Prevalence of multidimensional frailty and risk of sarcopenia in older people admitted to a medium-complexity hospital

a retrospective cross-sectional study

Authors

DOI:

https://doi.org/10.15448/2357-9641.2024.1.45597

Keywords:

Frail Elderly, Prevalence, Hospitalization, Sarcopenia

Abstract

Objective: to determine the prevalence of multidimensional frailty and the risk of sarcopenia in elderly individuals at the time of hospital admission.

Method: cross-sectional, quantitative, and retrospective study. Data were collected regarding a physical and functional assessment conducted at hospital admission: Clinical-Functional Vulnerability Index-20, Manual Muscle Testing of the Medical Research Council, Short Physical Performance Battery, and SARC-F+CP.

Results: the sample consisted of 1780 medical records of elderly individuals admitted to a public hospital in southern Brazil, divided into two groups: 60-79 years (n=635) and ≥80 years (n=1145), during the period from August 2019 to March 2020. Among older individuals aged 60-79 years: 65.7% (n=417) are frail, 32.9% (n=209) have muscle weakness, 61.7% (n=392) are unable or have very poor physical performance, and 28.5% (n=343) are at risk of sarcopenia. Older individuals aged ≥80 years: 87.2% (n=999) are frail, 45.2% (n=518) have muscle weakness, 83.9% (n=961) have very poor physical performance or are unable, and 71.5% (n=862) are at risk of sarcopenia.

Conclusion: there is a prevalence of multidimensional frailty, peripheral muscle weakness, incapacity in physical performance activities, and risks of sarcopenia among hospitalized older individuals.

 

Downloads

Author Biographies

Tatiane Caroline Boumer, Fundação Estatal de Atenção à Saúde (Feas); Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR, Brasil.

Master in Technology from the Pontifical Catholic University of Paraná (PUCPR), in Curitiba, PR, Brazil; specialist in gerontology from the Brazilian Society of Geriatrics and Gerontology (SBGG) Paraná, Brazil; postgraduate in the Multidisciplinary Residency in Elderly Health from the Municipal Health Department of Curitiba and the State Health Care Foundation, in Curitiba, PR, Brazil; postgraduate degree in Intensive Care from Facuminas, MG, Brazil. Graduated in Physiotherapy from the Pontifical Catholic University of Paraná (PUCPR), in Curitiba, PR, Brazil. PhD student in Technology at the Pontifical Catholic University of Paraná (PUCPR), in Curitiba, PR, Brazil.

Larissa Teleginski Wardenski , Fundação Estatal de Atenção à Saúde (Feas), Curitiba, PR, Brasil.

Postgraduate in the Multidisciplinary Residency in Elderly Health from the Municipal Health Department of Curitiba and the State Health Care Foundation, in Curitiba, PR, Brazil. Graduated in Speech Therapy from the State University of the Center-West, UNICENTRO, Brazil, PR, Brazil. Master's student of the Postgraduate Program in Nursing at the Federal University of Paraná (UFPR), in Curitiba, PR, Brazil.

Fabiana de Lima Granza , Fundação Estatal de Atenção a Saúde

Specialist in gerontology from the Brazilian Society of Geriatrics and Gerontology (SBGG), PR, Brazil; specialist in Health Education for SUS Preceptors. Graduated in Physiotherapy from Centro Universitário Uni Dom Bosco, in Curitiba, PR, Brazil.

Sandra Mari Pistore Fiori , Fundação Estatal de Atenção à Saúde (Feas), Curitiba, PR, Brasil.


Specialist in Intensive Care by Uninter. Graduated in Physiotherapy from the University of Western Santa Catarina (UNOESC), SC, Brazil.

Isabel de Lima Zanata , Fundação Estatal de Atenção à Saúde (Feas), Curitiba, PR, Brasil

PhD and Master in Communication Disorders from the Tuiuti do Paraná University (UTP), in Curitiba, PR, Brazil. Specialist in Preceptorship at SUS at Hospital Sírio-Libanês, SP, Brazil. Specialization in dysphagia from the Tuiuti University of Paraná, Curitiba, PR, Brazil. Specialist in gerontology from the Brazilian Society of Geriatrics and Gerontology (SBGG), PR, Brazil. Graduated in Speech Therapy from Universidade Tuiuti do Paraná (UTP), in Curitiba, PR, Brazil.

