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Fragility and their interface in homeostasis regulation of heart rate


Frailty is a distinct geriatric syndrome, with a high prevalence in advanced age and associated with increased risk for adverse outcomes. It has been described as a clinical state of vulnerability to stress, a result of declining resilience and physiologic reserve associated with aging. The study hypothesis is that the decline in the dynamic interactions between physiological systems involved in regulation of homeostasis heart rate (HR) are related to the fragility. Thus nonlinear algorithms for analysis of HR variability would be able to discriminate individuals in risk of frailty. It will be assessed the elderly enrolled in the Family Health Unit of Jardim São Carlos (about 740 individuals) that will be divided into three groups (frail, pre-frail and non-frail) according to the phenotype of frailty proposed by Fried et al (2001). Electrocardiogram will be collected for 10 minutes in the supine position, after will be realized an active postural change from supine to standing, staying 10 minutes in this position. To analysis of the series of RR intervals, linear (spectral analysis) and nonlinear analysis (symbolic analysis, Shannon's entropy, and conditional entropy) will be carry out. This study will provide data on cardiac autonomic control in the process of frailty, with the application of a non-linear algorithms and methodology of low cost, more convenient and easily accessible, allowing greater clinical applicability. (AU)

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