8
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Prevalencia y factores asociados de fragilidad en adultos mayores de 70 años en la comunidad Translated title: Prevalence and associated factors of frailty in adults over 70 years in the community

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Objetivo

          Estimar la prevalencia y analizar los factores asociados al síndrome de fragilidad en adultos ≥ 70 años, pertenecientes a un centro de salud de Asturias.

          Diseño

          Estudio observacional transversal.

          Emplazamiento

          Centro de Salud El Llano, Asturias.

          Participantes

          Adultos ≥ 70 años.

          Mediciones principales

          La fragilidad se definió por la presencia de ≥ 3 criterios del fenotipo de fragilidad de Fried. Variables secundarias: características sociodemográficas, estado de salud, estado funcional, estado cognitivo-afectivo y riesgo social. Se realizó un análisis bivariante y regresión logística.

          Resultados

          Se incluyeron 408 participantes con una edad media de 79,8 (DE 6,6) años, el 59,1% eran mujeres. La prevalencia de fragilidad fue del 27,7% y del 44,9% para la prefragilidad. El perfil sociodemográfico es de una mujer (77%), de elevada edad (> 84 años) (50,4%), sin estudios (65,5%), viuda (48,7%), con bajo nivel económico (47,8%) y en riesgo social (OR: 3,3; IC 95%: 2,5-4). Los factores que se asociaron estadísticamente con el síndrome de fragilidad fueron: comorbilidad alta (OR: 2,7; IC 95%: 1,5-5), polimedicación (OR: 1,9; IC 95%: 1,3-3), percepción de la calidad de vida con la salud (OR: 0,95; IC 95%: 0,93-0,97); deambulación alterada (OR: 17,9; IC 95%: 7,1-45,3), apoyo para la marcha (OR: 10,5; IC 95%: 4,7-23,4), alto riesgo de caídas (OR: 6,4; IC 95%: 3,8-10,8), dependencia para las ABVD (OR: 4; IC 95%: 2,4-6,6), AIVD (OR: 9,7; IC 95%: 4,7-20), discapacidad (OR: 37,7; IC 95%: 52,2-274,5), deterioro cognitivo (OR: 4,1; IC 95%: 1,8-9,3) y depresión (OR: 4,8; IC 95%: 2,7-8,7).

          Conclusiones

          La fragilidad es un síndrome multifactorial de elevada prevalencia en los mayores de 70 años, en el que además de los criterios de fragilidad de Fried deben de ser analizados aspectos del estado de salud, funcionales, cognitivos-afectivos y sociales.

          Translated abstract

          Objective

          To estimate the prevalence and analyze the factors associated with frailty syndrome, in adults ≥70 years old, belonging to a health center in Asturias.

          Design

          Observational cross-sectional study.

          Participants

          Adults ≥70 years of age.

          Site

          Health Centre of Llano (Asturias).

          Main measurements

          Frailty was defined by the presence of ≥3 criteria of Fried's frailty phenotype. Secondary variables: sociodemographic characteristics, health status, functional status, cognitive-affective status and social risk. A bivariate analysis and logistic regression were performed.

          Results

          Four hundred eight participants were included, with a mean age of 79.8 (SD 6.6), 59.1% female. The prevalence of frailty was 27.7% and 44.9% for pre-frailty. The sociodemographic profile is that of a woman (77%), of high age (>84 years) (50.4%), without studies (65.5%), widow (48.7%) with low economic status (47.8%) and at social risk (OR: 3.3; 95% CI: 2.5-4). Factors that were statistically associated with frailty syndrome were: high comorbidity (OR: 2.7; 95% CI: 1.5-5), polypharmacy (OR: 1.9; 95% CI: 1.3-3), perception of quality of life with health (OR: 0.95; 95% CI: 0.93-0.97), impaired ambulation (OR: 17.9; 95% CI: 7.1-45.3), support for walking (OR: 10.5; 95% CI: 4.7-23.4), high risk of falls (OR: 6.4; 95% CI: 3.8-10.8), ABVD (OR: 4; 95% CI: 2.4-6.6), AIVD (OR: 9.7; 95% CI: 4.7-20), disability (OR: 37.7; 95% CI: 52.2-274.5), cognitive impairment (OR: 4.1; 95% CI: 1.8-9.3) and depression (OR: 4.8; 95% CI: 2.7-8.7).

          Conclusions

          Frailty is a multifactorial syndrome, with a high prevalence in those over 70 years of age, in which, in addition to Fried's criteria of frailty, aspects of health, functional, cognitive-affective and social status must be analyzed.

          Related collections

          Most cited references28

          • Record: found
          • Abstract: not found
          • Article: not found

          The CES-D Scale: A Self-Report Depression Scale for Research in the General Population

          L Radloff (1977)
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission.

