Is slowness a better discriminator of disability than frailty in older adults?

Abstract Background The trajectory of incident disability that occurs simultaneously with changes in frailty status, as well as how much each frailty component contributes to this process in the different sexes, are unknown. The objective of this study is to analyse the trajectory of the incidence o...

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Main Authors: Dayane Capra deOliveira, Roberta de OliveiraMáximo, Paula Camila Ramírez, Aline Fernanda deSouza, Mariane Marques Luiz, Maicon Luis Bicigo Delinocente, Marcos Hortes Nisihara Chagas, Andrew Steptoe, Cesar deOliveira, Tiago da SilvaAlexandre
Format: Article
Language:English
Published: Wiley 2021-12-01
Series:Journal of Cachexia, Sarcopenia and Muscle
Subjects:
Online Access:https://doi.org/10.1002/jcsm.12810
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author Dayane Capra deOliveira
Roberta de OliveiraMáximo
Paula Camila Ramírez
Aline Fernanda deSouza
Mariane Marques Luiz
Maicon Luis Bicigo Delinocente
Marcos Hortes Nisihara Chagas
Andrew Steptoe
Cesar deOliveira
Tiago da SilvaAlexandre
author_facet Dayane Capra deOliveira
Roberta de OliveiraMáximo
Paula Camila Ramírez
Aline Fernanda deSouza
Mariane Marques Luiz
Maicon Luis Bicigo Delinocente
Marcos Hortes Nisihara Chagas
Andrew Steptoe
Cesar deOliveira
Tiago da SilvaAlexandre
author_sort Dayane Capra deOliveira
collection DOAJ
description Abstract Background The trajectory of incident disability that occurs simultaneously with changes in frailty status, as well as how much each frailty component contributes to this process in the different sexes, are unknown. The objective of this study is to analyse the trajectory of the incidence of disability on basic and instrumental activities of daily living (BADL and IADL) as a function of the frailty changes and their components by sex over time. Methods Longitudinal analyses of 1522 and 1548 of the English Longitudinal Study of Ageing study participants without BADL and IADL disability, respectively, and without frailty at baseline. BADL and IADL were assessed using the Katz and Lawton Scales and frailty by phenotype at 4, 8, and 12 years of follow‐up. Generalized mixed linear models were calculated for the incidence of BADL and IADL disability, as an outcome, using changes in the state of frailty and its components, as the exposure, by sex in models fully adjusted for sociodemographic, behavioural, biochemical, and clinical characteristics. Results The mean age, at baseline, of the 1522 eligible individuals free of BADL and free of frailty was 68.1 ± 6.2 years (52.1% women) and of the 1548 individuals free IADL and free frailty was 68.1 ± 6.1 years (50.6% women). Women who became pre‐frail had a higher risk of incidence of disability for BADL and IADL when compared with those who remained non‐frail (P < 0.05). Men and women who became frail had a higher risk of incidence of disability regarding BADL and IADL when compared with those who remained non‐frail (P < 0.05). Slowness was the only component capable of discriminating the incidence of disability regarding BADL and IADL when compared with those who remained without slowness (P < 0.05). Weakness and low physical activity level in men and exhaustion in women also discriminated the incidence of disability (P < 0.05). Conclusions Slowness is the main warning sign of functional decline in older adults. As its evaluation is easy, fast, and accessible, screening for this frailty component should be prioritized in different clinical contexts so that rehabilitation strategies can be developed to avoid the onset of disability.
