Vo2peak um biomarcador de fragilidade em adultos mais velhos
DOI:
https://doi.org/10.31423/oikos.v36i1.20586Palavras-chave:
Envelhecimento, Fragilidade, Biomarcador, VO2peakResumo
Esta revisão descrever as alterações fisiológicas que ocorrem nos sistemas respiratório e cardiovascular como parte do processo de envelhecimento e avalia a aptidão cardiorrespiratória (ACR), destacando o VO2pico como possível biomarcador de fragilidade em pessoas idosas (PI). A evidência disponível indica uma relação inversa entre o VO2pico e a fragilidade, sugerindo que este parâmetro, ao refletir o estado funcional dos principais sistemas fisiológicos, poderia desempenhar um papel crucial na identificação precoce desta condição. Isto é particularmente relevante, uma vez que a detecção atempada permitiria o desenho de estratégias de intervenção preventiva personalizadas, focadas na melhoria da funcionalidade física e na redução de riscos como quedas, hospitalizações ou perda de autonomia nos PI. No entanto, embora os resultados atuais sejam encorajadores, ainda são necessários estudos longitudinais e ensaios clínicos bem desenhados para estabelecer com maior certeza a utilidade clínica do VO2pico como marcador prognóstico e guia para intervenções terapêuticas.
Downloads
Referências
AFILALO, J. et al. Role of Frailty in Patients With Cardiovascular Disease. The American Journal of Cardiology, v. 103, n. 11, p. 1616–1621, 1 jun. 2009.
AHMED, B. et al. The Implications of Aging on Vascular Health. International journal of molecular sciences, v. 25, n. 20, 1 out. 2024.
AHMED, H. M. et al. Maximal Exercise Testing Variables and 10-Year Survival: Fitness Risk Score Derivation From the FIT Project. Mayo Clinic Proceedings, v. 90, n. 3, p. 346–355, 1 mar. 2015.
AMBAGTSHEER, R. C. et al. Should we screen for frailty in primary care settings? A fresh perspective on the frailty evidence base: A narrative review. Preventive medicine, v. 119, p. 63–69, fev. 2019.
BARLETTA, K. E. et al. Leukocyte compartments in the mouse lung: Distinguishing between marginated, interstitial, and alveolar cells in response to injury. Journal of Immunological Methods, v. 375, n. 1–2, p. 100–110, 31 jan. 2012.
BARTHELEMY, J.-C. et al. Targeting autonomic nervous system as a biomarker of well-ageing in the prevention of stroke. Frontiers in Aging Neuroscience, v. 14, 15 set. 2022.
BILLINGSLEY, H. et al. Lifestyle Interventions with a Focus on Nutritional Strategies to Increase Cardiorespiratory Fitness in Chronic Obstructive Pulmonary Disease, Heart Failure, Obesity, Sarcopenia, and Frailty. Nutrients 2019, Vol. 11, Page 2849, v. 11, n. 12, p. 2849, 21 nov. 2019.
BOWDISH, D. M. E. The Aging Lung: Is Lung Health Good Health for Older Adults? Chest, v. 155, n. 2, p. 391–400, 1 fev. 2019a.
BOWDISH, D. M. E. The Aging Lung: Is Lung Health Good Health for Older Adults? Chest, v. 155, n. 2, p. 391–400, 1 fev. 2019b.
BUDINGER, G. S. et al. The Intersection of Aging Biology and the Pathobiology of Lung Diseases: A Joint NHLBI/NIA Workshop. The Journals of Gerontology: Series A, v. 72, n. 11, p. 1492–1500, 12 out. 2017.
BUSHNELL, C. et al. 2024 Guideline for the Primary Prevention of Stroke: A Guideline From the American Heart Association/American Stroke Association. Stroke, 21 out. 2024.
CARDÚS, J. et al. Increase in pulmonary ventilation-perfusion inequality with age in healthy individuals. American journal of respiratory and critical care medicine, v. 156, n. 2 Pt 1, p. 648–653, 1997.
