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BMC Geriatrics
Published in: BMC Geriatrics 1/2014

Open Access 01-12-2014 | Research article

Frailty among rural elderly adults

Authors: Carmen-Lucia Curcio, Guadalupe-Maria Henao, Fernando Gomez

Published in: BMC Geriatrics | Issue 1/2014

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Abstract

Background

This study aimed to estimate the prevalence and associated factors related to frailty, by Fried criteria, in the elderly population in a rural area in the Andes Mountains, and to analyze the relationship of these with comorbidity and disability.

Methods

A cross-sectional study was undertaken involving 1878 participants 60 years of age and older. The frailty syndrome was diagnosed based on the Fried criteria (weakness, low speed, low physical activity, exhaustion, and weight loss). Variables were grouped as theoretical domains and, along with other potential confounders, were placed into five categories: (a) demographic and socioeconomic status, (b) health status, (c) self-reported functional status, (d) physical performance-based measures, and (e) psychosocial factors. Chi-square, ANOVA, and multinomial logistic regression analyses were used to test the prognostic value of frailty for the outcomes of interest.

Results

The prevalence of frailty was 12.2%. Factors associated with frailty were age, gender, health status variables that included self-perceived health and number of chronic conditions, functional covariate variables that included disability in activities in daily living (ADL), disabilities in instrumental ADL, chair stand time, and psychosocial variables that included depressive symptoms and cognitive impairment. Higher comorbidity and disability was found in frail elderly people. Only a subset of frail elderly people (10%) reported no disease or disability.

