Changes in frailty conditions and phenotype components in elderly after hospitalization

Marchiori, Gianna Fiori; Tavares, Darlene Mara dos Santos

doi:10.1590/1518-8345.1417.2905

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Revista Latino-Americana de Enfermagem

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Original Article • Rev. Latino-Am. Enfermagem 25 • 2017 • https://doi.org/10.1590/1518-8345.1417.2905 copy

Changes in frailty conditions and phenotype components in elderly after hospitalization¹ 1 Paper extracted from Master’s Thesis “Prevalence and predictors of frailty syndrome in elderly during and after hospitalization”, presented to Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brazil. Supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil, process #475353/2012-9.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

describing the changes in frailty conditions over the period of a year after hospital discharge, verifying predictive variables for changes in frailty conditions and frailty phenotype components according to worsening, improving and stable groups.

Method:

a longitudinal survey carried out with 129 elderly. A structured form for socioeconomic and health data, scales (Geriatric Depression Scale - short form, Katz scale, Lawton and Brody scale) and frailty phenotype according to Fried were used. Descriptive analysis and multinomial logistic regression model (p<0.05) were performed.

Results:

we found that 56.7% of older adults changed their condition from non-frail to pre-frail, with no changes from non-frail to frail. Deaths were found between frail and pre-frail elderly. In the worsening group, the increase in the number of morbidities was a predictor for exhaustion and/or fatigue, while in the improving group, increased dependence on instrumental activities of daily living was a predictor for weight loss, and reduced scores indicative of depression due to low level of physical activity.

Conclusion:

a greater percentage of changes from non-frail condition to pre-frail older adults were observed, and health variables were only predictive for frailty phenotype components.

Descriptors:
Frail Elderly; Longitudinal Studies; Geriatric Nursing

Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo Av. Bandeirantes, 3900, 14040-902 Ribeirão Preto SP Brazil, Tel.: +55 (16) 3315-3451 / 3315-4407 - Ribeirão Preto - SP - Brazil
E-mail: rlae@eerp.usp.br

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[1] Corresponding Author: Darlene Mara dos Santos Tavares Universidade Federal do Triângulo Mineiro. Instituto de Ciências da Saúde Av. Frei Paulino, 30 Bairro: Abadia CEP: 38025-180, Uberaba, MG, Brasil E-mail: darlene.tavares@uftm.edu.br

Variables	Frailty condition
	Improving group			Worsening group
	OR*	IC ^† 95%	p ^ǂ	OR*	IC ^† 95%	p ^ǂ
ID score ^§ dif	0.88	0.74-1.05	0.155	1.00	0.84-1.20	0.965
Number of medications dif	0.96	0.82-1.13	0.649	1.06	0.90-1.24	0.486
Number of morbidities dif	1.02	0.87-1.19	0.808	1.06	0.91-1.23	0.478
BADL score ^\|\| dif	1.26	0.79-2.02	0.332	1.76	0.93-3.32	0.082
IADL score ^¶ dif	1.13	0.81-1.59	0.463	0.89	0.63-1.27	0.521

Variables and frailty phenotype components OR*		Improving group			Worsening group
Variables and frailty phenotype components OR*		95%CI ^†	p ^ǂ		OR*	95%CI ^†	p ^ǂ
Low walking speed
	ID score ^§ dif	1.10	0.88-1.38	0.389	0.94	0.78-1.14	0.553
	Number of medications dif	1.01	0.81-1.26	0.939	1.15	0.97-1.36	0.096
	Number of morbidities dif	0.98	0.80-1.19	0.837	1.09	0.92-1.28	0.324
	BADL score ^ǀǀ dif	0.68	0.42-1.09	0.108	1.10	0.61-1.99	0.753
	IADL score ^¶ dif	1.21	0.79-1.83	0.379	0.97	0.67-1.41	0.885
Decreased muscle strength
	ID score ^§ dif	1.17	0.95-1.45	0.145	0.89	0.64-1.24	0.493
	Number of medications dif	0.86	0.69-1.06	0.154	1.01	0.76-1.35	0.940
	Number of morbidities dif	0.98	0.81-1.17	0.807	1.05	0.79-1.39	0.748
	BADL score ^ǀǀ dif	0.86	0.52-1.42	0.556	1.21	0.47-3.12	0.689
	IADL score ^¶ dif	1.09	0.74-1.60	0.665	1.20	0.63-2.26	0.577
Self-reported exhaustion and/or fatigue
	ID score ^§ dif	0.89	0.74-1.08	0.244	0.81	0.62-1.05	0.114
	Number of medications dif	0.93	0.76-1.13	0.457	1.16	0.94-1.42	0.158
	Number of morbidities dif	0.84	0.70-1.02	0.077	1.26	1.01-1.56	0.040*
	BADL score ^ǀǀ dif	0.87	0.54-1.39	0.559	0.94	0.54-1.63	0.830
	IADL score ^¶ dif	0.83	0.54-1.26	0.379	1.29	0.82-2.03	0.268
Unintentional weight loss
	ID score ^§ dif	0.97	0.82-1.15	0.725	0.98	0.76-1.27	0.889
	Number of medications dif	0.92	0.78-1.08	0.304	1.02	0.79-1.32	0.877
	Number of morbidities dif	0.97	0.83-1.12	0.658	1.16	0.92-1.45	0.202
	BADL score ^ǀǀ dif	1.00	0.66-1.52	0.981	0.44	0.18-1.08	0.073
	IADL score ^¶ dif	1.42	1.02-1.97	0.038*	1.12	0.63-1.98	0.699
Low physical activity level
	ID score ^§ dif	0.75	0.58-0.97	0.030*	1.06	0.88-1.27	0.530
	Number of medications dif	0.87	0.69-1.10	0.244	0.98	0.83-1.17	0.848
	Number of morbidities dif	1.05	0.84-1.32	0.663	0.90	0.77-1.05	0.194
	BADL score ^ǀǀ dif	1.36	0.68-2.72	0.377	1.24	0.72-2.14	0.441
	IADL score ^¶ dif	1.24	0.75-2.03	0.399	1.09	0.77-1.55	0.607