Prevalence of frailty in a rural population aged 60 years and older with cardiovascular disease in Santander, Colombia
Abstract
Introduction. Given the increase in life expectancy, challenges arise for professionals who address the older adult population, including frailty as a prognostic factor for mortality and adverse events. The frequency of this geriatric syndrome varies across countries, and it is important to understand the local situation. The objective of this study was to describe the prevalence of frailty in patients aged 60 years and older in a Level I rural hospital in Santander, as well as its relationship with cardiovascular risk conditions and sociodemographic variables. Methodology. Cross sectional study conducted over a defined period with nonprobability sampling of consecutive cases. A total of 168 patients were included from July 2021 to September 2021. The FRAIL scale was used to assess frailty. Results. The prevalence of frailty was 11.9%. The median age for frail patients was 75.5 years. The most common comorbidities were hypertension (92.26%), dyslipidemia (50.60%), and non insulin dependent diabetes mellitus (33.93%). Variables associated with frailty included age greater than 82 years, a history of atrial fibrillation, chronic obstructive pulmonary disease (COPD), and creatinine greater than 1.2 mg/dL. Discussion. The prevalence of frailty was higher than that reported in studies conducted in European or Asian countries such as Korea, in contrast to data obtained from Brazilian and Mexican American populations, in whom greater frailty has been reported. Variables associated with increased risk have been described in international studies. Conclusions. This study provides local data, the results of which support the identification and care of patients with risk factors.
References
1. Departamento Administrativo Nacional de Estadística. Proyecciones de población [Internet]. Bogotá: DANE; 2024. Recuperado a partir de: https://www.dane.gov.co/index.php/estadisticas-por-tema/demografia-y-poblacion/proyecciones-de-poblacion
2. Old and frail. Br Med J [Internet]. 1968;23(1)-5594:723-4. PMID: 5641431. PMCID: PMC1985474. Recuperado a partir de: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1985474/
3. Fried LP, Cohen AA, Xue QL, Walston J, Bandeen-Roche K, Varadhan R. The physical frailty syndrome as a transition from homeostatic symphony to cacophony. Nature Aging [Internet]. 2021;1(1):36–46. doi: https://doi.org/10.1038/s43587-020-00017-z
4. James K, Jamil Y, Kumar M, Kwak MJ, Nanna MG, Qazi S, et al. Frailty and Cardiovascular Health. J Am Heart Assoc [Internet]. 2024;13(15). doi: https://doi.org/10.1161/JAHA.123.031736
5. Mas-Bargues C, Viña J, Borrás C. Editorial: Frailty- and age-associated diseases: possibilities for intervention. Front in Aging [Internet]. 2024;5. doi: https://doi.org/10.3389/fragi.2024.1522451
6. Huang L, Liang Z, Chen H. Association between physical activity and frailty transitions in middle-aged and older adults: a nationwide longitudinal study. Int J Behav Nutr Phys Act [Internet]. 2025;22(31). doi: http://dx.doi.org/10.1186/s12966-025-01725-8
7. Khor PY, Vearing RM, Charlton KE. The effectiveness of nutrition interventions in improving frailty and its associated constructs related to malnutrition and functional decline among community‐dwelling older adults: A systematic review. J Hum Nutr Diet [Internet]. 2021;35(3):566-582. doi: https://doi.org/10.1111/jhn.12943
8. Kim DH, Rockwood K. Frailty in Older Adults. N Engl J Med [Internet]. 2024;391:538-48. doi: http://dx.doi.org/10.1056/NEJMra2301292
9. Tan LF, Teng J, Chew ZJ, Choong A, Hong L, Aroos R, et al. Geriatric Services Hub - A Collaborative Frailty Management Model between The Hospital and Community Providers. J Frailty Aging [Internet]. 2023;12(4). doi: https://doi.org/10.14283/jfa.2023.23