Conclusions

A relevant number of elderly persons living in rural areas in the Andes Mountains are frail. The prevalence of frailty is similar to that reported in other populations in the Latin American region. Our results support the use of modified Cardiovascular Health Study criteria to measure frailty in communities other than urban settings. Frailty in this study was strongly associated with comorbidities, and frailty and comorbidity predicted disability.
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Literature
1.
Yang Y, Lee LC: Dynamics and heterogeneity in the process of human frailty and aging: evidence from the U.S. older adult population. J Gerontol B Soc Sci Psy Sci. 2010, 65: S246-S255.CrossRef
2.
Rodríguez-Mañas L, Féart C, Mann G, Viña J, Chatterji S, Chodzko-Zajko W, Gonzalez-Colaço Harmand M, Bergman H, Carcaillon L, Nicholson C, Scuteri A, Sinclair A, Pelaez M, Van der Cammen T, Beland F, Bickenbach J, Delamarche P, Ferrucci L, Fried LP, Gutiérrez-Robledo LM, Rockwood K, Rodríguez Artalejo F, Serviddio G, Vega E, on behalf of the FOD-CC group: Searching for an Operational Definition of Frailty: A Delphi Method Based Consensus Statement. The Frailty Operative Definition-Consensus Conference Project. J Gerontol A Biol Sci Med Sci. 2013, 14 (1): 62-67.CrossRef
3.
Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G, McBurnie MA: Frailty in older adults: evidence for a phenotype. J Gerontol A BiolSci Med Sci. 2001, 56: M146-M156. 10.1093/gerona/56.3.M146.CrossRef
4.
5.
Fernández-Bolaños M, Otero A, Zunzunegui MV, Beland F, Alarcón T, De Hoyos C, Castell MV: Sex differences in the prevalence of frailty in a population aged 75 and older in Spain. J Am Geriatr Soc. 2008, 56: 2370-2371. 10.1111/j.1532-5415.2008.02032.x.CrossRefPubMed
6.
Alcala MV, Puime A, Santos MT, Barral A, Montalvo JI, Zunzunegui MV: Prevalence of frailty in an elderly Spanish urban population. Relationship with comorbidity and disability. Aten Primaria. 2010, 42: 520-527. 10.1016/j.aprim.2009.09.024.CrossRefPubMed
7.
Abizanda-Soler P, Lopez-Torres Hidalgo J, Romero Rizos L, Lopez Jimenez M, Sanchez Jurado PM, Atienzar Nuñez P, Esquinas JL, Garcia I, Hernandez P, Bardales Y, Campos R, Martinez M, Nieto EO, Carion M, Ruiz A, Aguilar C, Manueco P, Oliver JL: Fragilidad y dependencia en Albacete (FRADEA) razonamiento, diseño y metodologia. Rev Esp Geriatr Gerontol. 2011, 46: 81-88. 10.1016/j.regg.2010.10.004.CrossRefPubMed
8.
Abizanda P, Sanchez-Jurado PM, Romero L, Paterna G, Martinez-Sanchez E, Atienzar-Nuñez P: Prevalence of frailty in a Spanish elderly population: the frailty and dependence in Albacete study. J Am Geriatr Soc. 2011, 59 (7): 1356-1359. 10.1111/j.1532-5415.2011.03463.x.CrossRefPubMed
9.
Jürschik Gimenez P, Escobar Bravo MA, NuinOrrio C, Botigué ST: Frailty criteria in the elderly: a pilot study. Aten Primaria. 2011, 43: 190-196. 10.1016/j.aprim.2010.03.020.CrossRefPubMed
10.
Garcia-Garcia F, Gutierrez G, Alfaro-Acha A, Amor MS, Lanza MAT, Escribano MV, Humanes S, Larrion JL, Gomez-Serranillo M, Rodriguez-Artalejo F, Rodriguez-Manas L: The prevalence of frailty syndrome in an older population from Spain. The Toledo Study for Healthy Aging. J Nutr Health Aging. 2011, 15 (10): 852-856. 10.1007/s12603-011-0075-8.CrossRefPubMed
11.
Castell Alcalá MV, Melgar Borrego AB, Julián Viñals R, Canto de Hoyos Alonso M: Consideraciones sobre los estudios de prevalencia de fragilidad en el mayor en España. Aten Primaria. 2011, 44 (5): 295-296.CrossRefPubMed
12.
Galban PA, Sansó FJ, Dìaz-Canel AM, Carrasco M, Oliva T: Envejecimiento poblacional y fragilidad en el adulto mayor. Rev Cubana Salud Pública. 2007, 33 (1): 1-17.
13.
Alvarado BE, Zunzunegui MV, Béland F: Life course social and health conditions linked to frailty in Latin American older men and women. J Gerontol A Biol Sci Med Sci. 2008, 63: 1399-1406. 10.1093/gerona/63.12.1399.CrossRefPubMed
14.
García-González JJ, García-Peña C, Franco-Marina F, Gutierrez-Robledo LM: A frailty index to predict the mortality risk in a population of senior Mexican adults. BMC Geriatr. 2009, 9: 47-10.1186/1471-2318-9-47. doi: 10.1186/1471-2318-9-47CrossRefPubMedPubMedCentral
15.
Varela-Pinedo L, Ortiz-Saavedra PJ, Chavez-Jimeno H: Velocidad de la marcha como indicador de fragilidad en adultos mayores de la comunidad en Lima, Peru. Rev Esp Geriatr Gerontol. 2010, 45 (1): 22-25. 10.1016/j.regg.2009.07.011.CrossRefPubMed
16.
Aguilar-Navarro S, Gutierrez-Robledo LM, Garcia-Lara JMA, Payette H, Amieva H, Avila- Funes JA: The phenotype of frailty predicts disability and mortality among Mexican community-dwelling elderly. J Frailty Aging. 2012, 1 (3): 111-117.PubMed
17.
Gomez F, Curcio CL, Henao GM: Fragilidad en ancianos colombianos. Rev. Medica. Sanitas. 2012, 15 (4): 8-16.
18.
Costa TB, Neri AL: Medidas de atividade física e fragilidade em idosos: dados do FIBRA Campinas, São Paulo, Brasil. Cad Saúde Pública. 2011, 27 (8): 1537-1550. 10.1590/S0102-311X2011000800009.CrossRefPubMed
19.
Yassuda MS, Lopes A, Cachioni M, Falcao DVS, Batistoni SST, Guimaraes VV, Neri AL: Frailty criteria and cognitive performance are related: data from the FIBRA study in Ermelino Matarazzo, Sao Paulo, Brazil. J Nutr Health Aging. 2012, 16 (1): 55-61. 10.1007/s12603-012-0003-6.CrossRefPubMed
20.
Sousa ACPA, Dias RC, Maciel ACC, Guerra RO: Frailty syndrome and associated factors in community-dwelling elderly in Northeast Brazil. Arch Gerontol Geriatr. 2012, 54 (2): e95-e101. 10.1016/j.archger.2011.08.010.CrossRefPubMed
21.
