Prevalence of factors related to frailty and physical mobility in older people with heart disease

a cross-sectional study in an outpatient setting

Authors

DOI:

https://doi.org/10.15448/2357-9641.2023.1.44836

Keywords:

Eldery, Frailty, Cardiovascular Disease, Vulnerability, Functional Performance

Abstract

Introduction: frailty is a multifactorial syndrome of biological, psychological, and social conditions that p  redisposes the older people to a decline in functionality and greater susceptibility to vulnerability. Such a condition can be exacerbated in those presenting comorbidities, with  cardiovascular diseases being particularly notable. Objective: To ascertain the prevalence of factors related to frailty and physical mobility, as well as the correlation between these indicators in elderly individuals in an outpatient setting.

Case material and methods: a cross-sectional study with an exploratory, descriptive, and quantitative approach evaluated a group of older individuals with chronic cardiovascular diseases of both sexes, aged ≥60 years, undergoing care at a cardiology outpatient clinic. Participants were categorized according to Fried’s physica’ frailty classification, and their physical mobility was assessed using the Timed Up and Go (TUG) test, muscular strength through handgrip strength (HGS), muscular quantity of calf muscles through calf circumference (CC), and multidimensional frailty with the Índice de Vulnerabilidade Clínico-Funcional (IVCF-20). Prevalence was investigated through relative andabsolute frequency, and for correlation analyses, the Spearman test was employed.

Results: the median age of the sample was 73 years; 41 (61.2%) were frail, 17 (25.4%) pre-frail, and 9 (13.4%) non-frails. Concerning physical mobility, the frail group exhibited muscular weakness with HGS of 15.3 kgf (1.6 – 33.3) and a longer required time in the TUG test of 16.3s (8.8 – 50.0). There is evidence of a correlation between IVCF-20 and TUG (p= <0.001; r=0.580), as well as a negative correlation between HGS and TUG (p= <0.001; r= -0.434) and IVCF-20 and HGS (p= <0.001; r= -0.378).

Conclusion: there is a prevalence of physical frailty in elderly individuals with cardiovascular diseases undergoing outpatient care. Mobility measures are correlated with each other.

Downloads

Download data is not yet available.

Author Biographies

Inaê Claudino Bochoski, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR, Brasil.

Graduada em Fisioterapia pela Pontifícia Universidade Católica do Paraná (PUCPR), em Curitiba, PR, Brasil.
Especializanda em Gerontologia Multidisciplinar: Saúde da Pessoa Idosa na Pontifícia Universidade Católica do Paraná (PUCPR), em Curitiba, PR, Brasil.

Maria Eduarda Polato Ferreira , Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR, Brasil.

Graduada em Fisioterapia pela Pontifícia Universidade Católica do Paraná (PUCPR), em Curitiba, PR, Brasil. Especializanda em Fisioterapia em Terapia Intensiva: Atenção Fisioterapêutica da UTI ao Domicílio na Pontifícia Universidade Católica do Paraná (PUCPR), em Curitiba, PR, Brasil.

Martin Peter Klein Wiemer , Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR, Brasil.

Graduado em Fisioterapia pela Pontifícia Universidade Católica do Paraná (PUCPR), em Curitiba, PR, Brasil.

 

Thais Souza Martins, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR, Brasil.

Graduada em Fisioterapia pela Pontifícia Universidade Católica do Paraná (PUCPR), em Curitiba, PR, Brasil.

Tatiane Caroline Boumer, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR, Brasil.

Mestre em Tecnologia em Saúde pela Pontifícia Universidade Católica do Paraná (PUCPR), em Curitiba, PR, Brasil; especialista na modalidade Residência em Saúde do Idoso da Secretaria Municipal da Saúde de Curitiba, PR, Brasil; especialista em Gerontologia pela Sociedade Brasileira de Geriatria e Gerontologia (SBGG), em São Paulo, SP, Brasil. Doutoranda em Tecnologia em Saúde na PUCPR, em Curitiba, PR, Brasil.