            A short battery of physical performance tests was used to assess lower extremity function in more than 5,000 persons age 71 years and older in three communities. Balance, gait, strength, and endurance were evaluated by examining ability to stand with the feet together in the side-by-side, semi-tandem, and tandem positions, time to walk 8 feet, and time to rise from a chair and return to the seated position 5 times. A wide distribution of performance was observed for each test. Each test and a summary performance scale, created by summing categorical rankings of performance on each test, were strongly associated with self-report of disability. Both self-report items and performance tests were independent predictors of short-term mortality and nursing home admission in multivariate analyses. However, evidence is presented that the performance tests provide information not available from self-report items. Of particular importance is the finding that in those at the high end of the functional spectrum, who reported almost no disability, the performance test scores distinguished a gradient of risk for mortality and nursing home admission. Additionally, within subgroups with identical self-report profiles, there were systematic differences in physical performance related to age and sex. This study provides evidence that performance measures can validly characterize older persons across a broad spectrum of lower extremity function. Performance and self-report measures may complement each other in providing useful information about functional status.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Frailty in older adults: evidence for a phenotype.

              Frailty is considered highly prevalent in old age and to confer high risk for falls, disability, hospitalization, and mortality. Frailty has been considered synonymous with disability, comorbidity, and other characteristics, but it is recognized that it may have a biologic basis and be a distinct clinical syndrome. A standardized definition has not yet been established. To develop and operationalize a phenotype of frailty in older adults and assess concurrent and predictive validity, the study used data from the Cardiovascular Health Study. Participants were 5,317 men and women 65 years and older (4,735 from an original cohort recruited in 1989-90 and 582 from an African American cohort recruited in 1992-93). Both cohorts received almost identical baseline evaluations and 7 and 4 years of follow-up, respectively, with annual examinations and surveillance for outcomes including incident disease, hospitalization, falls, disability, and mortality. Frailty was defined as a clinical syndrome in which three or more of the following criteria were present: unintentional weight loss (10 lbs in past year), self-reported exhaustion, weakness (grip strength), slow walking speed, and low physical activity. The overall prevalence of frailty in this community-dwelling population was 6.9%; it increased with age and was greater in women than men. Four-year incidence was 7.2%. Frailty was associated with being African American, having lower education and income, poorer health, and having higher rates of comorbid chronic diseases and disability. There was overlap, but not concordance, in the cooccurrence of frailty, comorbidity, and disability. This frailty phenotype was independently predictive (over 3 years) of incident falls, worsening mobility or ADL disability, hospitalization, and death, with hazard ratios ranging from 1.82 to 4.46, unadjusted, and 1.29-2.24, adjusted for a number of health, disease, and social characteristics predictive of 5-year mortality. Intermediate frailty status, as indicated by the presence of one or two criteria, showed intermediate risk of these outcomes as well as increased risk of becoming frail over 3-4 years of follow-up (odds ratios for incident frailty = 4.51 unadjusted and 2.63 adjusted for covariates, compared to those with no frailty criteria at baseline). This study provides a potential standardized definition for frailty in community-dwelling older adults and offers concurrent and predictive validity for the definition. It also finds that there is an intermediate stage identifying those at high risk of frailty. Finally, it provides evidence that frailty is not synonymous with either comorbidity or disability, but comorbidity is an etiologic risk factor for, and disability is an outcome of, frailty. This provides a potential basis for clinical assessment for those who are frail or at risk, and for future research to develop interventions for frailty based on a standardized ascertainment of frailty.
                Bookmark

                Author and article information

                Contributors
                Journal
                Aten Primaria
                Aten Primaria
                Atencion Primaria
                Elsevier
                0212-6567
                1578-1275
                21 September 2021
                December 2021
                21 September 2021
                : 53
                : 10
                : 102128
                Affiliations
                [a ]Enfermería Familiar y Comunitaria y Salud Mental, Centro de Salud de El Coto, Servicio de Salud del Principado de Asturias, Gijón, Asturias, España
                [b ]Unidad de Envejecimiento y Fragilidad, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Asturias, España
                [c ]Enfermería Familiar y Comunitaria, Centro de Salud El Llano, Servicio de Salud del Principado de Asturias, Gijón, Asturias, España
                [d ]Medicina Familiar y Comunitaria, Centro de Salud El Cristo, Servicio de Salud del Principado de Asturias, Oviedo, Asturias, España
                [e ]Servicio de Medicina Preventiva y Salud Publica, Facultad de Medicina, Oviedo, Asturias, España
                [f ]Geriatría, Centro de Salud El Llano, Servicio de Salud del Principado de Asturias, Gijón, Asturias, España
                [g ]Departamento de Enfermería, Universidad de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, España
                [h ]Unidad de Investigación en Cuidados y Servicios de Salud (Investén-isciii), Instituto de Salud Carlos III, Madrid, España
                [i ]CIBER Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, España
                Author notes
                [* ]Autor para correspondencia. laramenendezgonzalez@ 123456gmail.com
                Article
                S0212-6567(21)00162-1 102128
                10.1016/j.aprim.2021.102128
                8473464
                34560377
                ddabb409-71f4-45e2-8620-fdda37498a72
                © 2021 The Authors

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 30 January 2021
                : 25 April 2021
                Categories
                Original

                envejecimiento,fragilidad,atención primaria de salud,prevalencia,personas con discapacidad,aging,frail elderly,primary health care,prevalence,disabled persons

                Comments

                Comment on this article

                scite_

                Similar content138

                Cited by6

                Most referenced authors742