COUCH, M. J.; OURIADOV, A. V.; ALBERTA, M. S. Aging of the respiratory system. Kosin Medical Journal, v. 31, n. 1, p. 11–18, 4 fev. 2016.
DANI, M. et al. New horizons in the ageing autonomic nervous system: orthostatic hypotension and supine hypertension. Age and Ageing, v. 51, n. 8, 2 ago. 2022.
DE CARVALHO BASTONE, A. et al. Aerobic Fitness and Habitual Physical Activity in Frail and Nonfrail Community-Dwelling Elderly. Journal of physical activity & health, v. 12, n. 9, p. 1304–1311, 1 set. 2015a.
DE CARVALHO BASTONE, A. et al. Aerobic Fitness and Habitual Physical Activity in Frail and Nonfrail Community-Dwelling Elderly. Journal of Physical Activity and Health, v. 12, n. 9, p. 1304–1311, 1 set. 2015b.
DEKKER, J. M. et al. Heart Rate Variability from Short Electrocardiographic Recordings Predicts Mortality from All Causes in Middle-aged and Elderly Men: The Zutphen Study. American Journal of Epidemiology, v. 145, n. 10, p. 899–908, 15 maio 1997.
DENG, Y.; SATO, N. Global frailty screening tools: Review and application of frailty screening tools from 2001 to 2023. Intractable and Rare Diseases Research, v. 13, n. 1, p. 1–11, 2024a.
DENG, Y.; SATO, N. Global frailty screening tools: Review and application of frailty screening tools from 2001 to 2023. Intractable and Rare Diseases Research, v. 13, n. 1, p. 1–11, 2024b.
DENT, E. et al. Physical Frailty: ICFSR International Clinical Practice Guidelines for Identification and Management. Journal of Nutrition, Health and Aging, v. 23, n. 9, p. 771–787, 2019a.
DENT, E. et al. Physical Frailty: ICFSR International Clinical Practice Guidelines for Identification and Management. The Journal of Nutrition, Health & Aging, v. 23, n. 9, p. 771, 1 nov. 2019b.
DENT, E. et al. Physical Frailty: ICFSR International Clinical Practice Guidelines for Identification and Management. Journal of Nutrition, Health and Aging, v. 23, n. 9, p. 771–787, 1 nov. 2019c.
ENSRUD, K. E. et al. Comparison of 2 frailty indexes for prediction of falls, disability, fractures, and death in older women. Archives of internal medicine, v. 168, n. 4, p. 382–389, 25 fev. 2008.
EVARISTO, S. et al. Muscular fitness and cardiorespiratory fitness are associated with health-related quality of life: Results from labmed physical activity study. Journal of Exercise Science & Fitness, v. 17, n. 2, p. 55–61, 20 maio 2019.
EZZATVAR, Y. et al. Cardiorespiratory fitness measured with cardiopulmonary exercise testing and mortality in patients with cardiovascular disease: A systematic review and meta-analysis. Journal of sport and health science, v. 10, n. 6, p. 609–619, 1 dez. 2021.
FALLER, J. W. et al. Instruments for the detection of frailty syndrome in older adults: A systematic review. PLOS ONE, v. 14, n. 4, p. e0216166, 1 abr. 2019.
FEWKES, J. J. et al. Association between endothelial function and skin advanced glycation end-products (AGEs) accumulation in a sample of predominantly young and healthy adults. Cardiovascular diabetology, v. 23, n. 1, 1 dez. 2024.
FLETCHER, G. F. et al. Exercise standards for testing and training: A scientific statement from the American heart association. Circulation, v. 128, n. 8, p. 873–934, 20 ago. 2013.
FRIED, L. P. et al. Frailty in Older Adults: Evidence for a Phenotype. The Journals of Gerontology: Series A, v. 56, n. 3, p. M146–M157, 1 mar. 2001.
FRIED, L. P. et al. Untangling the Concepts of Disability, Frailty, and Comorbidity: Implications for Improved Targeting and Care. The Journals of Gerontology: Series A, v. 59, n. 3, p. M255–M263, 1 mar. 2004.