Luciano Alves Leandro, Pontifícia Universidade Católica do Paraná - PUCPR

Doutor em Medicina Interna pela Universidade Federal do Paraná (UFPR); mestre em Medicina Interna pela Universidade Federal do Paraná (UFPR), em Curitiba, PR, Brasil; especialista na modalidade Aprimoramento em Fisioterapia em Geriatria e Gerontologia pelo Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), em São Paulo, SP, Brasil; especialista em Gerontologia pela Sociedade Brasileira de Geriatria e Gerontologia (SBGG), em São Paulo, SP, Brasil. Professor da Pontifícia Universidade Católica do Paraná (PUCPR), em Curitiba, PR, Brasil.

References

Qianqian Gao Q, Mei F, Shang Y, Hu K, Chen F, Zhao L, Ma B. Global prevalence of sarcopenic obesity in older adults: a systematic review and meta-analysis. Clin Nutr 2021 Jul;40(7):4633-4641. https://doi.org/10.1016/j.clnu.2021.06.009 DOI: https://doi.org/10.1016/j.clnu.2021.06.009

Ciosak SI, Braz E, Costa MF, Nakano NG, Rodrigues J, Alencar RA, Rocha AC. Senescence and senility: the[ new paradigm in primary health care. Rev Esc Enferm USP. 2011 Dec;45 Spec No 2:1763-8. https://doi: 10.1590/s0080-62342011000800022 DOI: https://doi.org/10.1590/S0080-62342011000800022

Ministério da Saúde. “Use o coração para vencer as doenças cardiovasculares”: 29/9 – Dia Mundial do Coração [Internet]. [place unknown]: Biblioteca Virtual em Saúde [cited 2023 Aug]. Available from: https://bvsms.saude.gov.br/use-o-coracao-para-vencer-as-doencas-cardiovasculares-29-9-dia-mundial-do-coracao/# :~:text= -No%20Brasil%2C%20as%20doen%C3%A7as%20cardiovasculares,250%25%20desses%20eventos%20no%20pa%C3%ADs

Organização Pan-Americana da Saúde. Doenças cardiovasculares continuam sendo principal causa de morte nas Américas [Internet]. [place unknown]: OPAS; 2021 Set 20 [cited 2023 Aug]. Available from: https://www.paho.org/pt/noticias/29-9-2021-doencas cardiovasculares-continuam-sendo-principal-causa-morte-nas-americas

Powell-Wiley TM, Poirier P, Burke LE, et al. Obesity and cardiovascular disease: a scientific statement from the American Heart Association. Circulation. 2021;143(21):984-1010. https://doi.org/10.1161/CIR.0000000000000973 DOI: https://doi.org/10.1161/CIR.0000000000000973

Soysal P, et al. Inflammation, frailty and cardiovascular disease. Adv Exp Med Biol 2020 Jan;1216:55-64. https://link.springer.com/chapter/10.1007/978-3-030-33330-0_7 DOI: https://doi.org/10.1007/978-3-030-33330-0_7

Frisoli Junior A, et al. Fragilidade é um preditor independente de morte precoce em idosos ambulatoriais com doenças cardiovasculares no estudo SARCOS. Rev. Soc. Cardiol. 2018. https://doi.org/10.29381/0103-8559/20182803331-5 DOI: https://doi.org/10.29381/0103-8559/20182803331-5

SBC (Sociedade Brasileira de Cardiologia). Atualização das diretrizes em cardiogeriatria da sociedade brasileira de cardiologia. 2019;112(5). http://publicacoes.cardiol.br/portal/abc/portugues/2019/v11205/pdf/edicao/179/#zoom=z

Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G, McBurnie MA; Cardiovascular health study collaborative research group. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001 Mar;56(3):M146-56. https://doi.org/10.1093/gerona/56.3.m146 DOI: https://doi.org/10.1093/gerona/56.3.M146

