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Researchers at the Federal University of São Carlos (UFSCar) in São Paulo State, Brazil, in partnership with colleagues at University College London in the United Kingdom, have discovered an effective, simple and inexpensive method to predict the risk of functional disability in the elderly. . They analyzed data from over 3,000 people over the age of 60 living in England and found that slow walking alone can be considered a predictor of loss of the ability to perform basic activities. and instrumental of everyday life (BADL and IADL).

Our study has shown that measuring walking speed alone is sufficient for an effective prediction of loss of functional ability in the elderly. Based on our results, we can say that the slowness of walking precedes this loss by several years. This is an important result because it makes it easier to track the problem. It also allows not only physiotherapists, clinicians and geriatricians, but also any healthcare professional to detect the risk. “

Tiago da Silva Alexandre, professor, Department of Gerontology at UFSCar 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 data relating to the physical condition, overall health and gait of participants in the English Longitudinal Study of Aging (ELSA).

Loss of ability to perform BADL (get up, take a bath, eat, walk, dress, etc.) and IADL (do housework, do laundry, prepare meals, use transport, do errands , manage finances, manage drugs, etc.) may precede or appear at the same time as frailty.

Frailty, a condition encountered in much of the elderly, can be defined as a clinically recognizable state of increased vulnerability resulting from an aging 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 walking speed, grip strength, level of physical activity, exhaustion, and unintentional weight loss.

“Frailty is not synonymous with disability, but it is a risk factor for loss of functional capacity,” said Alexandre. “We assessed 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, requiring attention. materials and questionnaires. It is not universally used. “

The researchers compared overall frailty with each of the five components, concluding that slowness of walking alone was the best predictor of BADL and IADL for both sexes. “It’s an early indicator. The result makes it easier for healthcare professionals to spot a problem. They can start looking for the causes of slowness earlier,” said Dayane Capra de Oliveira, lead author of the article. .

According to Alexandre, the earlier the problem is identified, the more resources and approaches can be mobilized to deal with it. “It is more difficult to start treatment when a subject is already having difficulty in several daily activities,” he said. “There are options, but the results are not as good as they can be when the problem is caught early. This is why it is so important to offer a simpler, safer and cheaper approach for predict loss of functional ability. “

The authors detected a higher risk of disability in BADL and IADL in pre-frail women than in pre-frail men. The incidence of pre-frailty was only a predictor of disability in women. They note that women have greater physiological reserves than men and are more resistant to changes in several systems. This may be due to the higher incidence in men of life-threatening disorders such as stroke, cancer, and lung disease, as well as unhealthy habits such as smoking and drinking, as well as the need to perform a exhausting manual labor, while women live longer with debilitating illnesses. like osteoarthritis, depression and high blood pressure.

Previous research has shown differences in these processes in men and women aged 60 and over, Alexandre noted. On a related note, our study also suggests that men experience a very short process of decline to disability due to 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 much faster route to early detection of decline and impending loss of ability to perform daily activities in older people. “This will help implement early interventions before the disability materializes,” he said.


Journal reference:

Capra de Oliveira, D., et al. (2021) Is slowness a better discriminator of disability than frailty in the elderly ?. Journal of Cachexia Sarcopenia and Muscle.