FUNG, E. et al. PERFORMANCE OF CARDIOPULMONARY EXERCISE CAPACITY AND PHYSICAL FITNESS INDICATORS IN DIFFERENTIATING PRE-FRAIL AND ROBUST ELDERLY. Canadian Journal of Cardiology, v. 34, n. 10, p. S6–S7, 1 out. 2018.
FUNG, E. et al. PEAK OXYGEN UPTAKE, OXYGEN UPTAKE EFFICIENCY SLOPE, AND 6-MINUTE WALK DISTANCE CAN PREDICT LONG-TERM SURVIVAL IN COMMUNITY-BASED NONFRAIL OLDER ADULTS. Canadian Journal of Cardiology, v. 35, n. 10, p. S60–S61, 1 out. 2019.
FUNG, E. et al. Predicting 10-year mortality in older adults using VO2max, oxygen uptake efficiency slope and frailty class. European journal of preventive cardiology, v. 28, n. 10, p. 1148–1151, 1 out. 2021.
GARBER, C. E. et al. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Medicine and science in sports and exercise, v. 43, n. 7, p. 1334–1359, jul. 2011.
GARCÍA-GARCÍA, F. J. et al. A new operational definition of frailty: the Frailty Trait Scale. Journal of the American Medical Directors Association, v. 15, n. 5, p. 371.e7-371.e13, maio 2014.
GARCÍA-GARCÍA, F. J. et al. Frailty Trait Scale–Short Form: A Frailty Instrument for Clinical Practice. Journal of the American Medical Directors Association, v. 21, n. 9, p. 1260- 1266.e2, 1 set. 2020.
GILLOOLY, M.; LAMB, D. Airspace size in lungs of lifelong non-smokers: effect of age and sex. Thorax, v. 48, n. 1, p. 39–43, 1 jan. 1993.
GOBBENS, R. J. J. et al. The Tilburg Frailty Indicator: psychometric properties. Journal of the American Medical Directors Association, v. 11, n. 5, p. 344–355, 2010.
HE, N. et al. Relationship Between Sarcopenia and Cardiovascular Diseases in the Elderly: An Overview. Frontiers in Cardiovascular Medicine, v. 8, p. 743710, 9 dez. 2021.
HERDY, A. H.; CAIXETA, A. Brazilian Cardiorespiratory Fitness Classification Based on Maximum Oxygen Consumption. Arquivos Brasileiros de Cardiologia, v. 106, n. 5, p. 389, 1 maio 2016.
HOFMANN, M. A. et al. RAGE mediates a novel proinflammatory axis: a central cell surface receptor for S100/calgranulin polypeptides. Cell, v. 97, n. 7, p. 889–901, 25 jun. 1999.
HOOGENDIJK, E. O. et al. Components of the Frailty Phenotype in Relation to the Frailty Index: Results From the Toulouse Frailty Platform. Journal of the American Medical Directors Association, v. 16, n. 10, p. 855–859, 1 out. 2015.
IBRAHIM, A. et al. Association between maximal oxygen consumption and physical performance tests among older adults with cognitive frailty. Experimental Gerontology, v. 184, p. 112326, 1 dez. 2023.
JACKSON, A. S. et al. Role of Lifestyle and Aging on the Longitudinal Change in Cardiorespiratory Fitness. Archives of Internal Medicine, v. 169, n. 19, p. 1781–1787, 26 out. 2009.
K WASSERMAN, J HANSEN, D SUE, W STRINGER, B. W. Principles of Exercise Testing and Interpretation. The Canadian Journal of Cardiology, v. 23, n. 4, p. 274, 2007.
KAHLON, S. et al. Association between frailty and 30-day outcomes after discharge from hospital. CMAJ?: Canadian Medical Association journal = journal de l’Association medicale canadienne, v. 187, n. 11, p. 799–804, 11 ago. 2015.
KODAMA, S. et al. Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women: a meta-analysis. JAMA, v. 301, n. 19, p. 2024–2035, 20 maio 2009.