Rockwood K, Mitnitski A. Frailty in relation to the accumulation of deficits. J Gerontol A Biol Sci Med Sci. 2007;62:722-7. DOI: https://doi.org/10.1093/gerona/62.7.722

Carneiro JA, et al. Frailty in the elderly: prevalence and associated factors. Rev. Bras. Enferm. 2017Jul-Aug;70(4):747-52. https://doi.org/10.1590/0034-7167-2016-0633 DOI: https://doi.org/10.1590/0034-7167-2016-0633

Sousa CR, et al. Factors associated with vulnerability and fragility in the elderly: across-sectional study. Rev. Bras. de Enferm. 2021 Oct 1;75(2):e20200399. https://doi.org/10.1590/0034-7167-2020-0399 DOI: https://doi.org/10.1590/0034-7167-2020-0399

Podsiadlo D, Richardson S. The timed ‘Up & Go’: A test of basic functional mobility for frail elderly persons.

J Am Geriatr Soc. 1991;39(2):142-8. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x DOI: https://doi.org/10.1111/j.1532-5415.1991.tb01616.x

Arantes PMM, Reis MM. Medida da força de preensão manual: validade e confiabilidade do dinamômetro saehan. Fisiot Pesq. 2011;18(2):176-81. https://doi.org/10.1590/S1809-29502011000200013. DOI: https://doi.org/10.1590/S1809-29502011000200013

Paula JA, et al. Análise de métodos para detectar sarcopenia em idosas independentes da comunidade. Rev Bras Geriatr Gerontol. 2016 Apr;19(2):235-46. DOI: https://doi.org/10.1590/1809-98232016019.140233

Moraes EN, Carmo JA, Moraes FL, Azevedo RS, Machado CJ, Romero DH, et al. Clinical-functional vulnerability index-20 (IVCF-20): rapid recognition of frail older adults. Revista de Saúde Pública [Internet]. 2016 Dez [cited 2021 Out 27];50:81. Available from: https://doi.org/10.1590/S1518- 8787.2016050006963 DOI: https://doi.org/10.1590/s1518-8787.2016050006963

Nofuji Y, Shinkai S, Taniguchi Y, Amano H, Nishi M, Murayama H, Fujiwara Y, Suzuki T. Associations of walking speed, grip strength, and standing balance with total and cause-specific mortality in a general population of japanese elders. J Am Med Dir Assoc. 2016 Feb;17(2):184.e1-184.e7. https://doi.org/10.1016/j.jamda.2015.11.003 DOI: https://doi.org/10.1016/j.jamda.2015.11.003

Chua KY, et al. Handgrip strength and timed up-and-go (TUG) test are predictors of short-term mortality among elderly in a population-based cohort in Singapore. J Nutr Health Aging. 2020;24(4):371-8. https://link.springer.com/article/10.1007/s12603-020-1337-0 DOI: https://doi.org/10.1007/s12603-020-1337-0

Shin S, Valentine RJ, Evans EM, Sosnoff JJ. Lower extremity muscle quality and gait variability in older adults. Age Ageing. 2012;41:595-9. https://doi.org/10.1093/ageing/afs032 DOI: https://doi.org/10.1093/ageing/afs032

Cawthon PM, Fox KM, Gandra SR, Delmonico MJ, Chiou C-F, Anthony MS, et al. Do muscle mass, muscle density, strength, and physical function similarly influence risk of hospitalization in older adults? J Am Geriatr Soc. 2009;57:1411-9 https://doi.org/10.1111/j.1532-5415.2009.02366.x DOI: https://doi.org/10.1111/j.1532-5415.2009.02366.x

Finn M, Green P. The influence of frailty on outcomes in cardiovascular disease. Rev Esp Cardiol (Engl Ed). 2015 Aug;68(8):653-6. https://doi.org/10.1016/j.rec.2015.04.005 DOI: https://doi.org/10.1016/j.rec.2015.04.005

