Association between frailty syndrome and sedentary behavior among community-dwelling older adults in the Amazon region: a cross-sectional study

Santos, Izabelle Santos dos; Silva, Caroline de Fátima Ribeiro; Ohara, Daniela Gonçalves; Matos, Areolino Pena; Pinto, Ana Carolina Pereira Nunes; Pegorari, Maycon Sousa

doi:10.1590/1516-3180.2020.0546.R1.14122020

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Sao Paulo Medical Journal

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ORIGINAL ARTICLE • Sao Paulo Med. J. 139 (3) • 2021 • https://doi.org/10.1590/1516-3180.2020.0546.R1.14122020 copy

Association between frailty syndrome and sedentary behavior among community-dwelling older adults in the Amazon region: a cross-sectional study

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

BACKGROUND:

Existence of an association between sedentary behavior and frailty among older adults has been suggested. However, there is a lack of studies conducted in Brazil, especially in areas of the Amazon region.

OBJECTIVE:

To analyze the association between frailty syndrome and sedentary behavior among community-dwelling older adults.

DESIGN AND SETTING:

Cross-sectional study carried out in Macapá, state of Amapá, Brazil.

METHODS:

Frailty status was assessed using Fried's frailty phenotype, and sedentary behavior was evaluated using two questions concerning time spent in a seated position, from the International Physical Activity Questionnaire (IPAQ). A multinomial logistic regression model was used to verify the association between frailty syndrome and sedentary behavior.

RESULTS:

The final study sample was made up of 411 older adults with a mean age of 70.14 ± 7.25 years and an average daily duration of sedentary behavior of 2.86 ± 2.53 hours. The prevalence of non-frailty was 28.7%, prevalence of pre-frailty was 58.4% and prevalence of frailty was 12.9%. The adjusted analysis showed that there were independent associations between sedentary behavior and pre-frailty (odds ratio, OR = 1.18; 95% confidence interval, CI: 1.03-1.34) and between sedentary behavior and frailty (OR = 1.20; 95% CI: 1.02-1.40).

CONCLUSION:

Frailty and pre-frailty status were associated with sedentary behavior among community-dwelling older adults.

KEY WORDS (MeSH terms):
Aged; Health services for the aged; Sedentary behavior; Frail elderly

AUTHORS’ KEY WORDS:
Older adults; Health of the elderly; Physical inactivity

		Frailty syndrome				Total sample (n=411)
Variables		Frail53 (12.9%)	Pre-frail240 (58.4%)	Non-frail118 (28.7%)	P	Total sample (n=411)
Age (years)		74 ± 8.49	70.64 ± 7.26	67.41 ± 5.44	< 0.001^* * Non-frail ≠ Pre-frail ≠ Frail	70.14 ± 7.25
Sex
	Male	13 (24.5%)	77 (32.1%)	48 (40.7%)	0.088	138 (33.6%)
	Female	40 (75.5%)	163 (67.9%)	70 (59.3%)	0.088	273 (66.4%)
Education (years)		4.43 ± 4.37	5.61 ± 5.21	6.78 ± 5.55	0.010^ Non-frail ≠ Frail	5.79 ± 5.25
Marital status
	With partner	49 (41.5%)	140 (58.3%)	31 (58.5%)	0.008	220 (53.5%)
	Without partner	69 (58.5%)	100 (41.7%)	22 (41.5%)	0.008	191 (46.5%)
Living arrangement
	Alone	2 (3.8%)	15 (6.2%)	11 (9.3%)	0.357	28 (6.8%)
	Accompanied	51 (96.2%)	225 (93.8%)	107 (90.7%)	0.357	383 (93.2%)
Health perception
	Positive	53 (44.9%)	63 (26.3%)	8 (15.4%)	< 0.001	124 (30.2%)
	Negative	65 (55.1%)	177 (73.8%)	44 (84.6%)	< 0.001	286 (69.6%)
Smoking habit
	Yes	10 (8.5%)	25 (11.7%)	1 (1.9%)	0.081	39 (9.5%)
	No	118 (91.5%)	212 (88.3%)	52 (98.1%)	0.081	372 (90.5%)
Hospitalization in the last year
	Yes	10 (8.5%)	35 (14.6%)	13 (24.5%)	0.019	58 (14.1%)
	No	108 (91.5%)	205 (85.4%)	40 (75.5%)	0.019	353 (85.9%)
BADL
	Dependent	8 (15.1%)	18 (7.5%)	4 (3.4%)	0.024	30 (7.3%)
	Independent	45 (84.9%)	222 (92.5%)	114 (96.6%)	0.024	381 (92.7%)
IADL
	Dependent	43 (81.1%)	175 (72.9%)	68 (57.6%)	0.002	286 (69.6%)
	Independent	10 (18.9%)	65 (27.1%)	50 (42.4%)	0.002	125 (30.4%)
Sedentary behavior (hours)		3.28 ± 2.77	3.01 ± 2.77	2.40 ± 1.74	0.038^* ***** Non-frail ≠ Pre-frail.	2.86 ± 2.53

		Frailty syndrome*
Variables			Pre-frail			Frail
Variables		OR	95% CI	P	OR	95% CI	P
Age (years)		1.06	1.02-1.10	0.003	1.11	1.05-1.17	< 0.001
Sex
	Male	1.95	1.17-3.26	0.755	1.66	0.70-3.88	0.243
	Female		1			1
Education (years)		0.98	0.94-1.03	0.556	0.96	0.88-1.03	0.317
Marital status
	With partner		1			1
	Without partner	0.50	0.29-0.85	0.011	0.62	0.28-1.37	0.243
Living arrangement
	Alone	1.72	0.67-4.41	0.255	1.54	0.27-8.56	0.619
	Accompanied		1			1
Health perception
	Positive		1			1
	Negative	1.95	1.17-3.26	0.010	3.24	1.31-8.02	0.011
Smoking habit
	Yes	2.19	0.94-5.07	0.067	0.41	0.04-3.52	0.418
	No		1			1
Hospitalization in the last year
	Yes	2.02	0.90-4.51	0.085	3.42	1.23-9.47	0.011
	No		1			1
BADL
	Dependent	2.02	0.61-6.67	0.249	3.01	0.73-12.46	0.127
	Independent		1			1
IADL
	Dependent	1.46	0.87-2.47	0.149	1.55	0.65-3.72	0.321
	Independent		1			1
Sedentary behavior (hours)		1.18	1.03-1.34	0.013	1.20	1.02-1.40	0.023

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[1] Address for correspondence: Maycon Sousa Pegorari, Departamento de Ciências Biológicas, Curso de Graduação em Fisioterapia da Universidade Federal do Amapá (UNIFAP), Rodovia Juscelino Kubitschek, Km 02 — Campus Marco Zero Jardim Marco Zero — Macapá (AP) — Brasil. CEP 68903-419 Tel. (+55 96) 4009-2944 E-mail: mayconpegorari@yahoo.com.br