10. Cesari M, Prince M, Thiyagarajan JA, De Carvalho IA, Bernabei R, Chan P, et al. Frailty: An emerging public health priority. J Am Med Dir Assoc [Internet]. 2016;17(3):188–92. doi: http://dx.doi.org/10.1016/j.jamda.2015.12.016
11. Lee L, Heckman G, Molnar FJ. Frailty Identifying elderly patients at high risk of poor outcomes. Can Fam Physician [Internet]. 2015;61(3):227-31. Recuperado a partir de: https://pubmed.ncbi.nlm.nih.gov/25767167/
12. Organización Panamericana de la Salud. Atención integrada para las personas mayores (ICOPE): Guía sobre la evaluación y los esquemas de atención centrados en la persona en la atención primaria de salud. Manual. Washington, D.C. [Internet]; 2020. Recuperado a partir de: https://iris.paho.org/handle/10665.2/51973
13. Yao X, Li H, Leng SX. Inflammation and immune system alterations in frailty. Clin Geriatr Med [Internet]. 2011;27(1):79–87. doi: http://dx.doi.org/10.1016/j.cger.2010.08.002
14. Saedi AA, Feehan J, Phu S, Duque G. Current and emerging biomarkers of frailty in the elderly. Clin Interv Aging [Internet]. 2019;14:389–98. doi: http://dx.doi.org/10.2147/CIA.S168687
15. Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet [Internet]. 2013;381(9868):752–62. doi: http://dx.doi.org/10.1016/S0140-6736(12)62167-9
16. Feng Z, Lugtenberg M, Franse C, Fang X, Hu S, Jin C, et al. Risk factors and protective factors associated with incident or increase of frailty among community-dwelling older adults: A systematic review of longitudinal studies. PLoS One [Internet]. 2017;12(6):e0178383. doi: http://dx.doi.org/10.1371/journal.pone.0178383
17. Trevisan C, Veronese N, Maggi S, Baggio G, De Rui M, Bolzetta F, et al. Marital status and frailty in older people: Gender differences in the Progetto Veneto Anziani longitudinal study. J Womens Health (Larchmt) [Internet]. 2016;25(6):630–7. doi: http://dx.doi.org/10.1089/jwh.2015.5592
18. Verlaan S, Ligthart-Melis GC, Wijers SLJ, Cederholm T, Maier AB, de van der Schueren MAE. High prevalence of physical frailty among community-dwelling malnourished older adults–A systematic review and meta-analysis. J Am Med Dir Assoc [Internet]. 2017;18(5):374–82. doi: http://dx.doi.org/10.1016/j.jamda.2016.12.074
19. Wang X, Hu J, Wu D. Risk factors for frailty in older adults. Medicine (Baltimore) [Internet]. 2022;101(34):e30169. doi: http://dx.doi.org/10.1097/MD.0000000000030169
20. Gagesch M, Chocano-Bedoya PO, Abderhalden LA, Freystaetter G, Sadlon A, Kanis JA, et al. Prevalence of physical frailty: Results from the DO-HEALTH study. J Frailty Aging [Internet]. 2022;11(1):18–25. doi: http://dx.doi.org/10.14283/jfa.2021.18
21. Avila-Funes JA, Carcaillon L, Helmer C, Carrière I, Ritchie K, Rouaud O, et al. Is frailty a prodromal stage of vascular dementia? Results from the Three-City Study. J Am Geriatr Soc [Internet]. 2012;60(9):1708–12. doi: http://dx.doi.org/10.1111/j.1532-5415.2012.04142.x
22. Etman A, Burdorf A, Van-der Cammen TJM, Mackenbach JP, Van-Lenthe FJ. Socio-demographic determinants of worsening in frailty among community-dwelling older people in 11 European countries. J Epidemiol Community Health [Internet]. 2012;66(12):1116–21. doi: http://dx.doi.org/10.1136/jech-2011-200027
23. Collard RM, Boter H, Schoevers RA, Oude-Voshaar RC. Prevalence of frailty in community-dwelling older persons: a systematic review. J Am Geriatr Soc [Internet]. 2012;60(8):1487–92. doi: http://dx.doi.org/10.1111/j.1532-5415.2012.04054.x
24. Abizanda-Soler P, López-Torres Hidalgo J, Romero-Rizos L, López-Jiménez M, Sánchez-Jurado PM, Atienzar-Núñez P, et al. Fragilidad y dependencia en Albacete (estudio FRADEA): razonamiento, diseño y metodología. Rev Esp Geriatr Gerontol [Internet]. 2011;46(2):81–8. doi: http://dx.doi.org/10.1016/j.regg.2010.10.004
25. Ottenbacher KJ, Ostir GV, Peek MK, Snih SA, Raji MA, Markides KS. Frailty in older Mexican Americans: Frailty in older Mexican Americans. J Am Geriatr Soc [Internet]. 2005;53(9):1524–31. doi: http://dx.doi.org/10.1111/j.1532-5415.2005.53511.x
