Rastreamento da fragilidade em pessoas idosas com Hipertensão Arterial Sistêmica por instrumentos diferentes

Abstract

Aging is a continuous process that generates complex, gradual and inevitable changes, through changes in chronological age, variation in physical and cognitive function. In line with the increase in life expectancy, the prevalence of functional impairments and Chronic Noncommunicable Diseases (NCDs) such as systemic arterial hypertension (SAH) is increasing. This study aimed to compare the degree of agreement and correlation of the Edmonton Frail Scale (EFS) and the Clinical-Functional Vulnerability Index-20 (IVCF-20) instruments in elderly people with systemic arterial hypertension living in the community in the municipality of Montes Claros, north of Minas Gerais, Brazil. This is a cross-sectional study, nested within a population-based and household-based cohort. The sample was defined randomly, by conglomerates in two stages. Baseline data collection, the first moment, took place at the elderly person's home between May and July 2013. The second moment, the first wave of the study, was between November 2016 and February 2017. This study is a clipping of the larger research and included only elderly people with SAH. Demographic, social, economic and clinical characteristics were evaluated, in addition to frailty, which was verified through the EFS and the IVCF-20. The Kappa statistic was used in order to verify the agreement between the EFS and IVCF-20 instruments, considering the dichotomization of frailty in the community elderly (frail and non-frail). The correlation between the instruments was evaluated using Pearson's coefficient, considering the total scores of each of the EFS and IVCF-20 instruments. Sensitivity, specificity, predictive values were determined. 281 elderly people with hypertension participated in the study, the prevalence of frailty was 31.3% by EFS and 22.1% by IVCF-20. The Kappa statistic was 0.604 and Pearson's correlation coefficient was 0.621 (p<0.001). The accuracy was 84.34% (good accuracy). It was found that the EFS and IVCF-20 instruments showed moderate agreement, strong positive correlation and good accuracy, demonstrating similarity between the instruments' components, although different prevalences were found for frailty in elderly people with SAH. These findings highlight the need for standardization of the instrument to be used in Primary Health Care (PHC), because, even if they have similarities, the different prevalences interfere in directing assistance in planning prevention, protection and recovery actions, aiming at maintaining of functional capacity during aging.