LADD SELDEEN, K. et al. VO2MAX, 6-minute walk, and muscle strength each correlate with frailty in US veterans. 2024.
LAKATTA, E. G.; LEVY, D. Arterial and Cardiac Aging: Major Shareholders in Cardiovascular Disease Enterprises. Circulation, v. 107, n. 1, p. 139–146, 7 jan. 2003.
LANG, J. J. et al. Cardiorespiratory fitness is a strong and consistent predictor of morbidity and mortality among adults: an overview of meta-analyses representing over 20.9 million observations from 199 unique cohort studies. British journal of sports medicine, v. 58, n. 10, p. 556–566, 1 maio 2024.
LEE, K. A. et al. Immune Senescence, Immunosenescence and Aging. Frontiers in Aging, v. 3, p. 900028, 2022.
LIGUORI, G. et al. ACSM’s Guidelines for Exercise Testing and Prescription 9th Ed. 2014. The Journal of the Canadian Chiropractic Association, v. 58, n. 3, p. 328, 2014.
LIU, X. et al. Categorization of lung mesenchymal cells in development and fibrosis. iScience, v. 24, n. 6, 25 jun. 2021.
MAXWELL, C. A.; DIETRICH, M. S.; MILLER, R. S. The FRAIL Questionnaire: A Useful Tool for Bedside Screening of Geriatric Trauma Patients. Journal of trauma nursing?: the official journal of the Society of Trauma Nurses, v. 25, n. 4, p. 242–247, 2018.
MEZZANI, A. et al. Aerobic exercise intensity assessment and prescription in cardiac rehabilitation: a joint position statement of the European Association for Cardiovascular Prevention and Rehabilitation, the American Association of Cardiovascular and Pulmonary Rehabilitation and the Canadian Association of Cardiac Rehabilitation. European Journal of Preventive Cardiology, v. 20, n. 3, p. 442–467, 1 jun. 2013.
NAVARRETE-VILLANUEVA, D. et al. Frailty and Physical Fitness in Elderly People: A Systematic Review and Meta-analysis. Sports Medicine, v. 51, n. 1, p. 143–160, 1 jan. 2021.
OFORI-ASENSO, R. et al. Global Incidence of Frailty and Prefrailty Among Community-Dwelling Older Adults: A Systematic Review and Meta-analysis. JAMA Network Open, v. 2, n. 8, p. e198398, 2 ago. 2019a.
OFORI-ASENSO, R. et al. Global Incidence of Frailty and Prefrailty Among Community-Dwelling Older Adults: A Systematic Review and Meta-analysis. JAMA Network Open, v. 2, n. 8, p. e198398, 2 ago. 2019b.
ORTEGA-MARTÍNEZ, M. et al. Analysis of Cell Turnover in the Bronchiolar Epithelium Through the Normal Aging Process. Lung, v. 194, n. 4, p. 581–587, 1 ago. 2016.
OVIEDO-BRIONES, M. et al. A Comparison of Frailty Assessment Instruments in Different Clinical and Social Care Settings: The Frailtools Project. Journal of the American Medical Directors Association, v. 22, n. 3, p. 607.e7-607.e12, 1 mar. 2021.
PANENI, F. et al. The Aging Cardiovascular System. Journal of the American College of Cardiology, v. 69, n. 15, p. 1952–1967, abr. 2017.
PETERS, L. L. et al. Measurement properties of the Groningen Frailty Indicator in home-dwelling and institutionalized elderly people. Journal of the American Medical Directors Association, v. 13, n. 6, p. 546–551, 2012.
RAMOS JESUS, F. et al. Immunosenescence and Inflammation in Chronic Obstructive Pulmonary Disease: A Systematic Review. Journal of Clinical Medicine, v. 13, n. 12, p. 3449, 1 jun. 2024.
RAO, A. K. et al. Systematic review of the effects of exercise on activities of daily living in people with Alzheimer’s disease. The American journal of occupational therapy?: official publication of the American Occupational Therapy Association, v. 68, n. 1, p. 50–56, jan. 2014.
