FRAILTY SYNDROME IN INSTITUTIONALIZED OLDER ADULTS: IS HYPERTENSION A PROTECTIVE FACTOR?

Authors

  • Maria Armanda Marques Mestre, Santa Casa da Misericórdia de Alvaiázere – Alvaiázere, Portugal
  • Vítor Costa Especialista em Medicina do Trabalho e Medicina Geral e Familiar, Santa Casa da Misericórdia de Alvaiázere, Portugal
  • Beatriz Furtado Licenciada, Santa Casa da Misericórdia de Alvaiázere, Portugal
  • Ana Faria Doutora, Escola Superior de Tecnologia da Saúde de Coimbra, Portugal
  • Marisa Cebola Doutora, (H&TRC) - Centro de Investigação em Saúde e Tecnologia; (ESTeSL) – Dietética e Nutrição, Escola Superior Tecnologia da Saúde de Lisboa; (IPL) - Instituto Politécnico de Lisboa

DOI:

https://doi.org/10.58043/rphrc.31

Keywords:

older adults, hypertension, frailty syndrome

Abstract

Introduction: Portuguese older adults have a high prevalence of chronic disease, such as hypertension. Frailty is a multidimensional syndrome, in which a state of extreme vulnerability to endogenous and exogenous factors is recognized, due to cumulative decline associated with the ageing process, potentially leading to a state of total dependence. The aim of this investigation was to establish na association between the presence of hypertension and frailty syndrome in institutionalized older adults.

Methods: This is a cross-sectional study for which institutionalized older adults from two institutions in Leiria district (Portugal) were invited to participate. Demographic data was collected, as well as clinical history. Frailty syndrome was assessed using Fried’s Frailty Phenotype. This study was approved by the Ethical Committee of the Centro Académico de Medicina de Lisboa. All participants or legal representatives signed the informed written consent for participation.

Results: One hundred and forty-seven older adults were included, mainly female (63,2%), with a mean age of 82.6 years old (SD=8.6), ranging from 63 to 103. Hypertension was found in 59.6% of the sample. Frailty syndrome was found in 41.5%. Simultaneously, frailty and hypertension were present in 59.6% of the sample. No statistically significant association was found between the presence of hypertension and frailty.

Conclusion: In this study, institutionalized older adults presented a high prevalence of hypertension and frailty. The possible influence of the presence of frailty syndrome in the therapeutic benefit of treating hypertension highlights the importance of assessing this condition in individuals with hypertension.

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References

Publications Office of the European Union. The 2018 Ageing Report: Underlying Assumptions & Projection Methodologies. Luxembourg; 2018.

United Nations, Department of Economic and Social Affairs PD. World Population Prospects: The 2017 Revision, Key Findings and Advance Tables. World Population Prospects. 2017.

United Nations, Department of Economic and Social Affairs PD. World Population Ageing 2015. 2015.

Instituto Nacional de Estatística (INE). Projeções de População Residente 2015 - 2080. Instituto Nacional de Estatística. 2017.

Direção-Geral da Saúde. A Saúde dos Portugueses - Perspetiva 2015. Direção-Geral da Saúde, editor. 2015.

World Health Organization. World Report on Ageing and Health. World Health Organization. 2015.

Agüero-Torres H, von Strauss E, Viitanen M, Winblad B, Fratiglioni L. Institutionalization in the elderly: the role of chronic diseases and dementia. Cross-sectional and longitudinal data from a population-based study. J Clin Epidemiol. Agosto de 2001;54(8):795–801.

Litchford MD. Counteracting the Trajectory of Frailty and Sarcopenia in Older Adults. Nutr Clin Pract. Agosto de 2014;29(4):428–34.

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. 1 de Março de 2016;17(3):188–92.

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. 2016;17(3):188–92

Bernabei R, Martone AM, Vetrano DL, Calvani R, Landi F, Marzetti E. Frailty, Physical Frailty, Sarcopenia: A New Conceptual Model. Stud Health Technol Inform. 2014;203:78–84.

Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in Older Adults: Evidence for a Phenotype. Journals Gerontol Ser A Biol Sci Med Sci. 1 de Março de 2001;56(3):M146–57.

González-Vaca J, de la Rica-Escuín M, Silva-Iglesias M, Arjonilla-García MD, Varela-Pérez R, Oliver-Carbonell JL, et al. Frailty in INstitutionalized older adults from ALbacete. The FINAL Study: rationale, design, methodology, prevalence and attributes. Maturitas. Janeiro de 2014;77(1):78–84.

