A influência de hábitos de vida (tabagismo, consumo nocivo de álcool e sedentarismo) associados à hipertensão arterial sistêmica na sídrome da fragilidade no idoso / The influence of health related behaviors (smoking, immoderate alcohol consumption and low physical training) associated with systemic hypertension in the elderly frailty sídrome

Ana Paula do Amaral Carvalho e Silva

Knowledge about frailty of the elderly is relatively recent. Few studies have attempted to investigate lifestyle and cardiovascular abnormalities in the frailty phenotype. This analysis allows a better comprehension of the biological versus multi-dimensional aspects of the syndrome, and it permits the identification of potentially adverse life behaviors to propose a therapeutic approach to frailty. Objective: To evaluate the association between behaviors related to cardiovascular risk (smoking, immoderate alcohol consumption and low physical training) and the transition to Frailty, as well to investigate the role of systemic arterial hypertension as a mediator of this transition in the elderly population of FIBRA Project - polo UNICAMP, Campinas, Brazil. Material and Methods: This is a cross-sectional study where were interviewed 3478 community-dwelling people of both sexes aged over 65 living in six Brazilian cities. The elderly were randomly recruited according to urban census areas. For inclusion, the elderly should be aged 65 years or older, to understand the instructions, agree to participate and belong to a previously defined census area. Exclusion criteria were: a) elderly people with severe cognitive impairment suggestive of dementia, as evidenced by problems with memory, attention, local and temporal orientation b) those who were using wheelchairs or who find themselves temporarily or permanently bedridden c) patients with serious stroke sequelae with localized loss of strength and/or aphasia d) patients with severe or unstable Parkinson s disease stage, with severe motor skills, speech or affection impairment e) patients with severe deficits in hearing or vision, which considerably hindered communication and f) those who were in terminal stage of life. Older people, who firstly attended a session of data collection and signed an informed consent, underwent to a screening test applying the Mini-Mental State Examination (MMSE). After all, evaluation of sociodemographic characteristics, and measures of anthropometric, blood pressure, oral health and frailty parameters were proceeded. Those who scored below the cutoff on the MMSE were dismissed, and those who scored above were referred to the second part of the protocol. 2318 seniors were selected to participate of the second part of the protocol, by which they were investigated about smoking, alcohol consumption, physical activity and self-reported hypertension. Those who were considered frail had three or more of the following criteria: unintentional weight loss, fatigue, slow gait, low physical activity and low handgrip strength. Findings related to smoking, immoderate alcohol consumption, low physical training and hypertension were correlated with the fragility. Conclusion: Of life behaviors assessed in this sample, only the sedentary lifestyle was related to frailty. Low physical training is one of the strongest predictors of disability in the elderly, conferring increased risk of disease, institutionalization and death, conditions which define frailty in the elderly.

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