Comparação da fragilidade em idosos comunitários por faixa etária e instrumentos diferentes

Abstract

Population aging is occurring at an accelerated rate in the world population, especially in Brazil, and has become a major challenge for the current century. This process caused a increase in the prevalence of chronic non-communicable diseases, making the development of actions to stratify frailty in the elderly relevant, making it a public health priority. Tracking and detecting frailty in the elderly can be carried out using different instruments, however, there is no consensus on the choice of which instrument is the most protected for use by researchers and clinicians, since there is not yet a standard measurement universal for fragility. The objective of this study is to investigate frailty in community-dwelling elderly people by age group, using the Edmonton Frailty Scale (EFE) and Functional Clinical Vulnerability Index (IVCF-20) instruments regarding the degree of agreement and correlation. This is a cross-sectional study nested within a population-based cohort, with probabilistic sampling, by conglomerates and in two stages. The first stage uses the census sector as the sampling unit; while the second determined the number of households according to the population density of elderly individuals. The Kappa statistic analyzed the degree of agreement and the Pearson coefficient evaluated the perspective between the instruments. For this study, 394 community elderly people were allocated, predominantly female (66.7%) and aged between 65 and 69 years old (26.4%). The prevalence of frailty was higher among those aged 90 years and over, being 44.4% both by IVCF-20 and EFS. There was a higher prevalence of frailty in elderly people aged between 60 and 79 years old and it decreased more between 85 and 89 years old, when using the EFS. The Kappa statistic revealed a low level of agreement (0.399) between the instruments in the age group between 65 and 69 years old, while in the age group equal to or greater than 90 years old, there was a strong agreement (Kappa 0.775). The IVCF-20 and EFS instruments showed strong agreement and demonstrated greater coherence in assessing frailty in long-lived elderly people. It is concluded that the IVCF-20 instruments and the EFS showed agreement and a moderate to strong positive correlation. In the age groups between 80 and 85 years old and 90 years old and over, the prevalence of frailty was the same for both instruments, which demonstrates the strong association between frailty and advanced age. Therefore, it is essential that health professionals take a more accurate look, planning their actions and care not only by population group, but also by age stratification within this population.