Elisangela Ferretti Manffra, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR, Brasil.

PhD in Physics from Universitat Wuppertal, BUGW, Germany. Master in Physics from the University of São Paulo (USP), Brazil. Graduated in Electrical Industrial Engineering from the Federal Technological University of Paraná (UTFPR), in Curitiba, PR. Brazil. Full professor at the Pontifical Catholic University of Paraná (PUCPR), professor of the Postgraduate Program in Health Technology (PPGTS) and the Undergraduate Course in Biomedical Engineering.

Paulo Henrique Coltro, Fundação Estatal de Atenção à Saúde (Feas), Curitiba, PR, Brasil.

Master in Communication Disorders from Universidade Tuiuti do Paraná (UTP), in Curitiba, PR, Brazil; specialist in Quality and Safety in Patient Care at Hospital Sírio Libanês; specialist in gerontology from the Brazilian Society of Geriatrics and Gerontology (SBGG), PR, Brazil; specialist in intensive care from Faculdade Inspirar and certified by ASSOBRAFIR/COFFITO, in Curitiba, PR, Brazil. Graduated in Physiotherapy from the Pontifical Catholic University of Paraná (PUCPR), in Curitiba, PR, Brazil.

References

Thompson MQ, Tucker GR, Adams RJ. Frailty and sarcopenia in combination are more predictive of mortality than either condition alone. Maturitas. 2021 Feb;144:102-7. https://doi.org/10.1016/j.maturitas.2020.11.009 DOI: https://doi.org/10.1016/j.maturitas.2020.11.009

Antunes AC, Araújo DA, Veríssimo MT, Amaral TF. Sarcopenia and hospitalisation costs in older adults: a cross-sectional study. Nutr Diet. 2017;74(1):46-50. DOI: https://doi.org/10.1111/1747-0080.12287

Adebusoye LA, Cadmus EO, Owolabi MO, Ogunniyi A. Frailty and mortality among older patients in a tertiary hospital in Nigeria. Ghana Med J. 2019;53(3):210-6. DOI: https://doi.org/10.4314/gmj.v53i3.5

Pereira AM, Rosa AC. Linha guia da saúde do idoso. Curitiba: SESA; 2018. 128 p.

Liberalesso TE, Dallazen F, Bandeira VA, Berlezi EM. Prevalência de fragilidade em uma população de longevos na região Sul do Brasil. Saúde Debate. 2017;41(113):553-62. DOI: https://doi.org/10.1590/0103-1104201711316

Hoogendijk EO, Afilalo J, Ensrud KE, Kowal P, Onder G, Fried LP. Frailty: implications for clinical practice and public health. Lancet. 2019;394(10206):1365-75. https://doi.org/10.1016/S0140-6736(19)31786-6 DOI: https://doi.org/10.1016/S0140-6736(19)31786-6

Moraes EN, Lanna FM, Santos RR, Bicalho MAC, Machado CJ, Romero DE. A new proposal for the clinical-functional categorization of the elderly: visual scale of frailty (vs-frailty). J Aging Res Clin Pract. 2016;5(1):24-30. https://doi.org/10.14283/jarcp.2016.84 DOI: https://doi.org/10.14283/jarcp.2016.84

Cunha AIL, Veronese N, de Melo Borges S, Ricci NA. Frailty as a predictor of adverse outcomes in hospitalized older adults: a systematic review and meta-analysis. Ageing Res Rev. 2019;56:100960. https://doi.org/10.1016/j.arr.2019.100960 DOI: https://doi.org/10.1016/j.arr.2019.100960

Carvalho TC, Valle AP do, Jacinto AF, Mayoral VF de S, Boas PJFV. Impact of hospitalization on the functional capacity of the elderly: a cohort study. Rev Bras Geriatr e Gerontol. 2018;21(2):134-42. https://doi.org/10.1590/1981-22562018021.170143 DOI: https://doi.org/10.1590/1981-22562018021.170143

