Fragilidade, equilíbrio e desempenho funcional de pessoas idosas em diferentes cenários do contexto amazônico

Abstract

Aging brings increasing challenges, especially when accompanied by health impairment or dependency. Among these challenges, frailty and loss of functionality increase the risk of falls and reduce quality of life. In the Amazon context, there is little research on these aspects, especially in the riverside population living in floating homes. The study aimed to evaluate frailty, balance, and functional performance in elderly individuals who meet or do not meet the physical activity recommendations in different scenarios in the Amazon context. This was a cross-sectional, descriptive, and analytical study with 217 elderly individuals (≥ 60 years old), distributed according to housing conditions and physical activity recommendations: urban areas that meet (G1, n=60) or do not meet (G2, n=60) the recommendations, and rural areas that meet (G3, n=50) or do not meet (G4, n=47) the physical activity recommendations. It was conducted in Manaus (AM) and in nine riverside communities located on the Negro and Solimões rivers. Socioeconomic variables, health conditions and history of falls in the last year were assessed. Balance was measured by the MiniBESTest, frailty was assessed by the Fried phenotype, categorizing individuals as frail (≥ 3 criteria) or non-frail, and functional performance was analyzed by three tests: Five Times Sit-to-Stand Test (FTSTS), Handgrip Strength Test (HGS) and Gait speed Test (GTS). Data were analyzed using descriptive statistics. Body balance and the FTSTS and HGS tests were analyzed by the Kruskal-Wallis test, and GTS by One-Way ANOVA and Tukey's post-hoc test to compare performance in these variables between groups. For frailty and associated factors, hierarchical binary logistic regression was performed. Among the population evaluated, the group composed of elderly people from rural areas who do not meet the physical activity recommendations had a higher prevalence of frailty (78.7%) and falls (44.7%), worse performance in postural balance (22.70 ± 2.12 points) and functional performance in the FTSTS and HGS tests (18.4 ± 4.40 s and 0.74 ± 0.13 m/s), respectively. In the handgrip strength test, results were higher by 23.50 kgf. All variables evaluated showed significant differences between the groups (p < 0.001). Frailty was associated with physical activity (OR = 2.42; p = 0.013), handgrip strength (OR = 2.61; p = 0.025) and use of medications (OR = 0.39; p = 0.017). Elderly people living in rural areas who do not meet the physical activity recommendations represent a vulnerable population, with a high risk of falls, reduced functional mobility and deficits in lower limb strength and endurance, while at the same time, they have better performance in handgrip strength. The findings are associated with the daily demands of the lifestyle in riverside floating communities and, together, highlight the need for interventions aimed at implementing strategies that reduce the risk of falls, favoring the general functionality of this population.