Frailty is an important and complex phenomenon in the fields of
geriatrics and gerontology and a highly relevant topic. Frailty syndrome (FS)
is a multidimensional clinical condition characterized by loss of physiological
and cognitive reserves across multiple organ systems. The Fried frailty
phenotype is the main model used to categorize FS. Recent studies have shown an
association between anemia, low hemoglobin concentration and frailty. This
study aimed to assess the association
between FS and anemia in community-dwelling elderly. An observational
cross-sectional design was used, with 308 elderly subjects. Most participants
were women (78.2%) between 60 and 69 years old (50.6%). The average schooling level was 9.7 years. Anemia was detected
in 9.7% of participants. The frequency of frailty, pre-frailty and non-frailty
was 8.2, 74.0 and 17.8%, respectively. The multivariate ordinal logistic
regression model identified low levels of brain-derived neurotrophic factor
(BDNF) (OR = 0.9, 95% CI = 0.9; 0.9) as risk factor associated with FS.
No significant association was found between frailty and anemia. Moreover, FS
may be influenced by low schooling levels, despite the non-significant result
obtained in the statistical model. These findings contribute to elucidating
other factors associated with FS, especially in community-dwelling elderly.
References
[1]
Veras, R. (2009) Population Aging Today: Demands, Challenges and Innovations. Revista de Saude Publica, 43, 1-7. https://doi.org/10.1590/S0034-89102009000300020
[2]
Instituto Brasileiro de Geografia e Estatística (IBGE) (2016) Mortality in Brazil. https://ibge.gov.br
[3]
Alves, L.C., Limann, B.C.Q., Vasconcelos, M.E.L., Carvalho, M.S., Vasconcelos, A.G.G., Fonseca, T.C.O., Lebrão, M.L. and Laurenti, R. (2007) The Effect of Chronic Diseases on Functional Status of the Elderly Living in the City of São Paulo, Brazil. Cadernos de Saúde Pública, 23, 1924-1930. https://doi.org/10.1590/S0102-311X2007000800019
[4]
Brito, M.C.C., Freitas, C.A.S.L., Mesquita, K.O. and Lima, G.K. (2013) Aging Population and the Challenges for Public Health: Review of Scientific Production. Revista Kairós: Gerontologia, 16, 161-178. https://revistas.pucsp.br/kairos/article/view/18552/13738
[5]
Fried, L.P., Tangen, C.M., Walston, J., Newman, A.B., Hirsch, C., Gottdiener, J., Seeman, T., Tracy, R., Kop, W.J., Burke, G. and Mcburmie, M.A. (2001) Frailty in Older Adults: Evidence for a Phenotype. The Journals of Gerontology, 56A, M146-M157. https://doi.org/10.1093/gerona/56.3.M146
[6]
Clegg, A., Young, J., Iliffe, S., Rikkert, M.O. and Rockwood, K. (2013) Frailty in Older People. The Lancet, 381, 752-762. https://doi.org/10.1016/S0140-6736(12)62167-9
[7]
Arantes, P.M.M., Alencar, M.A., Dias, R.C., Dias, J.M.D.D. and Pereira, L.S.M. (2009) Physical Therapy Treatment on Frailty Syndrome: Systematic Review. Revista Brasileira de Fisioterapia, 13, 365-375. https://doi.org/10.1590/S1413-35552009005000061
[8]
Röhrig, G. (2016) Anemia in the Frail, Elderly Patient. Clinical Interventions in Aging, 11, 319-326. https://doi.org/10.2147/CIA.S90727
[9]
Corona, L.P., Andrade, F.C.D., Duarte, Y.A.O. and Lebrao, M.L. (2015) The Relationship between Anemia, Hemoglobin Concentration and Frailty in Brazilian Older Adults. The Journal of Nutrition, Health & Aging, 19, 935-940. https://doi.org/10.1007/s12603-015-0502-3
[10]
Bosco, R.M., Assis, E.P.S., Pinheiro, R.R., Queiroz, L.C.V., Pereira, L.S.M. and Antunes, C.M.F. (2013) Anemia and Functional Capacity in Elderly. Cadernos de Saúde Pública, 29, 1322-1332. https://doi.org/10.1590/S0102-311X2013000700007
[11]
Assis, E.P.S., Macêdo, B.G., Oliveira, H.S.C., Rezende, P.P. and Antunes, C.M.F. (2018) Anemia and the Frailty Syndrome amongst the Elderly Living in the Community: A Systematic Review. Revista Brasileira de Geriatria e Gerontologia, 21, 229-237. https://doi.org/10.1590/1981-22562018021.170100
[12]
Figueiredo, I.M., Sampaio, R.F., Mancini, M.C., Silva, F.C.M. and Souza, M.A.P. (2007) Test of Grip Strength Using the Jamar Dynamometer. Revista Acta Fisiátrica, 14, 104-110. https://doi.org/10.5935/0104-7795.20070002 http://www.revistas.usp.br/actafisiatrica/article/view/102799
[13]
World Health Organization (WHO) (2019) Anemia Diagnosis. https://www.who.int/topics/anaemia/en
[14]
Sousa, A.C.P.A., Dias, R.C., Maciel, A.C.C. and Guerra, R.O. (2012) Frailty Syndrome and Associated Factors in Community-Dwelling Elderly in Northeast Brazil. Archives of Gerontology and Geriatrics, 54, 95-101. https://doi.org/10.1016/j.archger.2011.08.010
[15]
Lustosa, L.P, Pereira, D.S., Dias, R.C., Britto, R.R., Parentoni, N.A. and Pereira, L.S.M. (2011) Translation and Cultural Adaptation of the Minnesota Leisure Time. Geriatria & Gerontologia, 5, 57-65. https://s3-sa-east-1.amazonaws.com/publisher.gn1.com.br/ggaging.com/pdf/v5n2a03.pdf
[16]
Leopoldino, A.A.O. (2016) Fragility, Comorbidities, Pain Intensity, Disability and Quality of Life in Students with Acute Hypermobility: Data from the Back Complaints in the Elders study (BACE). Doctoral Thesis, Federal University of Minas Gerais, Belo Horizonte.
