Fatores associados a fragilidade em is=dosos hipertensos pela escala de fragilidade de Edmonton e pelo índice de vulnerabilidade clínico funcional-20

Abstract

The aging of the population causes an increase in the prevalence of systemic arterial hypertension, which is one of the main health problems in this population, making the elderly a fragile being. Frailty screening takes place using several simple and quick tools, with the Edmonton Frailty Scale (EFS) and the Clinical Functional Vulnerability Index-20 (IVCF-20) being the most used. Based on this, the aim of the study was to evaluate the prevalence of frailty and compare the variables associated with this frailty in Brazilian community-dwelling hypertensive elderly using the EFS and the IVCF-20 Index. This is a cross-sectional and analytical assessment, conducted with community-dwelling elderly aged ≥ 60 years, living in the city of Montes Claros, Minas Gerais, Brazil. Sample selection followed the cluster probabilistic model. Data were collected between November 2016 and February 2017 through the application of a questionnaire at home. Demographic, socioeconomic and clinical assistance variables were analyzed. Poisson regression with robust variance was used to obtain crude and adjusted prevalence ratios. 281 elderly hypertensives participated. The general prevalence of frailty according to the EFS was 31.3% and according to the IVCF-20 it was 22.1%. The variables that, after the multiple analysis, were statistically associated with frailty in hypertensive elderly people, by the EFS and IVCF-20 simultaneously, were: advanced age, presenting rheumatoid arthritis/arthrosis as a comorbidity, stroke, negative self perception of health, falls and hospitalizations in the last 12 months. Only for the EFS, less than 4 years of study, not having a religious practice and not having their own income were the associated variables. While according to the IVCF-20, only monthly family income was associated with frailty. It was found that there is a higher prevalence of hypertension among frail elderly people. The prevalence of frail hypertensive elderly from the application of EFS was higher, being more sensitive. It is noticed that the associated factors were also divergent between the scales. These results demonstrate the need for a gold standard instrument to assess frailty.