Impacts of frailty on the negative health outcomes of elderly Brazilians

a representative sample of elderly persons from the city of Juiz de Fora, Minas Gerais, Brazil, who had been evaluated with regard to frailty, socio-demographic conditions and health in 2009, were reevaluated in terms of negative health outcomes between 2014 and 2015 (n=304).

Results:

The results revealed a greater incidence of falls, hospitalization, and death among frail elderly persons. The frail group also had an increased risk (1.5, crude estimate) of death during the follow-up period than the robust individuals. The pre-frail elderly had a 55% (crude) and 58% (adjusted) greater risk of falls, and an 89% (crude) greater risk of death than robust individuals.

Conclusion:

frailty, as well as pre-frailty, can increase the risk of adverse events in the health of the elderly.

Keywords:
Frailty; Epidemiology; Geriatric Assessment

Universidade do Estado do Rio Janeiro Rua São Francisco Xavier, 524 - Bloco F, 20559-900 Rio de Janeiro - RJ Brasil, Tel.: (55 21) 2334-0168 - Rio de Janeiro - RJ - Brazil
E-mail: revistabgg@gmail.com

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[1] Correspondence Fernando Antonio Basile Colugnati E-mail: fcolugnati@gmail.com

Variables n (%)	Robust (n=143)	Pre-frail (n=241)	Frail (n=40)	Total (n=424)	p
Female	87 (60.8%)	174 (72.2%)	35 (87.5%)	295 (69.8%)	0.002
Age (years), mean (±standard deviation)	71.9 (±5.8)	75.1 (±6.8)	79.0 (±4.0)	74.46 (±6.8)	0.001*
Age (years)					0.001
65 to 69	59 (41.2%)	59 (24.4%)	3 (7.5%)	121 (28.5%)
70 to 79	66 (46.1%)	115 (47.7%)	22 (55%)	203 (47.8%)
80 or more	18 (12.5%)	67 (27.8%)	15 (37.5%)	100 (23.5%)
Ethnicity
White	97 (67.8%)	175 (72.6%)	32 (80.0%)	304 (71.7%)
Black	16 (11.1%)	23 (9.5%)	2 (5%)	41 (9.7%)	0.719**
Mixed Race	30 (20.2%)	40 (16.6%)	6 (15.0%)	75 (17.7%)
Ethnicity - Outros	0	3 (1.2%)	0	3 (0.7%)
Currently working	27 (18.8%)	24 (9.9%)	1 (2.5%)	52 (12.3%)	0.005
Literacy	28 (19.6%)	49 (20.4%)	14 (35.0%)	91 (21.46%)	0.134
Functional Capacity (Instrumental Activities of Daily Living)	20.6 (± 0.8)	19.8 (2.0)	16.5 (3.9)	19.7 (±2.2)	0.001
Comorbidities	39 (27.2%)	71 (29.4%)	11 (27.5%)	121 (28.5%)	0.890

Variables N (%)	Robust (n=90) (n=104)*	Pre-frail (n=131) (n=174)*	Frail (n=16) (n=26)*	Total (n=237) (n=304)*	p
Hospitalization	40 (38.8%)	70 (53.4%)	11 (68.7%)	115 (48.4%)	0.027
Number of hospitalizations	1.97 (2.3%)	1.98 (2.67%)	2.27 (2.83%)	2.00 (2.58%)	0.938
Total duration of hospitalizations (days), mean (±standard deviation)	13.42 (±21.3)	16.02 (±25.5)	27.72 (±26.1)	16.38 (±24.55)	0.224
Falls	30 (33.3%)	68 (51.9%)	7 (43.7%)	105 (44.30)	0.024
Need for medical services due to fall	15 (50.0%)	44 (64.7%)	5 (71.4%)	64 (60.95%)	0.327
Need for hospitalization due to fall	4 (13.3%)	13 (19.2%)	3 (42.86%)	20 (19.05%)	0.201
Duration of hospitalization due to fall, mean (± standard deviation)	9.60 (±12.5)	19.57 (±35.3)	24 (±21.5)	17.90 (±29.5)	0.770
Death*	14 (13.4%)	43 (24.7%)	10 (38.4%)	67 (22%)	0.010

	Rate Ratio of Incidence
	Pre-Frail				Frail
Variables	Crude	p	Adjusted	p	Crude	p	Adjusted	p
	(95% CI)		(95% CI)		(95% CI)		(95% CI)
Falls*	1.55 (1.01 - 2.39)	0.043	1.58 (1.02 - 2.46)	0.038	1.31 (0.57 - 2.98)	0.517	1.69 (0.70 - 4.09)	0.238
Hospitalization*	1.37 (0.91 - 2.06)	0.125	1.43 (0.94 - 2.16)	0.091	1.76 (0.89 - 3.48)	0.099	1.84 (0.83 - 4.05)	0.127
Mortality**	1.89 (1.03 - 3.46)	0.038	1.49 (0.80 - 2.80)	0.206	2.52 (1.09 - 5.84)	0.030	1.32 (0.48 - 3.61)	0.589