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

Brasil

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

Changes in frailty conditions and phenotype components in elderly after hospitalization¹

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

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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
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[TFN1] *OR: Odds Ratio; †CI: Confidence interval; ‡p<0.05; §ID: Indicative of Depression; ||BADL: Basic Activities of Daily Living; ¶IADL: Instrumental Activities of Daily Living.

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

Changes in frailty conditions and phenotype components in elderly after hospitalization1

ABSTRACT

Changes in frailty conditions and phenotype components in elderly after hospitalization¹