Estudo do impacto da fragilidade, multimorbidade e incapacidade funcional na sobrevida de idosos ambulatoriais

Abstract

This study aims to analyze the impact of frailty, multimorbidity and disability on the survival of elderly people attended in a geriatric outpatient facility, and identify the clinical risk factors associated with death. It is a longitudinal study, with 133 elderly people initially evaluated in relation to frailty, multimorbidity (simultaneous presence of three or more chronic diseases) and disability in Daily Life Activities. The Kaplan Meier method was used to analyze survival time, and the Cox regression was used for association of the clinical factors with death. In follow-up over six years, 21.2% of the participants died, survival being lowest among those who were fragile (p < 0.05). The variables frailty (HR = 2.26; CI95%: 1.03-4.93) and Chronic Renal Insufficiency (HR = 3.00; were the factors of highest risk for death in the multivariate analysis. Frailty had a negative effect on the survival of these patients, but no statistically significant association was found in relation to multimorbidity or disability. Tracking of vulnerabilities in the outpatient geriatric service is important, due to the significant number of elderly people with geriatric syndromes that use this type of service, and the taking of decisions on directions for care of these individuals.

Hemovigilance and patient safety: analysis of immediate transfusion reactions in elderly

“…Due to the progressive and dynamic sequential changes in the aging process, which are often followed by functional disabilities, weaknesses, vulnerability, and by the increased longevity of the population, individuals not only have become more susceptible to noncommunicable diseases (such as cancer, cardiovascular and respiratory diseases), but also to acute events of these or other pre-existing conditions, being affected by functional limitations and hospitalizations (4)(5)(6)(7)(8)(9)(10)(11) .…”

Aspectos bioéticos dos cuidados em saúde às pessoas idosas ao fim da vida [Bioethical aspects of the health care provided to older adults at the end of their lives] [Aspectos bioéticos de los cuidados de salud a adultos mayores en el final de la vida]

“…O predomínio da fragilidade, a existência de multimorbidade e perdas funcionais, que aumentam conforme o avançar da idade, exercem um grande impacto na sobrevida de idosos, trazendo implicações na suscetibilidade e evolução para a morte 4 .…”

Associations between Brain Structural Damage and Core Muscle Loss in Patients with Parkinson’s Disease

“…In addition to movement manifestations, several non-motor features, such as autonomic dysfunction, cognitive and psychiatric changes, dementia, sensory symptoms, and sleep disturbances are also commonly presented during disease progression [2]. Recently, physical frailty related to reduced physical activity has been identified as a predictor of decreased lifespan [3]. In PD, decreased physical activity and subsequent weakness occurs with disease progression [4].…”

“…Frailty and decreased muscle mass have been observed in patients with PD, causing morbidity and mortality [3]. It is known that many factors may influence muscle integrity [7], whereas the central nervous system plays a crucial role for maintenance of muscle integrity.…”