Elderly individuals diagnosed with frailty syndrome require prioritization in primary healthcare settings due to their heightened susceptibility to falls, hospitalizations, disability, and premature mortality. This syndrome is identified by three or more of the following indicators: unintended weight loss, exhaustion, muscle weakness, slow walking speed, and a reduced level of physical activity.
Research conducted by the Federal University of São Carlos (UFSCar) in Brazil and University College London (UCL) in the UK has unveiled that the precursors to frailty in old age are distinct for men and women.
Funded by FAPESP, this investigation’s findings have been documented in an article in the Archives of Gerontology and Geriatrics journal.
The study highlights that in men, the risk of developing frailty is escalated by osteoporosis, underweight, cardiac ailments, and impaired hearing. Conversely, in women, elevated fibrinogen levels (an indicator of cardiovascular disease), diabetes, and stroke significantly increase the risk of frailty.
These conclusions stem from an analysis of data involving 1,747 participants from the English Longitudinal Study of Ageing (ELSA), a continuous survey initiated in 2002 that examines the interplay between health, functionality, social connections, and economic status among individuals aged 50 and above residing in England. The selected participants, aged 60 or older, were devoid of frailty syndrome at the outset and were not considered pre-frail. Their interviews and evaluations were conducted quadrennially from 2004 to 2016.
Tiago da Silva Alexandre, a professor in the Department of Gerontology at UFSCar and the study’s senior author, posited that frailty syndrome signals the potential for adverse outcomes in the elderly. The study revealed multiple pathways to frailty and highlighted significant gender disparities that policymakers must consider. These insights could inform gender-specific strategies and interventions in primary healthcare for older adults.
Alexandre further explained that frailty syndrome possesses a phenotype, meaning a collection of easily recognizable signs and symptoms aimed at identifying older adults at a greater risk of adverse health outcomes. The research seeks to identify the attributes that may predispose individuals to frailty, thereby aiding in anticipating potential issues and formulating public policies tailored to both men and women.
Originating from Dayane Capra de Oliveira’s doctoral research under Alexandre’s supervision, the study underscores the role of sex-specific differences in risk factors for frailty, largely attributed to differing social roles and resource access throughout life between men and women.
Oliveira noted that frailty is a multifactorial condition. For men, socioeconomic factors, skeletal muscle disorders, heart disease, and low weight are fundamental to the onset of frailty. In contrast, for women, cardiovascular and neuroendocrine disturbances primarily drive the condition.
The research also points out the higher prevalence of frailty syndrome in women, partly due to their longer life expectancy. According to Alexandre, this complexity arises from varying life spans and disease prevalence between genders, with women more frequently affected by chronic, disabling conditions, leading to a higher incidence of frailty syndrome.
While certain frailty risk factors are common to both genders, such as age, low educational levels, sedentary lifestyles, and depression, differences in body composition and fat distribution, particularly in old age, may lead to metabolic changes and disease development, increasing frailty risk.
The study’s focus on individuals aged 60 or older residing in England does not necessarily predict how these gender-specific differences will manifest in future generations. However, it was observed that men in the cohort were more exposed to various risk factors, including working conditions, unhealthy diets, less frequent medical consultations, and higher consumption of alcohol and other substances, elevating their risk of cardiovascular diseases and heart attacks.
In summary, the gender-specific differences highlighted by the study serve as a backdrop to different ageing processes, causes of death or disability, and types of frailty experienced by men and women, underscoring the need for tailored approaches in managing frailty syndrome among the elderly.
More information: Dayane Capra de Oliveira et al, Does the incidence of frailty differ between men and women over time?, Archives of Gerontology and Geriatrics. DOI: 10.1016/j.archger.2022.104880
Journal information: Archives of Gerontology and Geriatrics Provided by Fundação de Amparo à Pesquisa do Estado de São Paulo
