Researchers from the Federal University of São Carlos (UFSCar) in the state of São Paulo, Brazil, in collaboration with colleagues from University College London in the United Kingdom, have discovered an efficient, simple and inexpensive way to predict the risk of functional disability. in older people. They analyzed data from over 3,000 over 60s living in England and found that slow walking alone can be considered a predictor of the loss of the ability to perform basic and instrumental activities of daily living (BADL and IADL).
“Our study demonstrated that just measuring the speed of gait is sufficient for an efficient prediction of loss of functional capacity in the elderly. Based on our findings, we can say that the slow pace precedes this loss by several years. This is an important finding because it makes it easier to track the problem. It also allows not only physiotherapists, doctors and geriatricians, but also any health professional to detect the risk, “he said. Tiago da Silva Alexandre, professor in the UFSCar Department of Gerontology and principal investigator of the study.
An article on the study is published In the Journal of cachexia, sarcopenia and muscle. The study was supported by FAPESP and analyzed physical condition, general health and gait data for participants in the English Longitudinal Study of Aging (ELSA).
Loss of the ability to perform BADL activities (getting out of bed, bathing, feeding, walking, dressing, etc.) and IADL (cleaning, doing laundry, preparing meals, using transportation, spending, managing finances, managing drugs, etc.) may precede or appear at the same time as frailty.
Frailty, a condition found in a large percentage of older people, can be defined as a clinically recognizable state of greater vulnerability resulting from an associated decline in physiological reserve and function, increasing the risk of falls, hospitalization and death . Diagnosis involves a series of assessments to measure parameters such as gait speed, grip strength, level of physical activity, exhaustion, and involuntary weight loss.
“Frailty is not synonymous with disability, but it is a risk factor for loss of functional capacity,”
; said Alexandre. “We evaluated frailty syndrome based on five symptoms or parameters. Subjects with one or two of these were classified as pre-frail and those with three or more as frail. This methodology is complex and requires equipment and questionnaires. It is not universally used. ”
The researchers compared overall frailty with each of the five components, concluding that slow gait alone was the best predictor of BADL and IADL for both genders. “It’s an early indicator. The discovery allows healthcare professionals to detect a problem more easily. They can start investigating the causes of slowness earlier, ”said Dayane Capra de Oliveira, first author of the article.
According to Alexandre, the earlier the problem is identified, the more resources and approaches can be used to deal with it. “It is more difficult to initiate treatment when a person is already experiencing difficulties in various daily activities,” he said. “There are options, but the results aren’t as good as they can be when the problem is detected early. This is why it is so important to offer a simpler, safer and more cost-effective approach to predicting loss of functional capacity. ”
The authors found a higher risk of disability in BADL and IADL in pre-frail women than in pre-frail men. The incidence of pre-frailty was a predictor of disability in women only. They note that women have greater physiological reserves than men and better tolerate changes in multiple systems. This may be due to the increased incidence in men of life-threatening ailments such as stroke, cancer and lung disease, along with unhealthy habits such as smoking and drinking, as well as the need for grueling manual labor, while women live longer with debilitating ailments such as osteoarthritis, depression and hypertension.
Previous research has shown differences in these processes in men and women aged 60 and over, Alexandre noted. “Following similar lines, our study also suggests that men undergo a very short process of decline to disability from these more serious illnesses, which can lead to death fairly quickly, while frailty and disability last longer in women, “he said.
For Capra, the study points to a significantly faster path to early detection of decline and impending loss of ability to perform daily activities in older people. “This will help implement rapid interventions before the disability materializes,” he said.
Information on the São Paulo Research Foundation (FAPESP)
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