ROBBINS, P. D. et al. Senolytic Drugs: Reducing Senescent Cell Viability to Extend Health Span. Annual review of pharmacology and toxicology, v. 61, p. 779, 6 jan. 2020.
ROCKWOOD, K. et al. A global clinical measure of fitness and frailty in elderly people. CMAJ?: Canadian Medical Association journal = journal de l’Association medicale canadienne, v. 173, n. 5, p. 489–495, ago. 2005.
RODRÍGUEZ MAÑAS, L. El informe de la Organización Mundial de la Salud sobre envejecimiento y salud: un regalo para la comunidad geriátrica. Revista Española de Geriatría y Gerontología, v. 51, n. 5, p. 249–251, 1 set. 2016.
ROSADO-PÉREZ, J.; MENDOZA-NÚÑEZ, V. M. Relationship Between Aerobic Capacity With Oxidative Stress and Inflammation Biomarkers in the Blood of Older Mexican Urban-Dwelling Population. Dose-Response, v. 16, n. 2, p. 1559325818773000, 1 abr. 2018.
ROSE, J. A. et al. Development, Progression, and Mortality of Suspected Interstitial Lung Disease in COPDGene. https://doi.org/10.1164/rccm.202402-0313OC, 12 ago. 2024.
ROSS, R. et al. Importance of Assessing Cardiorespiratory Fitness in Clinical Practice: A Case for Fitness as a Clinical Vital Sign: A Scientific Statement From the American Heart Association. Circulation, v. 134, n. 24, p. e653–e699, 13 dez. 2016.
SCHNEIDER, J. L. et al. The aging lung: Physiology, disease, and immunity. Cell, v. 184, n. 8, p. 1990–2019, 15 abr. 2021.
SCIACCHITANO, S. et al. To Be Frail or Not to Be Frail: This Is the Question—A Critical Narrative Review of Frailty. Journal of Clinical Medicine, v. 13, n. 3, p. 721, 1 fev. 2024.
SEPÚLVEDA, M. et al. Frailty in Aging and the Search for the Optimal Biomarker: A Review. Biomedicines, v. 10, n. 6, jun. 2022.
SHAMLIYAN, T. et al. Association of frailty with survival: A systematic literature review. Ageing Research Reviews, v. 12, p. 719–736, 2013.
SHARMA, G.; HANANIA, N. A.; SHIM, Y. M. The Aging Immune System and Its Relationship to the Development of Chronic Obstructive Pulmonary Disease. Proceedings of the American Thoracic Society, v. 6, n. 7, p. 573, 1 dez. 2009.
SINGAM, N. S. V.; FINE, C.; FLEG, J. L. Cardiac changes associated with vascular aging. Clinical Cardiology, v. 43, n. 2, p. 92–98, 16 fev. 2020.
SKLOOT, G. S. The Effects of Aging on Lung Structure and Function. Clinics in Geriatric Medicine, v. 33, n. 4, p. 447–457, 1 nov. 2017.
STEELL, L. et al. Dose-response associations of cardiorespiratory fitness with all-cause mortality and incidence and mortality of cancer and cardiovascular and respiratory diseases: the UK Biobank cohort study. British journal of sports medicine, v. 53, n. 21, p. 1371–1378, 1 nov. 2019.
SUGIE, M. et al. Peak oxygen uptake correlates with indices of sarcopenia, frailty, and cachexia in older Japanese outpatients. JCSM Rapid Communications, v. 4, n. 2, p. 141–149, 1 jul. 2021.
THEOU, O. et al. Disability and co-morbidity in relation to frailty: How much do they overlap? Archives of Gerontology and Geriatrics, v. 55, n. 2, p. e1–e8, 1 set. 2012.
TSAO, C. W. et al. Heart Disease and Stroke Statistics - 2023 Update: A Report from the American Heart Association. Circulation, v. 147, n. 8, p. E93–E621, 21 fev. 2023.
