Prevalence of factors related to frailty and physical mobility in older people with heart disease
a cross-sectional study in an outpatient setting
DOI:
https://doi.org/10.15448/2357-9641.2023.1.44836Keywords:
Eldery, Frailty, Cardiovascular Disease, Vulnerability, Functional PerformanceAbstract
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
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
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
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 PAJAR - Pan American Journal of Aging Research
![Creative Commons License](http://i.creativecommons.org/l/by/4.0/88x31.png)
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright
The submission of originals to PAJAR implies the transfer by the authors of the right for publication. Authors retain copyright and grant the journal right of first publication. If the authors wish to include the same data into another publication, they must cite PAJAR as the site of original publication.
Creative Commons License
Except where otherwise specified, material published in this journal is licensed under a Creative Commons Attribution 4.0 International license, which allows unrestricted use, distribution and reproduction in any medium, provided the original publication is correctly cited.