Prevalência e fatores associados à fragilidade em idosos não institucionalizados

Abstract

Objective: to investigate the prevalence and factors associated with frailty in non-institutionalized older adults living in northern Minas Gerais, Brazil. Method: data were collected in their homes, in 2013, based on a census cluster sampling. Demographic and socioeconomic variables, morbidities, utilization of health care services, and scores on the Edmonton Fragility Scale were analyzed. The adjusted prevalence ratios were obtained using the Poisson regression multiple analysis with robust variance. Results: the prevalence of frailty was 41.3%. The variables associated with frailty were: female gender, very old age, education of less than four years, not having been hospitalized in the last 12 months, having a caregiver, falling in the prior year, diabetes mellitus, cardiac disease, and osteoarticular disease. Conclusion: the prevalence of frailty was high. Some factors consist of modifi able conditions, which should encourage health actions aimed at this group. Descriptors: Aged; Health Vulnerability; Frail Elderly; Prevalence; Health of the Elderly. RESUMO Objetivo: verifi car a prevalência e os fatores associados à fragilidade em idosos não institucionalizados residentes ao norte de Minas Gerais, Brasil. Método: a coleta de dados ocorreu no domicílio em 2013, a partir de uma amostragem censitária por conglomerado. Foram analisadas variáveis demográfi cas e socioeconômicas, morbidades, utilização de serviços de saúde e o escore da Escala de Fragilidade de Edmonton. As razões de prevalências ajustadas foram obtidas por análise múltipla de regressão de Poisson com variância robusta. Resultados: a prevalência de fragilidade foi 41,3%. As variáveis associadas à fragilidade foram: sexo feminino, idosos longevos, escolaridade inferior a 4 anos, não ter sido internado nos últimos 12 meses, presença de cuidador, queda no último ano, diabetes mellitus, doença cardíaca e doença osteoarticular. Conclusão: a prevalência de fragilidade mostrou-se elevada. Alguns fatores representam condições modifi cáveis e devem estimular ações de saúde destinadas a esse grupo. Descritores: Idoso; Vulnerabilidade em Saúde; Idoso Fragilizado; Prevalência; Saúde do Idoso. RESUMEN Objetivo: determinar la prevalencia y factores asociados a la fragilidad en ancianos no institucionalizados residentes en el norte de Minas Gerais, Brasil. Método: los datos fueron recolectados en los hogares en 2013 a partir de un muestreo por conglomerados por sectores censitarios. Se analizaron variables demográfi cas y socioeconómicas, morbilidad, utilización de los servicios de salud y la puntuación de la Escala de Fragilidad de Edmonton. Se obtuvieron los cocientes de prevalencia ajustados mediante análisis múltiple de regresión de Poisson con varianza robusta. Resultados: la prevalencia de fragilidad fue 41.3%. Las variables asociadas con la fragilidad fueron sexo femenino, edad más avanzada, escolarización menor de 4 años, no haber sido hospitalizado en los últimos 12 meses, tener un cuidador, caída en el año anterior, diabetes mellitus, enferme...

Frailty in the elderly: prevalence and associated factors

“…These instruments have demonstrated acceptable reliability as well as a concurrent, predictive and good validity (17) . The results of this study confirm higher frequency of frailty as age increases, being more prevalent among the advanced age elderly; similar data have been found in other studies (6,13) . During the aging process, there is a gradual decrease of physiological reserve and consequent decline accumulated in several physiological systems, resulting in the condition of frailty 7) .…”

“…Studies that used the EFS also observed this relation (6,20) . Probably, frail elderlies need a caregiver to assist them on their basic and instrumental activities demanded daily.…”

“…However, in studies using EFS, prevalence of fragility in the elderly who lived in the community was 39.1% in Ribeirão Preto, São Paulo (11) and 41.3% in Montes Claros, Minas Gerais (6) , while in the elderly assisted by the Family Health Strategy in Embu, São Paulo, it was 30.1% (12) . Prevalence of frailty was 74.1% in the elderly of an institution of long permanence in Fortaleza, Ceará (13) ,while it was 95.2% in the elderly hospitalized in the Medical Clinic of the Emergency Department of a University Hospital of Ribeirão Preto, São Paulo (14) .…”

“…Progressive and fast increase of elderly Brazilian population points out new challenges to the health sector, due to change in the epidemiological profile of the country caused by the increasing prevalence of chronic non-communicable diseases (NCD). Such clinical conditions can expose the elderly to a state of vulnerability due to poor resolution of homeostasis after a stress event, a result of the cumulative decline in various physiological systems over life, which is an essential frailty characteristic in the elderly (1,(3)(4)(5)(6)(7) . Frailty in the elderly is a multi-dimensional syndrome that involves interaction of biological, psychological and social factors.…”

“…Frailty in the elderly is a multi-dimensional syndrome that involves interaction of biological, psychological and social factors. It is associated with a higher risk of adverse outcomes, such as decline in functional ability, falls, delirium, institutionalization, hospitalization and death (6)(7) . Regarding the need to implement a health care network for the elderly population, (8) .…”