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spelling doaj.art-817df2dadc5645faac60abb4d3e8ff132022-12-22T04:04:57ZengWileyJournal of Cachexia, Sarcopenia and Muscle2190-59912190-60092021-12-011262069207810.1002/jcsm.12810Is slowness a better discriminator of disability than frailty in older adults?Dayane Capra deOliveira0Roberta de OliveiraMáximo1Paula Camila Ramírez2Aline Fernanda deSouza3Mariane Marques Luiz4Maicon Luis Bicigo Delinocente5Marcos Hortes Nisihara Chagas6Andrew Steptoe7Cesar deOliveira8Tiago da SilvaAlexandre9Postgraduate Program in Physical Therapy Federal University of Sao Carlos São Carlos BrazilPostgraduate Program in Physical Therapy Federal University of Sao Carlos São Carlos BrazilPostgraduate Program in Physical Therapy Federal University of Sao Carlos São Carlos BrazilPostgraduate Program in Physical Therapy Federal University of Sao Carlos São Carlos BrazilPostgraduate Program in Physical Therapy Federal University of Sao Carlos São Carlos BrazilPostgraduate Program in Gerontology Federal University of Sao Carlos São Carlos BrazilPostgraduate Program in Gerontology Federal University of Sao Carlos São Carlos BrazilDepartment of Epidemiology and Public Health University College of London (UCL) London EnglandDepartment of Epidemiology and Public Health University College of London (UCL) London EnglandPostgraduate Program in Physical Therapy Federal University of Sao Carlos São Carlos BrazilAbstract Background The trajectory of incident disability that occurs simultaneously with changes in frailty status, as well as how much each frailty component contributes to this process in the different sexes, are unknown. The objective of this study is to analyse the trajectory of the incidence of disability on basic and instrumental activities of daily living (BADL and IADL) as a function of the frailty changes and their components by sex over time. Methods Longitudinal analyses of 1522 and 1548 of the English Longitudinal Study of Ageing study participants without BADL and IADL disability, respectively, and without frailty at baseline. BADL and IADL were assessed using the Katz and Lawton Scales and frailty by phenotype at 4, 8, and 12 years of follow‐up. Generalized mixed linear models were calculated for the incidence of BADL and IADL disability, as an outcome, using changes in the state of frailty and its components, as the exposure, by sex in models fully adjusted for sociodemographic, behavioural, biochemical, and clinical characteristics. Results The mean age, at baseline, of the 1522 eligible individuals free of BADL and free of frailty was 68.1 ± 6.2 years (52.1% women) and of the 1548 individuals free IADL and free frailty was 68.1 ± 6.1 years (50.6% women). Women who became pre‐frail had a higher risk of incidence of disability for BADL and IADL when compared with those who remained non‐frail (P < 0.05). Men and women who became frail had a higher risk of incidence of disability regarding BADL and IADL when compared with those who remained non‐frail (P < 0.05). Slowness was the only component capable of discriminating the incidence of disability regarding BADL and IADL when compared with those who remained without slowness (P < 0.05). Weakness and low physical activity level in men and exhaustion in women also discriminated the incidence of disability (P < 0.05). Conclusions Slowness is the main warning sign of functional decline in older adults. As its evaluation is easy, fast, and accessible, screening for this frailty component should be prioritized in different clinical contexts so that rehabilitation strategies can be developed to avoid the onset of disability.https://doi.org/10.1002/jcsm.12810FrailtyDisabilityTrajectoriesOlder adultsSlowness
spellingShingle Dayane Capra deOliveira
Roberta de OliveiraMáximo
Paula Camila Ramírez
Aline Fernanda deSouza
Mariane Marques Luiz
Maicon Luis Bicigo Delinocente
Marcos Hortes Nisihara Chagas
Andrew Steptoe
Cesar deOliveira
Tiago da SilvaAlexandre
Is slowness a better discriminator of disability than frailty in older adults?
Journal of Cachexia, Sarcopenia and Muscle
Frailty
Disability
Trajectories
Older adults
Slowness
title Is slowness a better discriminator of disability than frailty in older adults?
title_full Is slowness a better discriminator of disability than frailty in older adults?
title_fullStr Is slowness a better discriminator of disability than frailty in older adults?
title_full_unstemmed Is slowness a better discriminator of disability than frailty in older adults?
title_short Is slowness a better discriminator of disability than frailty in older adults?
title_sort is slowness a better discriminator of disability than frailty in older adults
topic Frailty
Disability
Trajectories
Older adults
Slowness
url https://doi.org/10.1002/jcsm.12810
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