Hao Q, Zhou L, Dong B, Yang M, Dong B, Weil Y. The role of frailty in predicting mortality and readmission in older adults in acute care wards: a prospective study. Sci Rep. 2019 Feb 4;9(1):1207. https://doi.org/10.1038/s41598-018-38072-7 DOI: https://doi.org/10.1038/s41598-018-38072-7

Covinsky KE, Pierluissi E, Johnston CB. Hospitalization-associated disability “She was probably able to ambulate, but i’m not sure.” JAMA - J Am Med Assoc. 2011;306(16):1782-93. http://10.1001/jama.2011.1556 DOI: https://doi.org/10.1001/jama.2011.1556

Sáez de Asteasu ML, Martínez-Velilla N, Zambom-Ferraresi F, Ramírez-Vélez R, García-Hermoso A, Cadore EL, et al. Changes in muscle power after usual care or early structured exercise intervention in acutely hospitalized older adults. J Cachexia Sarcopenia Muscle. 2020;11(4):997-1006. https://doi.org/10.1002/jcsm.12564 DOI: https://doi.org/10.1002/jcsm.12564

Verlaan S, Van Ancum JM, Pierik VD, Van Wijngaarden JP, Scheerman K, Meskers CGM, et al. Muscle measures and nutritional status at hospital admission predict survival and independent living of older patients - the EMPOWER study. J frailty aging. 2017;6(3):161-6. https://doi.org/10.14283/jfa.2017.23

Duarte YA de O, de Andrade CL, Lebrão ML. O índex de katz na avaliação da funcionalidade dos idosos. Rev da Esc Enferm. 2007;41(2):317-25. https://doi.org/10.1590/S0080-62342007000200021 DOI: https://doi.org/10.1590/S0080-62342007000200021

Moraes EN de, Carmo JA do, Moraes FL de, Azevedo RS, Machado CaJ, Montilla DER. Índice de vulnerabilidade clínico funcional-20 (IVCF-20): reconhecimento rápido do idoso frágil. Rev Saude Publica. 2016;50-81. https://doi.org/10.1590/S1518-8787.2016050006963 DOI: https://doi.org/10.1590/s1518-8787.2016050006963

Hermans G, Clerckx B, Vanhullebusch T, Segers J, Vanpee G, Robbeets C, et al. Interobserver agreement of medical research council sum score and handgrip strength in the intensive care unit. Muscle and Nerve. 2012;45(1):18-25. https://doi.org/10.1002/mus.22219 DOI: https://doi.org/10.1002/mus.22219

Gómez Montes JF, Curcio CL, Alvarado B, Zunzunegui MV, Guralnik J. Validity and reliability of the short physical performance battery (SPPB): A pilot study on mobility in the Colombian Andes. Colomb Med. 2013;44(3):165-71. https://doi.org/10.25100/cm.v44i3.1181 DOI: https://doi.org/10.25100/cm.v44i3.1181

Medina-Mirapeix F, Bernabeu-Mora R, Llamazares-Herrán E, Sánchez-Martínez MP, García-Vidal JA, Escolar-Reina P. Interobserver reliability of peripheral muscle strength tests and short physical performance battery in patients with chronic obstructive pulmonary disease: a prospective observational study. Arch Phys Med Rehabil. 2016;97(11):2002-5. http://dx.doi.org/10.1016/j.apmr.2016.05.004 DOI: https://doi.org/10.1016/j.apmr.2016.05.004

Arik G, Varan HD, Yavuz BB, Karabulut E, Kara O, Kilic MK, et al. Validation of katz index of independence in activities of daily living in turkish older adults. Arch Gerontol Geriatr. 2015;61(3):344-50. http://dx.doi.org/10.1016/j.archger.2015.08.019 DOI: https://doi.org/10.1016/j.archger.2015.08.019

Barbosa-Silva TG, Menezes AM, Bielemann RM, Malmstrom TK, Gonzalez MC; Grupo de Estudos em Composição Corporal e Nutrição (COCONUT). Enhancing SARC-F: Improving Sarcopenia Screening in the Clinical Practice. J Am Med Dir Assoc. 2016 Dec 1;17(12):1136-1141. https://doi.org/10.1016/j.jamda.2016.08.004. Epub 2016 Sep 17. DOI: https://doi.org/10.1016/j.jamda.2016.08.004

