DANIEL APOLINARIO
Projetos de Pesquisa
Unidades Organizacionais
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- Effects of Brazil nut consumption on selenium status and cognitive performance in older adults with mild cognitive impairment: a randomized controlled pilot trial (vol 55, pg 107, 2016)(2021) CARDOSO, Barbara Rita; APOLINARIO, Daniel; BANDEIRA, Veronica da Silva; BUSSE, Alexandre Leopold; MAGALDI, Regina Miksian; JACOB-FILHO, Wilson; COZZOLINO, Silvia Maria Franciscato
- The Impact of Frailty on the Relationship between Life-Space Mobility and Quality of Life in Older Adults During the COVID-19 Pandemic(2021) SARAIVA, M. D.; APOLINARIO, D.; AVELINO-SILVA, T. J.; TAVARES, C. De Assis Moura; GATTAS-VERNAGLIA, I. F.; FERNANDES, C. Marques; RABELO, L. M.; YAMAGUTI, S. Tavares Fernandes; KARNAKIS, T.; KALIL-FILHO, R.; JACOB-FILHO, W.; ALIBERTI, Marlon Juliano RomeroBackground The COVID-19 pandemic has led to abrupt restrictions of lile-space mobility. The impact of shelter-in-place orders on older adults' health and well-being is still unclear. Objective To investigate the relationship between life-space mobility and quality of life (QoL) in older adults with and without frailty during the COVID-19 pandemic. Design Multicenter prospective cohort study based on structured telephone interviews. Setting Four geriatric outpatient clinics in the metropolitan area of Sao Paulo, Brazil. Participants 557 community-dwelling adults aged 60 years and older. Measurements The Life-Space Assessment was used to measure community mobility before and during the COVID-19 pandemic, and a previously validated decrease of >= 5 points defined restricted life-space mobility. Frailty was assessed through the FRAIL (fatigue, resistance, ambulation, illnesses, and loss of weight) scale. The impact of shelter-in-place orders on QoL was evaluated with the question << How is the COVID-19 pandemic affecting your QoL?>>, to which participants could respond << not at all >>, << to some extent >>, or << to a great extent >>. We used ordinal logistic regressions to investigate the relationship between restricted life-space mobility and impact on QoL, adjusting our analyses for demographics, frailty, comorbidities, cognition, functionality, loneliness, depression, and anxiety. We explored whether frailty modified the association between life-space mobility and impact on QoL. Results Participants were on average 80 +/- 8 years old, 65% were women, and 33% were frail. The COVID-19 quarantine led to a restriction of community mobility in 79% of participants and affected the QoL for 77% of participants. We found that restricted life-space mobility was associated with impact on QoL in older adults during the pandemic, although frailty modified the magnitude of the association (P-value for interaction=0.03). Frail participants who experienced restricted life-space mobility had twice the odds of reporting an impact on QoL when compared with non-frail individuals, with respective adjusted odds ratios of 4.20 (95% CI=2.36-7.50) and 2.18 (95% CI=1.33-3.58). Conclusion Older adults experienced substantial decreases in life-space mobility during the COVID-19 pandemic, and this unexpected change impacted their QoL. Providers should be particularly watchful for the consequences of abrupt life-space restrictions on frail individuals.
- Impact of the COVID-19 pandemic on the life-space mobility of older adults with cancer(2021) GATTAS-VERNAGLIA, Isabella Figaro; RAMOS, Paola Teruya; PERINI, Maria Laura Lazaretti; HIGA, Camila Suemi; APOLINARIO, Daniel; ALIBERTI, Marlon Juliano Romero; KANAJI, Ana Lumi; ADRIAZOLA, Izabela Ono; SARAIVA, Marcos Daniel; AVELINO-SILVA, Thiago Junqueira; TAVARES, Caio de Assis Moura; JACOB-FILHO, Wilson; KARNAKIS, Theodora
- COVID-19 is not over and age is not enough: Using frailty for prognostication in hospitalized patients(2021) ALIBERTI, Marlon Juliano Romero; SZLEJF, Claudia; AVELINO-SILVA, Vivian I.; SUEMOTO, Claudia Kimie; APOLINARIO, Daniel; DIAS, Murilo Bacchini; GARCEZ, Flavia Barreto; TRINDADE, Carolina B.; AMARAL, Jose Renato das Gracas; MELO, Leonardo Rabelo de; AGUIAR, Renata Cunha de; COELHO, Paulo Henrique Lazzaris; HOJAIJ, Naira Hossepian Salles de Lima; SARAIVA, Marcos Daniel; SILVA, Natalia Oliveira Trajano da; JACOB-FILHO, Wilson; AVELINO-SILVA, Thiago J.Background Frailty screening using the Clinical Frailty Scale (CFS) has been proposed to guide resource allocation in acute care settings during the pandemic. However, the association between frailty and coronavirus disease 2019 (COVID-19) prognosis remains unclear. Objectives To investigate the association between frailty and mortality over 6 months in middle-aged and older patients hospitalized with COVID-19 and the association between acute morbidity severity and mortality across frailty strata. Design Observational cohort study. Setting Large academic medical center in Brazil. Participants A total of 1830 patients aged >= 50 years hospitalized with COVID-19 (March-July 2020). Measurements We screened baseline frailty using the CFS (1-9) and classified patients as fit to managing well (1-3), vulnerable (4), mildly (5), moderately (6), or severely frail to terminally ill (7-9). We also computed a frailty index (0-1; frail >0.25), a well-known frailty measure. We used Cox proportional hazards models to estimate the association between frailty and time to death within 30 days and 6 months of admission. We also examined whether frailty identified different mortality risk levels within strata of similar age and acute morbidity as measured by the Sequential Organ Failure Assessment (SOFA) score. Results Median age was 66 years, 58% were male, and 27% were frail to some degree. Compared with fit-to-managing-well patients, the adjusted hazard ratios (95% confidence interval [CI]) for 30-day and 6-month mortality were, respectively, 1.4 (1.1-1.7) and 1.4 (1.1-1.7) for vulnerable patients; 1.5 (1.1-1.9) and 1.5 (1.1-1.8) for mild frailty; 1.8 (1.4-2.3) and 1.9 (1.5-2.4) for moderate frailty; and 2.1 (1.6-2.7) and 2.3 (1.8-2.9) for severe frailty to terminally ill. The CFS achieved outstanding accuracy to identify frailty compared with the Frailty Index (area under the curve = 0.94; 95% CI = 0.93-0.95) and predicted different mortality risks within age and acute morbidity groups. Conclusions Our results encourage the use of frailty, alongside measures of acute morbidity, to guide clinicians in prognostication and resource allocation in hospitalized patients with COVID-19.