Therapeutic competitions and frailty among older adults in São Paulo city: a cross-sectional population-based study, 2015.

Abstract

Objective: To identify the presence of therapeutic competitions according to the frailty component classification and to assess association between therapeutic competitions and frailty in people aged 60 or over in the city of São Paulo, Brazil.

Methods: This was a population-based cross-sectional study. Frailty was identified when three to five components defined by Fried were present, and pre-frailty was identified when one or two were present. Therapeutic competitions were characterized by use of medication for a specific chronic non-communicable disease that negatively affects another disease. We used multinomial logistic regression.

Results: Therapeutic competitions were identified for 13.2% of the 1,224 participants. Of this total, 18.7% were considered to be frail individuals. The most prevalent therapeutic competition involved diabetes and cardiovascular disease (4.2% of the total and 6.8% of frail people) with metformin or angiotensin-converting enzyme inhibitors. The presence of two therapeutic competitions in individuals with multimorbidity increased the likelihood of pre-frailty (odds ratio 2.51; 95% confidence interval 1.10; 5.76).

Conclusion: Therapeutic competitions are common in the elderly population and more frequent among frail elderly people, with increased likelihood of pre-frailty when two therapeutic competitions are present.