Factors associated with frailty syndrome in the rural elderly

Quantitative, analytical, transversal study conducted with 820 elderly subjects registered in the Family Health Strategy (FHS) in the rural area in the municipality of Pelotas, from July to October 2014.

Results:

among those evaluated, 43.41% showed FS. These factors were consolidated as associated with the condition: low income (PR: 1.54, p ≤ 0.001), low educ. level (PR: 1.45, p ≤ 0.001), nutritional status (obesity) (PR:1.89, p ≤ 0.001), physical inactivity (PR:1.93, p = 0.003), cognitive deficit (PR:2.07, p = 0.005), and poor self-perceived health (PR: 8.21, p ≤ 0.001).

Conclusion:

the findings may contribute effectively to the establishment of prevention and screening measures for frailty among the elderly by health professionals, especially nurses, aiming to prevent the occurrence of the syndrome and adverse and undesirable outcomes.

Descriptors:
The Elderly; Health of the Elderly; The Frail Elderly; Rural Population; Nursing

Variables	Frailty		p value^# # Chi-square test.
Variables	No	Yes	p value^# # Chi-square test.
Age ≥ 80 years			0.04
No	398 (85.75%)	322 (90.45%)
Yes	66 (14.25%)	34 (9.55%)
Skin color			0.69
Not black	453 (97.63%)	346 (97.19%)
Black	11 (2.37%)	10 (2.81%)
Sex			0.14
Male	214 (46.12%)	146 (41.01%)
Female	250 (53.88%)	210 (58.99%)
Living alone			0.44
No	419 (90.3%)	327 (91.85%)
Yes	45 (9.7%)	29 (8.15%)
Living in reduced space			0.63
No	439 (94.61%)	334 (93.82%)
Yes	25 (5.39%)	22 (6.18%)
Low income^* * N = 815 (five missing for the low income variable);			0.16^## ## Fisher's exact test.
No	458 (99.35%)	348 (98.31%)
Yes	3 (0.65%)	6 (1.69%)
Low educational level^ * *** N = 813 (seven missing for the low educational level variable);			< 0.001
No	276 (60.26%)	156 (43.94%)
Yes	182 (39.74%)	199 (56.06%)
Nutritional status ^* ***** N = 796 (24 missing for the nutritional status variable);			0.005^## ## Fisher's exact test.
Low weight	8 (1.79%)	4 (1.15%)
Eutrophy	169 (37.72%)	93 (26.72%)
Overweight	176 (39.28)	152 (43.68%)
Obesity	95 (21.21%)	99 (28.45%)
Physical activity^** ****** N = 218 (two missing for the physical activity variable).			< 0.001
No	92 (19.87%)	115 (32.39%)
Yes	371(80.13%)	240 (67.61%)
Cognitive deficit			< 0.001
No	92 (19.83%)	38 (10.67%)
Yes	372 (80.17%)	318 (89.33%)
Self-perceived health			< 0.001
Very poor	10 (2.18%)	40 (11.27%)
Poor	10 (2.18%)	32 (9.01%)
Regular	154 (33.55%)	158 (44.51%)
Good	232 (50.54%)	111 (31.27%)
Very good	53 (11.55%)	14 (3.94%)
Institutionalization in the last year			0.25^## ## Fisher's exact test.
No	464 (100%)	355 (99.72%)
Yes	0 (0%)	1 (0.28%)
Hospitalization in the last year			< 0.001
No	419 (90.3%)	287 (80.62%)
Yes	45 (9.7%)	69 (19.38%)
Functional capacity (Katz)			0.11
Independent	370 (79.74%)	301 (84.55%)
Partially dependent	82 (17.67%)	44 (12.36%)
Totally dependent	12 (2.59%)	11 (3.09%)
Functional capacity (Lawton)			0.07
Independent	251 (54.09%)	197 (55.33%)
Partially dependent	170 (36.64%)	141 (39.61%)
Totally dependent	43 (9.27%)	18 (5.06%)
Falls			0.001
No	356 (76.72%)	235 (66.01%)
Yes	108 (23.28%)	121(33.99%)
Morbidity			0.03
No	28 (6.03%)	10 (2.81%)
Yes	436 (93.97%)	346 (97.19%)

Variables	Adjusted prevalence ratio (confidence intervals of 95%)	p value
Age		= 0.109
60-69 years	1
70-79 years	0.76 (0.57-1.01)
80 years or more	0.6 (0.38-0.95)
Sex		= 0.270
Male	1
Female	1.13 (0.96-1.32)
Income		< 0.001
Up to two minimum wages	1
More than two minimum wages	1.54 (0.97-2.47)
Low educational level		< 0.001
No	1
Yes	1.45 (1.24-1.69)
Nutritional status		< 0.001
Eutrophy	1
Low weight	0.91 (0.27-3.1)
Overweight	1.57 (1.13-2.19)
Obesity	1.89 (1.3-2.77)
Physical activity		= 0.003
No	1.93 (1.41-2.66)
Yes	1
Cognitive deficit		< 0.005
No	1
Yes	2.07 (1.38-3.11)
Self-perceived health		< 0.001
Very poor/poor	8.21 (4.79-14.06)
Regular	2.34 (1.72-3.18)
Good/very good	1.00
Functional capacity (Katz)		= 0.484
Independent	1
Partially dependent	0.66 (0.44-1.08)
Totally dependent	1.13 (0.49-2.59)
Functional capacity (Lawton)		= 0.353
Independent	1
Partially dependent	1.06 (0.79-1.41)
Totally dependent	0.53 (0.3-1.12)
Falls in the last 12 months		= 0.012
No	1
Yes	1.7 (1.25-2.31)
Morbidity		= 0.078
No	1
Yes	1.68 (0.99-2.88)

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[1] Corresponding Author: Patrícia Mirapalheta Pereira de Llano. E-mail: pati_llano@yahoo.com.br

Self-reported component of frailty	Questions and answers
Weight loss (scored in this component the elderly who reported more than 3 kg)	In the last 12 months, have you lost weight without following a diet? If so, how many kilos? Between 1 kg and 3 kg More than 3 kg No
Reduced strength	In the last 12 months (last year), have you been feeling weaker? Do you think your strength has diminished? Yes No
Reduced walking speed	Do you think you walk slower nowadays than you walked 12 months (one year) ago? Yes No
Low physical activity	Do you think you do less physical activity than you did 12 months (one year) ago? Yes No
Reported fatigue (scored in this component the elderly who reported "sometimes" or "most of the time" in at least one of the questions)	How often, in the last week, have you felt that you could not carry out your activities (started something but could not finish it)? Never or rarely (less than one day) Few times (one to two days) Sometimes (three to four days) Most of the time
	How often, in the last week, did performing your routine activities require a great effort from you? Never or rarely (less than one day) Few times (one to two days) Sometimes (three to four days) Most of the time