Kırılganlığın sosyal komponentinin geriatrik sendromlar ile ilişkisi

Abstract

Sayın H.; The Relationship between Social Components of Frailty and Geriatric Syndromes; Hacettepe University Faculty of Medicine (HÜTF), Department of Internal Medicine Residency Thesis; Ankara, 2023. The social component of frailty is a definition that we have begun to understand better recently and is linked to many adverse conditions in the geriatric population. Social frailty is defined as the risk of not satisfying one or more basic social requirements throughout the life. Social frailty includes inadequate participation in social networks, the perceived support insufficiency, losing resources or the risk of losing resources that are significant for social requirements. The aim of our study is to understand better the conception of social fraility and determine the extent of social frailty. Therefore, 136 outpatients who underwented comprehensive geriatric assessment were accepted to our study for social frailty screening and BIA and muscle USG measurements were performed. Social fraility was detected in 41 (30.1%) patients in this study. According to univariate analysis, the mean age, living alone, having asthma or COPD and being unmarried (single/divorced/widow) were significantly higher in geriatric individuals living with social fraility. ADL, IADL, MNA-SF scores were significantly lower, and SARC-F, FRAIL, Modified Fried and Edmonton scores were significantly higher in social frail group. In our study, lower walking speed, longer 5-time sit-to-stand time and longer Timed up and Go time and higher rate of assistive device usage (cane and walker) were significantly found in social frail group. The phase angle value in BIA measurements was significantly lower in the social fraile group. In our study, logistic regression analysis was conducted using two different models. According to the multiple regression analysis model, which includes and examines factors such as age, gender, living alone, medication count, and frailty based on the Edmonton test, it was observed that age, gender, and medication count did not increase the risk of social frailty. However, living alone increased the risk of social frailty by 5.1 times (95% CI: 1.812-14.546, p=0.002), and the presence of frailty based on the Edmonton test increased the risk of social frailty by 4.7 times (95% CI: 1.758-12.655, p=0.006). In the second model, where factors such as age, gender, living alone, medication count, and the presence of physical frailty based on the Modified Fried Index were included and examined, it was found that age and gender did not increase the risk of social frailty. However, living alone increased the risk of social frailty by 5.2 times (95% CI: 1.871-14.735, p=0.002), each additional medication count increased the risk of social frailty by 19% (95% CI: 1.041-1.361, p=0.011), and the presence of physical frailty based on the Modified Fried Index increased the risk of social frailty by 4 times (95% CI: 1.499-10.753, p=0.006). Our findings show that the conception of social fraility which is associated with many adverse conditions and has less data in the literature, should not be ignored when evaluating patients. This approach may be useful in preventing complications that may accompany social fraility.