Fragilidade e mortalidade de idosos em contexto de alta vulnerabilidade social: um estudo prospectivo
Autor(a) principal: | |
---|---|
Data de Publicação: | 2021 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Repositório Institucional da UFSCAR |
Texto Completo: | https://repositorio.ufscar.br/handle/ufscar/14105 |
Resumo: | Frailty is a multidimensional syndrome and a predictor of adverse outcomes in the elderly. The aim of this study was to identify changes in the levels of frailty and its relationship with mortality in the elderly in a context of high social vulnerability. This is a prospective cohort study. Two assessment surveys were carried out: one at the baseline (2015) and another after 36 months (2018) in the municipality of São Carlos - SP. For data collection, we used the Phenotype of Fragility, instruments for sociodemographic characterization, health conditions and mortality. The data were analyzed using the software R version 3.5.3 in R-Studio, in which descriptive analyzes were performed, where the quantitative variables were presented in the form of median and the qualitative variables in the form of absolute frequency. Kruskal-Wallis test was also performed; Equality of proportions test; Multinomial logistic regression; Kaplan-Meier survival analysis and Cox Regression. The project to which this study is linked was authorized by the Ethics Committee of the Federal University of São Carlos and the use of the database was authorized. In the first assessment, in 2015, carried out with 346 elderly people, there was a predominance of female elderly (56.4%) and aged between 60-69 years (53.2%). In the second assessment, in 2018, 223 elderly people were reevaluated, who were mostly female (57.4%) and aged between 70 and 79 years old (44.8%). Among those who died, there was a predominance of elderly men (64.5%) and aged between 70 and 79 years (38.7%). Among the fragile assessed in 2015, 36.8% remained in this condition, while 52.5% returned to pre-fragility and 11.8% became non-fragile. In relation to the pre-fragile, 25.4% became non-fragile, 57.9% remained as pre-fragile and 16.7% became fragile. Among those without fragility, 37.9% remained non-fragile, 58.6% became pre-fragile and 3.4% became fragile. In the first assessment, the male gender and the presence of depressive symptoms were configured as factors associated with pre-frailty and frailty. The age group from 70 to 79 years old, on the other hand, was associated with pre-frailty, while lower education and self-rated health were considered to be conditions associated with frailty. While higher education and better health-related quality of life were predictors of pre-frailty and frailty, respectively. Of the elderly who died, 15.6% were frail, 6.2% pre-frail and 3.4% non-frail. In the survival analysis, he identified a higher proportion of non-frail elderly compared to the frail (p = 0.027), as well as for female (p = 0.038), younger (p = 0.021), physically active (p <0.001), with good and excellent self-perception of health status (p <0.001), without urinary (p = 0.013) and fecal incontinence (p = 0.048) and absence of depressive symptoms (p = 0.043). As for the Cox regression model, it was found that frailty (p = 0.040), male gender (p = 0.030), age over 80 years (p = 0.009) and fecal incontinence (p = 0.020) were predictors for death. In conclusion there were changes in the prevalence of frailty, since in the second assessment the prevalence of frail elderly people decreased. However, most participants remained in a pre-fragile condition. There was also a relationship between frailty and mortality, as this condition being a predictor of death in the elderly in a context of high social vulnerability. |
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Menezes, Ana Laura CostaOrlandi, Fabiana de Souzahttp://lattes.cnpq.br/7395879552721664http://lattes.cnpq.br/8695772348526600cf3eeca2-a00a-4053-9f86-f9490c80d9072021-04-13T11:25:32Z2021-04-13T11:25:32Z2021-01-11MENEZES, Ana Laura Costa. Fragilidade e mortalidade de idosos em contexto de alta vulnerabilidade social: um estudo prospectivo. 2021. Tese (Doutorado em Enfermagem) – Universidade Federal de São Carlos, São Carlos, 2021. Disponível em: https://repositorio.ufscar.br/handle/ufscar/14105.https://repositorio.ufscar.br/handle/ufscar/14105Frailty is a multidimensional syndrome and a predictor of adverse outcomes in the elderly. The aim of this study was to identify changes in the levels of frailty and its relationship with mortality in the elderly in a context of high social vulnerability. This is a prospective cohort study. Two assessment surveys were carried out: one at the baseline (2015) and another after 36 months (2018) in the municipality of São Carlos - SP. For data collection, we used the Phenotype of Fragility, instruments for sociodemographic characterization, health conditions and mortality. The data were analyzed using the software R version 3.5.3 in R-Studio, in which descriptive analyzes were performed, where the quantitative variables were presented in the form of median and the qualitative variables in the form of absolute frequency. Kruskal-Wallis test was also performed; Equality of proportions test; Multinomial