Aubertin-Leheudre M, Woods AJ, Anton S, Cohen R, Pahor M. Frailty Clinical Phenotype: A Physical and Cognitive Point of View. Em: Nestle Nutrition Institute workshop series. 2015. p. 55–64.

Morley JE, Vellas B, Abellan van Kan G, Anker SD, Bauer JM, Bernabei R, et al. Frailty consensus: A call to action. J Am Med Dir Assoc. 2013;14(6):392–7.

Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in Older Adults: Evidence for a Phenotype. J Gerontol Med Sci. 2001;56(3):46–56.

Landi F, Cherubini A, Cesari M, Calvani R, Tosato M, Sisto A, et al. Sarcopenia and frailty: From theoretical approach into clinical practice. Eur Geriatr Med. 2016;7(3):197–200.

Direção-Geral da Saúde. Norma no 20/2011 - Hipertensão Arterial: definição e classificação. 2013.

Jorge IN de SDR. 1o Inquérito Nacional de Saúde com Exame Físico (INSEF 2015): Estado de Saúde. Lisboa: INSA, IP; 2016. 1–61 p.

Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 1 de Setembro de 2018;39(33):3021–104.

Direção-Geral da Saúde.Norma no 26/2011 - Abordagem Terapêutica da Hipertensão Arterial. 2013.

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. 2018;8(12):1–8.

Odden MC, Beilby PR, Peralta CA. Blood Pressure in Older Adults: the Importance of Frailty. Curr Hypertens Rep. Julho de 2015;17(7):55.

Odden MC, Beilby PR, Peralta CA. Blood Pressure in Older Adults: the Importance of Frailty. Curr Hypertens Rep. Julho de 2015;17(7):55.

European Commission. Population ageing in Europe-Facts, implications and policies. Directorare-General for Research and Innovation. 2014. 1–76 p.

Jyrkkä J, Enlund H, Lavikainen P, Sulkava R, Hartikainen S. Association of polypharmacy with nutritional status, functional ability and cognitive capacity over a three-year period in an elderly population. Pharmacoepidemiol Drug Saf. Maio de 2011;20(5):514–22.

Beckett NS, Peters R, Fletcher AE, Staessen JA, Liu L, Dumitrascu D, et al. Treatment of Hypertension in Patients 80 Years of Age or Older. N Engl J Med. Maio de 2008;358(18):1887–98.

Wright JT, Williamson JD, Whelton PK, Snyder JK, Sink KM, Rocco M V., et al. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med. 2015;373(22):2103–16.

Ruilope LM, Ruiz‐Hurtado G. Management of hypertension in the very old: aggressive reduction of blood pressure is harmful in most patients. J Hum Hypertens. 2020;1–5.

Onder G, Penninx BWJH, Balkrishnan R, Fried LP, Chaves PHM, Williamson J, et al. Relation between use of angiotensin-converting enzyme inhibitors and muscle strength and physical function in older women: An observational study. Lancet. 2002;359(9310):926–30.

Wing LMH, Reid CM, Ryan P, Beilin LJ, Brown MA, Jennings GLR, et al. A Comparison of Outcomes with Angiotensin-Converting–Enzyme Inhibitors and Diuretics for Hypertension in the Elderly. N Engl J Med. 13 de Fevereiro de 2003;348(7):583–92.

Mendes J, Amaral TF, Borges N, Santos A, Padrão P, Moreira P, et al. Handgrip strength values of Portuguese older adults: A population based study. BMC Geriatr. 2017;17(1):1–12.

Guerra RS, Fonseca I, Pichel F, Restivo MT, Amaral TF. Handgrip strength and associated factors in hospitalized patients. J Parenter Enter Nutr. 2015;39(3):322–30.

Grabovac I, Haider S, Mogg C, Majewska B, Drgac D, Oberndorfer M, et al. Frailty Status Predicts All-Cause and Cause-Specific Mortality in Community Dwelling Older Adults. J Am Med Dir Assoc. 2019;20(10):1230-1235.e2.

Published

2022-06-04

How to Cite

1.
Marques MA, Costa V, Furtado B, Faria A, Cebola M. FRAILTY SYNDROME IN INSTITUTIONALIZED OLDER ADULTS: IS HYPERTENSION A PROTECTIVE FACTOR?. RH [Internet]. 2022 Jun. 4 [cited 2024 Dec. 4];(83):8-15. Available from: https://revistahipertensao.pt/index.php/rh/article/view/31

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