Baptista RR, Vaz MA. Arquitetura muscular e envelhecimento: adaptação funcional e aspectos clínicos; revisão da literatura. Fisioter Pesqui. 2009;16(4):368-73. https://doi.org/10.1590/S1809-29502009000400015 DOI: https://doi.org/10.1590/S1809-29502009000400015

Isaia G, Maero B, Gatti A, Neirotti M, Ricauda NA, Bo M, et al. Risk factors of functional decline during hospitalization in the oldest old. Aging Clin Exp Res. 2009;21(6):453-7. https://doi.org/10.1007/BF03327448 DOI: https://doi.org/10.1007/BF03327448

Kamper AM, Stott DJ, Hyland M, Murray HM, Ford I. Predictors of functional decline in elderly people with vascular risk factors or disease. Age Ageing. 2005;34(5):450-5. https://doi.org/10.1093/ageing/afi137 DOI: https://doi.org/10.1093/ageing/afi137

Kawasaki K, Diogo MJD. Variação da independência funcional em idosos hospitalizados relacionada a variáveis sociais e de saúde. Acta Fisiátr. [Internet]. 9º de setembro de 2007 [citado 10 dez. 2023];14(3):164-9. Disponível em: https://www.revistas.usp.br/actafisiatrica/article/view/102826

Sthal HC, Berti HW, Palhare V de C. Grau de dependência de idosos hospitalizados para realização das atividades básicas da vida diária. Texto e Context Enferm. 2011;20(1):59-67. https://doi.org/10.1590/S0104-07072011000100007 DOI: https://doi.org/10.1590/S0104-07072011000100007

Chodos AH, Kushel MB, Greysen SR, Guzman D, Kessell ER, Sarkar U, et al. Hospitalization-Associated Disability in Adults Admitted to a Safety-Net Hospital. J Gen Intern Med. 2015;30(12):1765-72. https://doi.org/10.1007/s11606-015-3395-2 DOI: https://doi.org/10.1007/s11606-015-3395-2

Melo RC, Cipolli GC, Buarque GLA, Yassuda MS, Cesari M, Oude Voshaar RC, et al. Prevalence of Frailty in Brazilian Older Adults: A Systematic Review and Meta-Analysis. J Nutr Heal Aging. 2020;24(7):708-16. https://doi.org/10.1007/s12603-020-1398-0 DOI: https://doi.org/10.1007/s12603-020-1398-0

Pereira AM, Rosa AC. Linha guia da saúde do idoso. Curitiba: Secretaria do Estado da Saúde do Paraná - SESA; 2018. 126 p.

Storti LB, Whebe F, Coelho SC, Kusumota L, Rodrigues RA, Marques S. Fragilidade de idosos internados na clínica médica da unidade de emergência de um hospital geral terciário. Texto Contexto Enferm. 2013;22(2):452-59. DOI: https://doi.org/10.1590/S0104-07072013000200022

Antunes JF, Okuno MF, Lopes MC, Campanharo CR, Assayag RE. Avaliação da fragilidade de idosos internados em serviço de emergência de um hospital universitário. Cogit. Enferm. 2015;20(2):264-71. DOI: https://doi.org/10.5380/ce.v20i2.39928

Leandro LA, Gomes LMR, Chevônica JP. Avaliação multidimensional da fragilidade em idosos hospitalizados. PAJAR. 2020;8(1):e37479. https://doi.org/10.15448/2357-9641.2020.1.37479 DOI: https://doi.org/10.15448/2357-9641.2020.1.37479

Published

2024-08-16

How to Cite

Boumer, T. C., Teleginski Wardenski , L., de Lima Granza , F., Pistore Fiori , S. M., de Lima Zanata , I., Ferretti Manffra, E., & Coltro, P. H. (2024). Prevalence of multidimensional frailty and risk of sarcopenia in older people admitted to a medium-complexity hospital: a retrospective cross-sectional study. PAJAR - Pan American Journal of Aging Research, 12(1), e45597. https://doi.org/10.15448/2357-9641.2024.1.45597

Issue

Section

Original Article

Most read articles by the same author(s)