Pott Junior Henrique, Pérez-Zepeda Mario Ulises, Andrew Melissa K, Rockwood Kenneth
Universidade Federal de São Carlos, São Carlos, Brasil.
Instituto Nacional de Geriatría, Ciudad de México, México.
Cad Saude Publica. 2025 Apr 28;41(3):e00041624. doi: 10.1590/0102-311XEN041624. eCollection 2025.
The Brazilian aging population will challenge publicly funded health services, on which most Brazilians rely. The country must prepare for aging-associated health challenges such as frailty. We used data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil) to generate a standardized Frailty Index (FI), assess frailty levels among this population, and supply reliable and nationwide information. In total, 9,901 adults aged 50 years or older were studied in the second wave of ELSI-Brazil. A 53-item FI was created according to a standardized protocol. Logistic regression was used to determine the association between frailty levels and disability/health status, whereas the relationship between frailty level, disabilities, and healthcare use was analyzed by a negative binomial regression. Frailty was high, with a 0.19 weighted mean FI score and 0.19 median. Frailty distribution was right-skewed, with higher levels in women and increased exponentially with age. Widow(er)s, black and mixed-race individuals, and those living in rural areas had higher levels of frailty. Regression models showed that higher frailty was associated with poorer self-assessment of health, higher disability, and greater use of healthcare services. This study shows a high prevalence of frailty in Brazilian middle-aged and older adults and its association with disability, health status, and healthcare service use. These relevant findings can inform healthcare policies and design services prioritizing this population's health, particularly for those using public healthcare.
巴西的老龄化人口将给大多数巴西人所依赖的公共资助医疗服务带来挑战。该国必须为与衰老相关的健康挑战（如身体虚弱）做好准备。我们利用巴西老龄化纵向研究（ELSI-巴西）的数据生成了一个标准化的虚弱指数（FI），评估了该人群中的虚弱水平，并提供了可靠的全国性信息。在ELSI-巴西的第二轮研究中，总共对9901名50岁及以上的成年人进行了研究。根据标准化方案创建了一个包含53个项目的FI。使用逻辑回归来确定虚弱水平与残疾/健康状况之间的关联，而通过负二项回归分析虚弱水平、残疾和医疗保健使用之间的关系。虚弱程度较高，加权平均FI得分为0.19，中位数为0.19。虚弱分布呈右偏态，女性的虚弱水平更高，且随年龄呈指数增长。丧偶者、黑人和混血人种以及农村地区居民的虚弱水平更高。回归模型表明，较高的虚弱程度与较差的健康自我评估、较高的残疾率以及更多地使用医疗服务有关。这项研究表明，巴西中老年人中虚弱的患病率很高，且与残疾、健康状况和医疗服务使用有关。这些相关发现可为医疗政策提供参考，并设计出优先考虑该人群健康的服务，特别是为那些使用公共医疗服务的人群。
