Análise discriminatória dos componentes do fenótipo da fragilidade física na pessoa idosa alagoana

Abstract

Fragility is characterized by being a state of systemic vulnerability, causing resistance to stressors and triggering the cycle of fragility. The aim of this study is to test the discriminatory capacity of each phenotype item in determining physical frailty in elderly individuals in Alagoas. This is an observational, analytical, and descriptive cross-sectional population-based study involving people aged 60 and older. Data collection was conducted through home visits using a questionnaire on sociodemographic and economic information. To classify frailty, the frailty phenotype proposed by Fried et al., (2001) was used, consisting of five items: unintentional weight loss, fatigue/exhaustion, muscle weakness, slow walking speed, and low energy expenditure. The original cutoff point described by Fried et al., (2001), and the modified cutoff point described by Aranda et al., (2011) were used to classify frailty. A total of 480 individuals were evaluated, of which 12.1% were classified as frail, 63.5% as pre-frail, and 24.4% as robust, using the cutoff point described by Fried et al., (2001). When removed from the phenotype, low energy expenditure (0.33, 95% CI 0.19-0.55) and fatigue (0.65, 95% CI 0.43-0.96) showed a significant difference in prevalence. For the prevalence of frailty and prefrailty comparing the original cutoff point with the modified cutoff point, a significant difference was found when all items were removed, except for low energy expenditure for frailty. The diagnostic accuracy results were consistent with the original frailty phenotype, indicating that the modified cutoff point did not bias the results: without unintentional weight loss (80.6%, 95% CI 76.8-84.0), without fatigue (85.8%, 95% CI 82.3-88.8), without weakness (79.5, 95% CI 75.7-83.1), without slow walking speed (80.6, 95% CI 76.8-84.0), and without low energy expenditure (97.7, 95% CI 95.9-98.8). The Frailty Phenotype with both the original and modified cutoff points showed a difference in the prevalences of frailty and pre-frailty. The diagnostic accuracy using the modified cutoff point demonstrated high capability in correctly discriminating individuals in their frailty and non-frailty conditions.