Health care are associated with worsening of frailty in community older adults

Abstract

OBJECTIVE: To identify the factors associated with the worsening of frailty in older adults resident in the community. METHODS: This is a prospective, longitudinal, and analytical study. The data collection in the baseline occurred in the participants’ homes from a random sampling by conglomerates. Demographic and socioeconomic variables, morbidities, and use of health services were analyzed. Frailty was measured by the Edmonton Frail Scale. The second data collection was performed after an average period of 42 months. The adjusted prevalence ratios were obtained by multiple Poisson regression analysis with robust variance. RESULTS: A total of 394 older adults participated in both phases of the study, with 21.8% of them presenting worsening of the frailty condition. The variables that remained statistically associated with the transition to a worse state of frailty were: polypharmacy, negative selfperception of health, weight loss, and hospitalization over the past 12 months. CONCLUSIONS: The factors associated with worsening of frailty along the studied period among older adults in the community were those related to health care. This result must be considered by health professionals when addressing frail and vulnerable older adults.

Impacto do apoio matricial a idosos na atenção primária: ensaio comunitário randomizado

“…Notably, these dimensions were already significantly better in the intervention before training, however it is emphasized that they remain statistically significant at the end. It is also noteworthy the need for accurate investigation of mobility issues and in the evaluation of the older adults, especially incontinence 15 , 24 , 32 .…”

“…Por conseguinte, esses indicadores complementam o IVCF-20 no screening da vulnerabilidade clínico-funcional dos idosos e da identificação da fragilidade, que representa um estado clínico dinâmico, multifatorial, resultante da somatória de déficits 15 , 16 , 24 , 25 , 31 que geralmente culminam em desfechos hostis aos indivíduos acometidos e ao sistema público 2 , 4 , 7 , 15 , 23 , 25 , 32 . Os estudos demonstram a associação de fragilidade com mobilidade reduzida, perda de peso 15 , 30 , 31 , presença de polipatologias 15 , 24 , 25 , 32 , incontinência e comprometimento da visão, além de outras síndromes geriátricas 15 , 30 , 31 .…”

“…Esses resultados podem ser explicados pela melhora da funcionalidade dos idosos decorrente de possível abordagem das variáveis humor e cognição, com reflexos favoráveis em sua independência e redução da vulnerabilidade. A literatura faz correlação entre o domínio mental, capacidade física e fragilidade, mencionando riscos e consequências dessa associação quanto ao detrimento da saúde e qualidade de vida do individuo 7,15,[22][23][24][25][29][30][31][32] . Ademais, promover ações para preservar a autonomia e a capacidade funcional do idoso reduz os desfechos adversos da fragilidade, pois a perda funcional é sempre patológica e requer investigação criteriosa 1,4,7,9,10,14,15,[22][23][24][25]31 .…”

“…Percebe-se que essas dimensões do instrumento já eram significativamente melhores na intervenção antes da capacitação, contudose ressalta que permanecem estatisticamente significantes ao final. Vale ressaltar ainda a necessidade de investigação acurada dos quesitos de mobilidade e na avalição dos idosos, especialmente a incontinência 15,24,32 .…”

<p>Preparing for the Maximum Emergency with a Simulation: A Table-Top Test to Evaluate Bed Surge Capacity and Staff Compliance with Training</p>

“…This in our opinion may be due to the fact that elderly patients had significant multi-morbidity, disability, instability of health, and social factors that required multidimensional assessment, diagnosis, and treatment. [26][27][28][29] We also believe that this data should be carefully studied in Western states where the average age is high and the prevalence of the elderly and the elderly is high. In fact, these patients are often polypathological and require repeated hospitalizations for exacerbations of chronic diseases and therefore in some hospitals, they can cover a considerable percentage of hospitalized patients.…”