[17]
Vieira, R.A., Guerra, R.O., Giacomin, K.C., Vasconcelos, K.S.S., Andrade, A.C.S.A., Pereira, L.S.M., Dias, J.M.D. and Dias, R.C. (2013) Prevalence of Frailty and Associated Factors in Community-Dwelling Elderly in Belo Horizonte, Minas Gerais State, Brazil: Data from the FIBRA Study. Cadernos de Saúde Pública, 29, 1631-1639. https://doi.org/10.1590/S0102-311X2013001200015
[18]
Lourenço, R.A., Guedes, D.V., Moreira, V.G., Delgado, F.E.F., Atalaia, K., Banhato, E. and Mármora, C.H.C. (2019) Prevalence of Frailty and Associated Factors in a Community-Dwelling Older People Cohort living in Juiz de Fora, Minas Gerais, Brazil: Fibra-JF Study. Ciência & Saúde Coletiva. 24, 35-44. https://doi.org/10.1590/1413-81232018241.29542016
[19]
Calado, L.B. (2013) Aspects of Frailty Syndrome in the Elderly in Ribeirão Preto. Master’s Project, Ribeirão Preto Medical School, Ribeirão Preto.
[20]
Alvarado, B.E., Zunxunegui, M.V., Béland, F. and Bamvita, J.M. (2008) Life Course Social and Health Conditions Linked to Frailty in Latin American Older Men and Women. The Journals of Gerontology, 63A, 1399-1406. https://doi.org/10.1093/gerona/63.12.1399
[21]
Buffon, P.L.D., Sgnaolin, V., Engroff, P., Viegas, K., Carli, G.A. (2015) Prevalence and Characterization of Anemia in Elderly Served by the Family Health Strategy. Revista Brasileira de Geriatria e Gerontologia, 18, 373-384. https://doi.org/10.1590/1809-9823.2015.14033
[22]
Santos, I.S., Scazufca, M., Lotufo, P.A., Menezes, P.R. and Benseñor, I.M. (2012) Anemia and Dementia among the Elderly: The São Paulo Ageing & Study. International Psychogeriatrics, 24, 74-81. https://doi.org/10.1017/S1041610211001724
[23]
Silva, C.L.A., Lima-Costa, M.F., Firmo, J.O.A. and Peixoto, S.V. (2012) Hemoglobin Level in Older Adults and the Association with Nutritional Status and Use of Health Services: The Bambuí Project. Cadernos de Saúde Pública, 28, 2085-2094. https://doi.org/10.1590/S0102-311X2012001100008
[24]
Silva, J.C., Moraes, Z.V., Silva, C.A., Mazon, S.B., Guariento, M.E., Neri, A.L. and Fattori, A. (2014) Understanding Red Blood Cell Parameters in the Context of the Frailty Phenotype: Interpretations of the FIBRA (Frailty in Brazilian Seniors) Study. Archives of Gerontology and Geriatrics, 59, 636-641. https://doi.org/10.1016/j.archger.2014.07.014
[25]
Haslam, A., Hausmam, D.B., Davery, A., Cress, M.E., Johnson, M.A. and Poon, L.W. (2012) Associations of Anemia and Physical Function in Georgia Centenarians. Journal of the American Geriatrics Society, 60, 2362-2363. https://doi.org/10.1111/jgs.12009
[26]
Coelho, F.M., Pereira, D.S., Lustosa, L.P., Silva, J.P., Dias, J.M.D., Dias, R.C.D., Queiroz, B.Z., Teixeira A.L., Teixeira, M.M. and Pereira, L.S.M. (2012) Physical Therapy Intervention (PTI) Increases Plasma Brain-Derived Neurotrophic Factor (BDNF) Levels in Non-Frail and Pre-Frail Elderly Women. Archives of Gerontology and Geriatrics, 54, 415-420. https://doi.org/10.1016/j.archger.2011.05.014
[27]
Pegorari, M.S. and Tavares, D.M.S. (2014) Factors Associated with the Frailty Syndrome in Elderly Individuals Living in the Urban Area. Revista Latino-Americana de Enfermagem, 22, 874-882. https://doi.org/10.1590/0104-1169.0213.2493
[28]
Tavares, D.M.S., Almeida, E.G., Ferreira, P.C.S., Dias, F.A. and Pegorari, N.S. (2014) Fragility Status among Elderly with Indicative of Depression by Gender. Jornal Brasileiro de Psiquiatria, 63, 347-353. https://doi.org/10.1590/0047-2085000000044