OBJECTIVE:To evaluate the adequacy of the Clinical-Functional Vulnerability Index-20, a rapid triage instrument to test vulnerability in Brazilian older adults, for the use in primary health care. METHODS:The study included convenience sample of 397 patients aged older than or equal to 60 years attended at Centro de Referência para o Idoso (Reference Center for Older Adults) and of 52 older adults the same age attended at the community. The results of the questionnaire, consisting of 20 questions, were compared with those of the Comprehensive Geriatric Assessment, considered a reference for identifying frail older adults. Spearman' s correlation was evaluated in the Clinical-Functional Vulnerability Index-20 with the Comprehensive Geriatric Assessment; the validity was verified by the area under the ROC curve; reliability was estimated by the percentage of agreement among evaluators and by the kappa coefficient, both with quadratic weighted. The cut-off point was obtained based on the higher accuracy criterion. Cronbach' s alpha, a measure of internal consistency, was estimated. RESULTS:The Spearman' s correlation coefficient was high and positive for both groups (0.792 for older adults attended at the Reference Center and 0.305 for older adults from the community [p < 0.001]). The area under the ROC curve for older adults attended at the Reference Center was substantial (0.903). The cut-off point obtained was six, and older adults with scores in Clinical-Functional Vulnerability Index-20 above that value had strong possibility of being frail. For older adults from the community, the quadratic weighted agreement among evaluators was 99.5%, and the global quadratic weighted kappa coefficient was 0.94. Cronbach' s alpha was high for older adults attended at the Reference Center (0.861) and those attended at the community (0.740). CONCLUSIONS:The Clinical-Functional Vulnerability Index-20 questionnaire, in the sample examined, turned out to be positively correlated with the Comprehensive Geriatric Assessment, in addition to the results indicating a high degree of validity and reliability. Thus, the Clinical-Functional Vulnerability Index-20 proves to be viable as a triage instrument in the primary health care that identifies frail older adults (older adults at risk of weakening and frail older adults).

Objetivo: O objetivo deste estudo foi identificar quais os idosos em risco de vulnerabilidade clínico-funcional que devem ser encaminhados para a atenção geriátrica-gerontológica especializada, tendo por base o Índice de Vulnerabilidade Clínico- Funcional-20 (IVCF-20) comparado com os escores da utilização da avaliação geriátrica ampla, utilizado como padrão ouro. Método: O estudo foi transversal, no qual foram comparados os resultados obtidos no IVCF-20 com os resultados verificados na Avaliação Geriátrica Ampla (AGA). Tendo em vista que idosos com escores acima de 6 estão em risco de vulnerabilidade clínico-funcional, objetivou-se definir, entre estes, a partir de qual escore os idosos seriam considerados em alto risco de vulnerabilidade, com base em alta especificidade (igual ou superior a 95%) e sensibilidade não inferior a 50%. Resultados: Identificou-se um ponto de corte de 15 pontos, com sensibilidade de 52% e especificidade de 98%. Conclusão: A elevada especificidade obtida indica que, provavelmente, poucos idosos em risco com pontuação igual ou superior a 15 seriam encaminhados desnecessariamente para a atenção gerontológica especializada, otimizando assim o uso dos recursos em saúde.