BACKGROUND: Frailty is a clinical syndrome, and its development is multifactorial and dynamic. The clinical indicators (physical measures and self-report) that characterize the syndrome tend to vary across studies. To determine the contributions of the indicators in the determination of frailty it is important to obtain data about the variations that occur among the levels of frailty. The aim of this study was to a) survey the prevalence of the frailty syndrome and of the indicators that compose the frailty phenotype in community-dwelling older adults, and b) to evaluate the contribution of each indicator in the determination frailty.
METHODS: Prevalence study carried out with 163 older adults who participated in two assessments; the first one was performed in 2009 and after 70 months the second assessment was conducted. Assessment of physical measurements was performed to constitute the frailty phenotype (gait speed and handgrip strength) alongside self-report (fatigue, unintentional weight loss, and physical activity), as proposed by Fried. We used the McNemar’s test and Pearson’s chi-square to analyze the differences between means and Multinomial Logistic Regression values.
RESULTS: There was an increase in the number of pre-frail older adults (from 47.85% to 65.03%) and frail ones (from 7.98% to 9.82%). The frailty indicators increased significantly (+ 8.6% for walking; + 6.8% for fatigue; + 6.8% for grip strength; + 1.2% for physical activity), except for the “weight loss” item (-3%). The indicators with the highest predictors of frailty in 2009 were fatigue (OR = 31.41; 95%CI 11.66-84-65, p<0.001) and weight loss (OR = 28.74; 95%CI 9.20-89.84, p<0.001). In the second assessment, the items that had the highest chance for developing frailty were slow gait (OR = 23.64; 95%CI 5.38-103.83, p<0.001) and muscle weakness (OR = 79.39; 95%CI 8.58-734.24, p<0.001).
CONCLUSION: There was an increase in frail and pre-frail older adults during the two assessments and an increase in the indicators that mark the syndrome phenotype. The explanatory models of frailty changed in both assessments. The evolution of frailty signals the necessity for interventions to be carried out with older adults to delay the progress of declining faculties that threaten their health.