FRAILTY IMPACT ON SURVIVAL ANALYSIS IN OLDER BRAZILIANS

INTRODUCTION:  The number of Brazilian older adults is expected to grow dramatically over the next decades. Frailty is an important health problem associated with high risk for adverse health outcomes including mortality, institutionalization, falls, decrease of functional capacity and hospitalization. Implications of these public health problem demand increasing attention, particularly because frailty has been documented as avoidable and reversible by active intervention strategies. Objective: To analyze the survival curve in a large, well-defined sample of older Brazilian (≥ 60 years) in four years follow up according frailty categories - no frail ,  pre frail and frail. 

METHODS:  The study is part of Longitudinal SABE Study (Health, Wellbeing and Aging) that began in 2000 (first wave) with a multistage, clustered, probabilistic sample (n=2143) of older adults (≥ 60 years) in Sao Paulo, Brazil. The second wave was carried out in 2006 when 1115 elders were re-interviewed and a new probabilistic cohort (60 to 64 years) was included (n=298). The same occurred (third wave) in 2010 (978 elders were re-interviewed and a new cohort (n=355) was included). The sample here is composed by elders interviewed in 2006 (n=1413). The variable dependent was frailty condition  using Fried’s Phenotype. Survival analysis was done based on data of 2010 (death analyses). Kaplan-Meier Survival Analysis was used to analyze the results considering frailty categories in baseline and and the presence or absence of cognitive decline. Losses occurred during the follow-up where considered with the half time of the period. 

RESULTS:  In 2006, frailty prevalence was 41.5 pre frail and 8.5 frail. The OR associated with frailty condition and survival was 2,72 (p=0.000; IC=1.665-4.464). Other variables associated were cognitive decline (OR=2.64; p=0.000;IC=1.702-4.098), gender (men) (OR=2.05; p=0.000; IC=1.538-2.755) and oldest age (OR=1.08; p=0.000; IC=1.059-1.1102).

CONCLUSIONS:  Frailty is associated with mortality in Brazilian elders and cognitive decline has an significant impact in this outcome.