VAZ FRAGOSO, C. A. et al. Frailty and respiratory impairment in older persons. The American journal of medicine, v. 125, n. 1, p. 79–86, jan. 2012.
VERLAAN, S. et al. High Prevalence of Physical Frailty Among Community-Dwelling Malnourished Older Adults–A Systematic Review and Meta-Analysis. Journal of the American Medical Directors Association, v. 18, n. 5, p. 374–382, 1 maio 2017.
VERONESE, N. (ED.). Frailty and Cardiovascular Diseases. Advances in Experimental Medicine and Biology. v. 1216, 2020.
WAGNER, J. U. G.; DIMMELER, S. Cellular cross-talks in the diseased and aging heart. Journal of Molecular and Cellular Cardiology, v. 138, p. 136–146, jan. 2020.
WANG, Y. et al. The aging lung: microenvironment, mechanisms, and diseases. Frontiers in Immunology, v. 15, p. 1383503, 2024.
WEIBEL, E. R. On the tricks alveolar epithelial cells play to make a good lung. American journal of respiratory and critical care medicine, v. 191, n. 5, p. 504–513, 1 mar. 2015.
WEISS, C. O. et al. Relationships of Cardiac, Pulmonary, and Muscle Reserves and Frailty to Exercise Capacity in Older Women. The Journals of Gerontology: Series A, v. 65A, n. 3, p. 287–294, 1 mar. 2010.
WOODHOUSE, K. W. et al. Who are the Frail Elderly?Quarterly Journal of Medicine. [s.l: s.n.]. Disponível em: <http://qjmed.oxfordjournals.org/>.
WORLD HEALTH ORGANIZATION. WHO Clinical Consortium on Healthy Ageing Topic focus: frailty and intrinsic capacity. [s.l: s.n.]. Disponível em: <https://iris.who.int/bitstream/handle/10665/272437/WHO-FWC-ALC-17.2-eng.pdf?sequence=1>. Acesso em: 24 out. 2024.
WORLD HEALTH ORGANIZATION. Envejecimiento y salud. Disponível em: <https://www.who.int/es/news-room/fact-sheets/detail/ageing-and-health>. Acesso em: 21 out. 2024.
YEH, C.-H. et al. Role of the autonomic nervous system in young, middle-aged, and older individuals with essential hypertension and sleep-related changes in neurocardiac regulation. Scientific Reports, v. 13, n. 1, p. 22623, 18 dez. 2023.
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Copyright (c) 2025 Oikos: Família e Sociedade em Debate
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
A revista se reserva o direito de efetuar, nos originais, alterações de ordem normativa, ortográfica e gramatical, com vistas a manter o padrão culto da língua, respeitando, porém, o estilo dos autores.
Os trabalhos publicados passam a ser propriedade da revista Oikos: Família e Sociedade em Debate. Deve ser consignada a fonte de publicação original. Para a disponibilização e utilização dos artigos em acesso aberto, o periódico adota a licença Creative Commons Attribution 4.0 International Public License: CC BY 4.0. Isso significa que outras pessoas podem compartilhar - copiar ou distribuir o material em qualquer mídia ou formato; adaptar - remixar, transformar e criar a partir do material para qualquer fim, desde que atribuído o devido crédito, fornecer um link para a licença e indicar se foram feitas alterações" (CC BY 4.0).
As opiniões emitidas pelos autores dos artigos são de sua exclusiva responsabilidade.
Quanto às questões de plágio, a Oikos utiliza o software de verificação de similaridade de conteúdo – política de plágio (CopySpider) nos artigos submetidos ao periódico.
Ao submeter o artigo, o autor se compromete que os dados relatados no artigo não são resultados de má conduta ética, tais como: dados produzidos, uso indevido de imagens, falsificação, plágio, autoplágio ou duplicidade. O autor declara que nada no artigo infringe qualquer direito autoral ou de propriedade intelectual de outrem, pois, caso contrário, ele poderá responder integralmente por qualquer dano causado a terceiros, em todas as esferas administrativas e jurídicas cabíveis, nos estritos termos da Lei nº 9.610/98