26. Bandeen-Roche K, Seplaki CL, Huang J, Buta B, Kalyani RR, Varadhan R, et al. Frailty in older adults: A nationally representative profile in the United States. J Gerontol A Biol Sci Med Sci [Internet]. 2015;70(11):1427–34. doi: http://dx.doi.org/10.1093/gerona/glv133
27. Almeida-Carneiro J, Rodrígues-Cardoso R, Silva-Durães M, Araújo-Guedes MCA, Leão-Santos F, Marques-da Costa F, et al. Frailty in the elderly: prevalence and associated factors. Rev Bras Enferm [Internet]. 2017;70(4):747–52. doi: http://dx.doi.org/10.1590/0034-7167-2016-0633
28. Melo RC, Cipolli GC, Buarque GLA, Yassuda MS, Cesari M, Oude-Voshaar RC, et al. Prevalence of frailty in Brazilian older adults: A systematic review and meta-analysis. J Nutr Health Aging [Internet]. 2020;24(7):708–16. doi: http://dx.doi.org/10.1007/s12603-020-1398-0
29. Choi J, Ahn A, Kim S, Won CW. Global prevalence of physical frailty by fried’s criteria in community-dwelling elderly with national population-based surveys. J Am Med Dir Assoc [Internet]. 2015;16(7):548–50. doi: http://dx.doi.org/10.1016/j.jamda.2015.02.004
30. Hyde Z, Flicker L, Smith K, Atkinson D, Fenner S, Skeaf L, et al. Prevalence and incidence of frailty in Aboriginal Australians, and associations with mortality and disability. Maturitas [Internet]. 2016;87:89–94. doi: https://doi.org/10.1016/j.maturitas.2016.02.013
31. Palomares-Cuadros J, Marcos-Marcos J, Marquina-Márquez A. “Aquí (en Sídney) estamos perdidos”: estudio etnográfico de la satisfacción vital de aborígenes urbanos australianos participantes en un programa sociocomunitario. Salud Colectiva [Internet]. 2020;16:e2553. doi: https://doi.org/10.18294/sc.2020.2553
32. Xu R, Li Q, Guo F, Zhao M, Zhang L. Prevalence and risk factors of frailty among people in rural areas: a systematic review and meta-analysis. BMJ Open [Internet]. 2021;11(4):e043494. doi: http://dx.doi.org/10.1136/bmjopen-2020-043494
33. Vetrano DL, Palmer KM, Galluzzo L, Giampaoli S, Marengoni A, Bernabei R, et al. Hypertension and frailty: a systematic review and meta-analysis. BMJ Open [Internet]. 2018;8(12):e024406. doi: http://dx.doi.org/10.1136/bmjopen-2018-024406
34. Wang Z, Wang Q, Pei J, Wang X, Li Y, Yan J, et al. Association between the frailty and cognitive impairment among patients with hypertension-A post hoc analysis of the SPRINT trial. J Am Heart Assoc [Internet]. 2023;12(7):e028736. doi: http://dx.doi.org/10.1161/JAHA.122 .028736
35. Dao HHH, Burns MJ, Kha R, Chow CK, Nguyen TN. The relationship between metabolic syndrome and frailty in older people: A systematic review and meta-analysis. Geriatrics [Internet]. 2022;7(4):76. doi: http://dx.doi.org/10.3390/geriatrics7040076
36. Bielecka-Dabrowa A, Ebner N, Rodrigues-Dos Santos M, Ishida J, Hasenfuss G, von Haehling S. Cachexia, muscle wasting, and frailty in cardiovascular disease. Eur J Heart Fail [Internet]. 2020;22(12):2314–26. doi: http://dx.doi.org/10.1002/ejhf.2011
37. Hanlon P, Guo X, McGhee E, Lewsey J, McAllister D, Mair FS. Systematic review and meta-analysis of prevalence, trajectories, and clinical outcomes for frailty in COPD. NPJ Prim Care Respir Med [Internet]. 2023;33(1):1. doi: http://dx.doi.org/10.1038/s41533-022-00324-5
38. Peralta-Flores MC, Rodríguez-Zamora MC, Amato D, Cabrera-Delgado AM. Análisis de la relación entre la fragilidad y la calidad de vida relacionada con la salud en pacientes en diálisis peritoneal continua ambulatoria. Enferma Nefrol [Internet]. 2023;26(2):133–8. doi: https://doi.org/10.37551/S2254-28842023013
39. Mei F, Gao Q, Chen F, Zhao L, Shang Y, Hu K, et al. Frailty as a predictor of negative health outcomes in chronic kidney disease: A systematic review and meta-analysis. J Am Med Dir Assoc [Internet]. 2021;22(3):535-543.e7. doi: http://dx.doi.org/10.1016/j.jamda.2020.09.033
40. Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol Series A [Internet]. 2001;56(3):M146-56. doi: http://dx.doi.org/10.1093/gerona/56.3.m146
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