病率，并明确其相关影响因素。方法：本研究为横断面研究，纳入巴西4个市镇的442名机构养老老年人。采用巴西版蒂尔堡衰弱指数量表（Tilburg Frailty Indicator, TFI）对衰弱状态进行评估。对研究人群的特征进行描述，估算衰弱患病率，统计TFI总分及各维度得分的均值。在校正混杂因素后，采用泊松回归分析探索所观察到的关联。结果：研究人群以男性为主（占比64.3%），受教育率为74.1%，平均年龄为75.0（9.9）岁。衰弱患病率为52.0%。TFI总均分为4.9（2.5）分，躯体、心理及社会维度得分均值分别为2.8（1.7）、1.3（0.9）及0.8（0.8）分。机构养老老年人的衰弱与以下变量相关：高龄、文盲状态、共病及多重用药。在多因素模型中，仅文盲状态与共病的关联仍具有统计学意义（PR=1.28，95%CI95%：1.07~1.54；PR=1.48，95%CI95%：1.21~1.81）。结论：本研究中衰弱患病率高于另外两项针对机构养老老年人的同类研究结果。本研究发现的关联已得到科学文献的佐证。TFI是基于衰弱完整概念的多维度评估工具，其巴西本土化版本可有效用于机构养老老年人的衰弱评估。不过仍需开展相关研究以评估其在社区老年人群中的应用价值。