Avila-Funes JA, Pina-Escudero SD, Aguilar-Navarro S, Gutierrez-Robledo LM, Ruiz Arregui L, Amieva H: Cognitive impairment and low physical activity are the components of frailty more strongly associated with disability. J Nutr Health Aging. 2011, 15 (8): 683-689. 10.1007/s12603-011-0111-8.CrossRefPubMed
22.
Curcio CL, Gomez F, Reyes-Ortiz CA: Activity restriction related to fear of falling among older people in the Colombian Andes Mountains: are functional or psychosocial risk factors more important?. J Aging Health. 2009, 21 (3): 460-479. 10.1177/0898264308329024.CrossRefPubMed
23.
Guigoz Y, Vellas B, Garry PJ: The Mini Nutritional Assessment (MNA): a practical assessment tool for grading the nutritional state of elderly patients. Nutrition in the elderly-the Mini Nutritional Assessment (MNA). Facts research and intervention in geriatrics. Edited by: Vellas BJ, Guigoz Y, Garry PJ, Albarede JL. 1997, Paris: Serdi Publishing, 15-
24.
Heikkinnen E, Waters WE, Brzezinski ZJ: The elderly in eleven countries. World Health Organization. Regional Office for Europe. 1983, Copenhagen: Public Health in Europe 21
25.
Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, Scherr PA, Wallace RB: A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Geronto. 1994, 49 (2): M85-M94. 10.1093/geronj/49.2.M85.CrossRef
26.
Curcio CL, Gómez JF: Fuerza de agarre en los adultos mayores de los centros dia del municipio de Manizales. Rev Asoc Colomb Gerontol Geriatr. 2005, 19 (4): 849-858.
27.
Reuben DB, Laliberte L, Hiris J, Mor V: A hierarchical exercise scale to measure function at the Advanced Activities of Daily Living (AADL) level. J Am Geriatr Soc. 1990, 38 (10): 855-861.CrossRefPubMed
28.
Menendez J, Guevara A, Arcia N, León-Diaz EM, Marin C, Alfonso JC: Enfermedades crónicas y limitación functional en adultos mayores: estudio comparativo en siete ciudades de América Latina y el Caribe. Rev Panam Salud Publica. 2005, 17: 353-361.CrossRefPubMed
29.
Rollason V, Vogt N: Reduction of polypharmacy in the elderly: a systematic review of the role of the pharmacist. Drugs Aging. 2003, 20 (11): 817-832. 10.2165/00002512-200320110-00003.CrossRefPubMed
30.
Tombaugh TN, McIntyre NJ: The Mini-Mental State Examination: a comprehensive review. J Am Geriatr Soc. 1992, 40: 922-935.CrossRefPubMed
31.
Baztán JJ, Pérez del Molino J, Alarcón T, San Cristóbal E, Izquierdo G, Manzabeitia I: Índice de Barthel: instrumento válido para la valoración funcional de pacientes con enfermedad cerebrovascular. Rev Esp Geriatr Gerontol. 1993, 28: 32-40.
32.
Curcio CL, Gómez JF, Galeano IC: Validez y reproducibilidad de las medidas basadas en la ejecución. Rev Esp Geriatr Gerontol. 2000, 35: 82-88.
33.
Cornoni-Huntley J, Brock DB, Ostfeld AM, Taylor JO, Wallace RB: The established populations for the epidemiologic study of the elderly: resource data book. 1986, Bethesda, MD: National Institutes of Health, NIH No. 86-2443)
34.
Martí D, Miralles R, Llorach I, García-Palleiro P, Esperanza A, Guillén J: Trastornos depresivos en una unidad de convalecencia: experiencia y validación de una versión española de 15 preguntas de la escala de depresión geriátrica de Yesavage. Rev Esp Geriatr Gerontol. 2000, 35: 7-14.
35.
Ottenbacher KJ, Graham JE, Al Snih S, Raji M, Samper-Ternent R, Ostir GV, Markides KS: Mexican Americans and frailty: findings from the Hispanic established populations epidemiologic studies of the elderly. Am J Public Health. 2009, 99 (4): 673-679. 10.2105/AJPH.2008.143958.CrossRefPubMedPubMedCentral
36.
Espinoza SE, Hazuda HP: Frailty in older Mexican-American and European-American adults: Is there an ethnic disparity?. J Am Geriatr Soc. 2008, 56: 1744-1749. 10.1111/j.1532-5415.2008.01845.x.CrossRefPubMed
37.
Cesari M, Demougeot L, Boccalon H, Vellas B: Prevalence of frailty and mobility limitation in a rural setting in France. J Frailty Aging. 2012, 1 (4): 169-173.PubMed
38.
Melzer D, Lan TY, Tom BDM, Deeg DJH, Guralnik JM: Variation in thresholds for reporting mobility disability between national population subgroups and studies. J Gerontol A Biol Sci Med Sci. 2004, 59 (12): 1295-1303. 10.1093/gerona/59.12.1295.CrossRefPubMed
39.
Santos-Eggimann B, Cuenoud P, Spagnoli J, Junod J: Prevalence of frailty in middle aged and older community-dwelling Europeans living in 10 countries. J Gerontol A Biol Sci Med Sci. 2009, 64 (6): 675-681.CrossRefPubMed
40.
Avila-Funes JA, Amieva H, Barberger-Gateau P, Le Goff M, Raoux N, Ritchie K, et al: Cognitive impairment improves the predictive validity of the phenotype of frailty for adverse health outcomes: the three-city study. J Am Geriatr Soc. 2009, 57: 453-461. 10.1111/j.1532-5415.2008.02136.x.CrossRefPubMed
41.
Samper-Ternent R, Al Snih S, Raji MA, Markides KS, Ottenbacher KJ: Relationship between frailty and cognitive decline in older Mexican Americans. J Am Geriatr Soc. 2008, 56 (10): 1845-1852. 10.1111/j.1532-5415.2008.01947.x.CrossRefPubMedPubMedCentral
42.
Mezuk B, Lohman M, Dumenci L, Lapane KL: Are depression and frailty overlapping syndromes in mid- and late-life? A latent variables analysis. Am J Geriatr Psych. 2013, 21: 560-569. 10.1016/j.jagp.2012.12.019.CrossRef
43.
Bergman H, Ferrucci L, Guralnik J, Hogan DB, Hummel S, Karunananthan S, Wolfson C: Frailty: an emerging research and clinical paradigm–issues and controversies. J Gerontol A BiolSci Med Sci. 2007, 62 (7): 731-737. 10.1093/gerona/62.7.731.CrossRef
Metadata
Title
Frailty among rural elderly adults
Authors
Carmen-Lucia Curcio
Guadalupe-Maria Henao
Fernando Gomez
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2014
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/1471-2318-14-2

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