Fragilidad, desempeño físico y riesgo de caídas en adultos mayores pertenecientes a una comuna de Cali, Colombia  <span class="so-article-trans-title" dir="auto"> Translated title: Fragility, physical performance and risk of falls among older adults in an area of Cali, Colombia </span>

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Abstract

RESUMEN Introducción: La progresión del envejecimiento poblacional va acompañada del aumento de la morbilidad, la cronicidad y con ello la fragilidad, que afecta finalmente a la población adulta mayor en la etapa final de la vida. Objetivo: Determinar el nivel de fragilidad, funcionalidad y riesgo de caídas en adultos mayores de una comuna de Cali, Colombia. Material y métodos: Estudio descriptivo en un grupo de adultos mayores de la ciudad de Cali, Colombia. El estudio contó con aval ético y todos los participantes firmaron el consentimiento informado. Se aplicó la batería corta de desempeño físico (SPPB) y se compararon los grupos por nivel de fragilidad en vigoroso, prefrágil y frágil. Resultados: Se vincularon 197 adultos mayores al estudio, en su mayoría mujeres, con una edad promedio de 73,88 ± 7,96 años. En la prueba de alcance funcional y fuerza de prensión manual por medio de dinamometría se obtuvo que el 14,2% de los participantes presentaban riesgo de caídas; en cuanto a la SPPB, el 12,7% presentaron limitación funcional y el 76,6% se encontraban en prefragilidad y fragilidad. Conclusión: La mayor cantidad de adultos mayores de la comuna 19 de Cali eran mujeres en prefragilidad, lo que claramente supone que en el corto/mediano plazo, por la edad y por el peor desempeño físico, empeorarían a fragilidad.

Translated abstract

ABSTRACT Introduction: The increasing aging of the population brings along increasing morbidity and chronicity, which leads to the fragility that affects older adults by the end of their life course. Objective: to establish the level of fragility, physical performance and risk of falls among older adults in an area of Cali, Colombia. Material and methods: Descriptive study among a group of older adults in the city of Cali, Colombia. The study had ethical approval and all participants granted informed consent. The study used the Short Physical Performance Battery (SPPB) and levels of fragility in participants was ranked in vigorous, pre-fragile and fragile. Results: 197 older adults took part in the study, most of them women averaging 73.88 ± 7.96 years old. Functional reach and hand dynamometer tests showed that 14,2% of the patients are in the risk of falls; SPPB showed that 12,7% have functional limitation and 76,6% are in the pre-fragility and fragility stages. Conclusion: The majority of older adults in the Comuna 19 area of Cali, Colombia, are women in pre-fragile stage, which clearly poses the risk that their condition can worsen into the fragility condition in the short and midterm, due to aging and a decline in physical performance.

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Frailty in elderly people

Andrew B. Clegg, John Young, Steve Iliffe … (2013)

Frailty is the most problematic expression of population ageing. It is a state of vulnerability to poor resolution of homoeostasis after a stressor event and is a consequence of cumulative decline in many physiological systems during a lifetime. This cumulative decline depletes homoeostatic reserves until minor stressor events trigger disproportionate changes in health status. In landmark studies, investigators have developed valid models of frailty and these models have allowed epidemiological investigations that show the association between frailty and adverse health outcomes. We need to develop more efficient methods to detect frailty and measure its severity in routine clinical practice, especially methods that are useful for primary care. Such progress would greatly inform the appropriate selection of elderly people for invasive procedures or drug treatments and would be the basis for a shift in the care of frail elderly people towards more appropriate goal-directed care. Copyright © 2013 Elsevier Ltd. All rights reserved.

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Inflammageing: chronic inflammation in ageing, cardiovascular disease, and frailty

Luigi Ferrucci, Elisa Fabbri (2018)

Most older individuals develop inflammageing, a condition characterized by elevated levels of blood inflammatory markers that carries high susceptibility to chronic morbidity, disability, frailty, and premature death. Potential mechanisms of inflammageing include genetic susceptibility, central obesity, increased gut permeability, changes to microbiota composition, cellular senescence, NLRP3 inflammasome activation, oxidative stress caused by dysfunctional mitochondria, immune cell dysregulation, and chronic infections. Inflammageing is a risk factor for cardiovascular diseases (CVDs), and clinical trials suggest that this association is causal. Inflammageing is also a risk factor for chronic kidney disease, diabetes mellitus, cancer, depression, dementia, and sarcopenia, but whether modulating inflammation beneficially affects the clinical course of non-CVD health problems is controversial. This uncertainty is an important issue to address because older patients with CVD are often affected by multimorbidity and frailty - which affect clinical manifestations, prognosis, and response to treatment - and are associated with inflammation by mechanisms similar to those in CVD. The hypothesis that inflammation affects CVD, multimorbidity, and frailty by inhibiting growth factors, increasing catabolism, and interfering with homeostatic signalling is supported by mechanistic studies but requires confirmation in humans. Whether early modulation of inflammageing prevents or delays the onset of cardiovascular frailty should be tested in clinical trials.