Associação da fragilidade com diabetes mellitus e hipertensão arterial sistêmica: um estudo da rede fibra

Abstract

Introduction: Frailty, diabetes mellitus and systemic arterial hypertension are frequent conditions in the elderly population and are increasingly recognized as public health problems, however this association is still little explored in the Brazilian population. Objective: To analyze the association between the burden of frailty with Diabetes Mellitus and Systemic Arterial Hypertension. Methodology: Data obtained by REDE FIBRA (Network of Studies on Frailty in Elderly Brazilians) were used, which consists of a cross-sectional, multicenter and multidisciplinary epidemiological study. It was carried out with elderly people aged 65 years or older, residents of 8 cities in different regions of the country. Sociodemographic characteristics, chronic diseases (Diabetes Mellitus and Systemic Arterial Hypertension) and the components of physical frailty were evaluated. Descriptive statistics were used for data analysis, followed by a Poisson Regression model and a Logistic Regression model. Results: The total sample consisted of 3390 elderly people, and of these 2365 presented at least 1 positive item. The prevalence of frailty was 16.4% and that of pre-frail was 53.4%. The reduction in the level of physical activity was the most prevalent item in the sample (57.3%). Elderly people diagnosed with diabetes and those with both comorbidities (diabetes and hypertension) had a greater burden of frailty. According to the logistic regression model, the elderly with a diagnosis of diabetes were more likely (OR = 2.34) to obtain the positive unintentional weight loss criterion, and the hypertensive elderly were more likely (OR = 1.62) of have a positive fatigue criterion, compared with those without any diagnosis. For muscle weakness, those with both diseases were less likely to obtain the positive criterion. Regarding the low level of physical activity and slow gait, no association was observed with the diseases evaluated. Conclusions: The association of Diabetes Mellitus and Systemic Arterial Hypertension with a greater burden of frailty, as well as the association of these comorbidities with a greater chance of positivity of the item unintentional weight loss and fatigue in the frailty phenotype, reinforces the importance of evaluation and identification of frailty in the routine care of patients with these diseases, in addition, it demonstrates the relevance of interventions with exercises aimed at physical function in the management of frailty in diabetic and/or hypertensive elderly.