Silva NA, Pedraza DF, Menezes TN. Desempenho funcional e sua associação com variáveis antropométricas e de composição corporal em idosos. Cienc. e Saúde Colet., 2015 Dez;20(12):3723-32. https://doi.org/10.1590/1413-812320152012.01822015 DOI: https://doi.org/10.1590/1413-812320152012.01822015

Son KY, Shin DW, Lee JE, Kim SH, Yun JM, Cho B. Association of timed up and go test outcomes with future incidence of cardiovascular disease and mortality in adults aged 66 years: Korean national representative longitudinal study over 5.7 years. BMC Geriatr. 2020 Mar 19;20(1):111. https://10.1186/s12877-020-01509-8 DOI: https://doi.org/10.1186/s12877-020-01509-8

Stone KA, Barry AM, Kotarsky CJ, Dicks ND, Stastny SN, Byun W, Mitchell S, McGrath R, Hackney KJ. Moderate to vigorous physical activity, leucine, and protein intake contributions to muscle health in middle age. J Frailty Sarcopenia Falls. 2022 Sep 1;7(3):123-32. DOI: https://doi.org/10.22540/JFSF-07-123

https://10.22540/JFSF-07-123

Rose Berlin Piodena-Aportadera M, Lau S, Chew J, Lim JP, Ismail NH, Ding YY, Lim WS. Calf circumference measurement protocols for sarcopenia screening: differences in agreement, convergent validity and diagnostic performance. Ann Geriatr Med Res. 2022 Sep;26(3):215-24. https://doi.org/10.4235/agmr.22.0057 DOI: https://doi.org/10.4235/agmr.22.0057

Abe T, et al. Lower body site-specific sarcopenia and accelerometer-determined moderate and vigorous physical activity: The HIREGASAKI study. Aging Clin Exp Res. 2012;24(6):657-62. https://doi.org/10.3275/8758 DOI: https://doi.org/10.1007/BF03654851

Rose Berlin Piodena-Aportadera M, Lau S, Chew J, Lim JP, Ismail NH, Ding YY, Lim WS. Calf circumference as a surrogate marker of muscle mass for diagnosing sarcopenia in Japanese men and women. Geriatr Gerontol Intt. 2015 Aug;15(8):969-76. https://doi.org/10.1111/ggi.12377 DOI: https://doi.org/10.1111/ggi.12377

Rodgers JL, Jones J, Bolleddu SI, Vanthenapalli S, Rodgers LE, Shah K, Karia K, Panguluri SK. Cardiovascular risks associated with gender and aging. J Cardiovasc Dev Dis. 2019 Apr 27;6(2):19. https://doi.org/3390/jcdd6020019 DOI: https://doi.org/10.3390/jcdd6020019

Wei J, et al. The association between low calf circumference and mortality: a systematic review and meta-analysis. Eur Geriatr Med. 2022;13:597-609. https://doi.org/10.1007/s41999-021-00603-3 DOI: https://doi.org/10.1007/s41999-021-00603-3

Rijk JM, Roos PR, Deckx L, van den Akker M, Buntinx F. Prognostic value of handgrip strength in people aged 60 years and older: a systematic review and meta-analysis. Geriatr Gerontol Int. 2016 Jan;16(1):5-20. https://doi.org/10.1111/ggi.12508 DOI: https://doi.org/10.1111/ggi.12508

Published

2023-11-16

How to Cite

Claudino Bochoski, I., Polato Ferreira , M. E., Peter Klein Wiemer , M., Souza Martins, T., Caroline Boumer, T., & Leandro, L. A. (2023). Prevalence of factors related to frailty and physical mobility in older people with heart disease: a cross-sectional study in an outpatient setting. PAJAR - Pan American Journal of Aging Research, 11(1), e44836. https://doi.org/10.15448/2357-9641.2023.1.44836