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Multicenter Study
. 2021 Apr 14;21(1):246.
doi: 10.1186/s12877-021-02193-y.

A multidimensional approach to frailty compared with physical phenotype in older Brazilian adults: data from the FIBRA-BR study

Claudia Venturini  1 , Rosana Ferreira Sampaio  2 , Bruno de Souza Moreira  3 , Eduardo Ferriolli  4 , Anita Liberalesso Neri  5 , Roberto Alves Lourenço  6 , Lygia Paccini Lustosa  7
Affiliations
Multicenter Study

A multidimensional approach to frailty compared with physical phenotype in older Brazilian adults: data from the FIBRA-BR study

Claudia Venturini et al. BMC Geriatr. .

Abstract

Background: Frailty is a predictor of negative health outcomes in older adults. The physical frailty phenotype is an often used form for its operationalization. Some authors have pointed out limitations regarding the unidimensionality of the physical phenotype, introducing other dimensions in the approach to frailty. This study aimed to create a multidimensional model to evaluate frailty in older Brazilian adults and to compare the dimensions of the model created among the categories of the physical frailty phenotype.

Methods: A cross-sectional study was conducted using data from 3569 participants (73.7 ± 6.6 years) from a multicenter and multidisciplinary survey (FIBRA-BR). A three-dimensional model was developed: physical dimension (poor self-rated health, vision impairment, hearing impairment, urinary incontinence, fecal incontinence, and sleeping disorder), social dimension (living alone, not having someone who could help when needed, not visiting others, and not receiving visitors), and psychological dimension (depressive symptoms, concern about falls, feelings of sadness, and memory problems). The five criteria of the phenotype created by Fried and colleagues were used to evaluate the physical frailty phenotype. The proposed multidimensional frailty model was analyzed using factorial analysis. Pearson's chi-square test was used to analyze the associations between each variable of the multidimensional frailty model and the physical phenotype categories. Analysis of variance compared the multidimensional dimensions scores among the three categories of the physical frailty phenotype.

Results: The factorial analysis confirmed a model with three factors, composed of 12 variables, which explained 38.6% of the variability of the model data. The self-rated health variable was transferred to the psychological dimension and living alone variable to the physical dimension. The vision impairment and hearing impairment variables were dropped from the physical dimension. The variables significantly associated with the physical phenotype were self-rated health, urinary incontinence, visiting others, receiving visitors, depressive symptoms, concern about falls, feelings of sadness, and memory problems. A statistically significant difference in mean scores for physical, social, and psychological dimensions among three physical phenotype categories was observed (p < 0.001).

Conclusions: These results confirm the applicability of our frailty model and suggest the need for a multidimensional approach to providing appropriate and comprehensive care for older adults.

Keywords: Frailty; Older adults; Psychological; Social.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
a Proposed multidimensional frailty model; b Final multidimensional frailty model after factorial analysis: physical dimension (range: 0–4); social dimension (range 0–3); psychological dimension (range 0–5). Source: Adapted from the Tilburg Frailty Indicator (Gobbens et al., 2010). Note: GDS-15 = Geriatric Depression Scale with 15 items; FES-I Brazil = Brazilian version of the Falls Efficacy Scale–International
See this image and copyright information in PMC

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