Original Article

Frailty among institutionalized older people: a cross-sectional study in Natal (Brazil)

Fabienne Louise Juvêncio Paes de Andrade¹, Javier Jerez-Roig^1,2, Louise Natália Mesquita Belém³, Kenio Costa de Lima¹

1. Postgraduate Program in Collective Health, Federal University of Rio Grande do Norte, Natal-RN, Brazil
2. Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Spain
3. Graduate Degree in primary health care, University of the State of Rio Grande do Norte, Mossoró, Brazil

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Keywords: Aging, Health of institutionalized elderly, Frail elderly, Long-term institution for elderly, Cross-sectional studies

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Abstract

Objective: Verify the prevalence of frailty and its associated factors in institutionalized older people. Methods: Crosssectional study carried out in 10 nursing homes in Natal (Brazil), between October/2013 and January/2014. All institutionalized older people 60+ that were not hospitalized, in terminal state, coma or under palliative care were included in the study. The dependent variable of the study was the presence/absence of frailty, classified according to the following criteria: severe cognitive decline and/or impossibility of independent walking or being bedridden. The 5 criteria (muscular weakness, unintentional weight loss, low physical activity level, slowness and exhaustion) of Fried et al. were considered for those with preserved cognitive and walking capacity. The chi-square test or Fisher’s test and logistic regression were used for bivariate and multiple analysis, respectively. Sociodemographic, institution-related and health-related variables were also included. Results: Of the 321 participating older people, 80.1% were considered frail, 16.8% pre-frail and 3.1% non-frail. The final model demonstrated association of frailty with age (OR=2.67; 95%CI 1.39-5.14; p=0.003), presence of chronic diseases (OR=10.27; 95%CI 3.42-30.90; p<0.001), systemic arterial hypertension (OR=0.11; 95%CI 0.05-0.27; p<0.001) and institutionalization due to lack of caregiver (OR=2.55; 95%CI 1.36-4.76; p=0.003) adjusted by sex and type of institution. Discussion: Frailty was highly prevalent in institutionalized older people and its association with multi-factor aspects suggested that action of health services and government representations could aid in the prevention or delay of frailty onset, improving the life quality of older people.

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