logistic regression; Kaplan-Meier survival analysis and Cox Regression. The project to which this study is linked was authorized by the Ethics Committee of the Federal University of São Carlos and the use of the database was authorized. In the first assessment, in 2015, carried out with 346 elderly people, there was a predominance of female elderly (56.4%) and aged between 60-69 years (53.2%). In the second assessment, in 2018, 223 elderly people were reevaluated, who were mostly female (57.4%) and aged between 70 and 79 years old (44.8%). Among those who died, there was a predominance of elderly men (64.5%) and aged between 70 and 79 years (38.7%). Among the fragile assessed in 2015, 36.8% remained in this condition, while 52.5% returned to pre-fragility and 11.8% became non-fragile. In relation to the pre-fragile, 25.4% became non-fragile, 57.9% remained as pre-fragile and 16.7% became fragile. Among those without fragility, 37.9% remained non-fragile, 58.6% became pre-fragile and 3.4% became fragile. In the first assessment, the male gender and the presence of depressive symptoms were configured as factors associated with pre-frailty and frailty. The age group from 70 to 79 years old, on the other hand, was associated with pre-frailty, while lower education and self-rated health were considered to be conditions associated with frailty. While higher education and better health-related quality of life were predictors of pre-frailty and frailty, respectively. Of the elderly who died, 15.6% were frail, 6.2% pre-frail and 3.4% non-frail. In the survival analysis, he identified a higher proportion of non-frail elderly compared to the frail (p = 0.027), as well as for female (p = 0.038), younger (p = 0.021), physically active (p <0.001), with good and excellent self-perception of health status (p <0.001), without urinary (p = 0.013) and fecal incontinence (p = 0.048) and absence of depressive symptoms (p = 0.043). As for the Cox regression model, it was found that frailty (p = 0.040), male gender (p = 0.030), age over 80 years (p = 0.009) and fecal incontinence (p = 0.020) were predictors for death. In conclusion there were changes in the prevalence of frailty, since in the second assessment the prevalence of frail elderly people decreased. However, most participants remained in a pre-fragile condition. There was also a relationship between frailty and mortality, as this condition being a predictor of death in the elderly in a context of high social vulnerability.A fragilidade é uma síndrome multidimensional e preditora de desfechos adversos em idosos. O objetivo deste estudo foi identificar alterações nos níveis de fragilidade e sua relação com a mortalidade de idosos em contexto de alta vulnerabilidade social. Trata-se de um estudo de coorte prospectivo. Foram realizadas duas avaliações de inquérito: uma na linha de base (2015) e outra após 36 meses (2018) no município de São Carlos – SP. Para a coleta de dados utilizou-se o Fenótipo de Fragilidade, instrumentos de caracterização sociodemográfica, de condições de saúde e mortalidade. Os dados foram analisados utilizando o software R versão 3.5.3 no R-Studio, no qual foram realizadas análises descritivas onde as variáveis quantitativas foram apresentadas sob a forma de mediana e as variáveis qualitativas sob a forma de frequência absoluta. Foram realizadas ainda este de Kruskal-Wallis; teste de igualdade de proporções; regressão logística multinomial; análise de sobrevivência de Kaplan-Meier e regressão de Cox. O projeto no qual este estudo está vinculado foi autorizado pelo Comitê de Ética da Universidade Federal de São Carlos e o uso do banco de dados foi autorizado. Na primeira avaliação, em 2015, realizada com 346 idosos, houve predomínio de idosos do sexo feminino (56,4%) e com faixa etária entre 60-69 anos (53,2%). Na segunda avaliação, em 2018, 223 idosos foram reavaliados, os quais eram majoritariamente do sexo feminino (57,4%) e faixa etária de 70 a 79 anos (44,8%). Entre aqueles que foram à óbito, houve predomínio de idosos do sexo masculino (64,5%) e com faixa etária de 70 a 79 anos (38,7%). Dentre os frágeis avaliados em 2015, 36,8% permaneceram nesta condição, enquanto que 52,5% retornaram à pré-fragilidade e 11,8% se tornaram não frágeis. Em relação aos pré-frágeis, 25,4% se tornaram não frágeis, 57,9% se mantiveram como pré-frágeis e 16,7% se tornaram frágeis. Já entre aqueles sem fragilidade, 37,9% se mantiveram não frágeis, 58,6% se tornaram pré-frágeis e 3,4% se tornou frágil. Na primeira avaliação o sexo masculino e a presença de sintomas depressivos configuraram-se como fatores associados à pré-fragilidade e fragilidade. Já a faixa etária de 70 a 79 anos foi associada à pré-fragilidade e maior escolaridade e autopercepção de saúde avaliada como boa foram condições associadas à fragilidade. Enquanto que maior escolaridade e melhor qualidade de vida relacionada à saúde foram fatores de proteção para o desenvolvimento de pré-fragilidade e fragilidade, respectivamente. Dos idosos que foram à óbito, 15,6% eram frágeis, 6,2% pré-frágeis e 3,4% não frágeis. Na análise de sobrevivência identificou maior proporção de idosos não frágeis comparado aos frágeis (p=0,027), assim como para aqueles do sexo feminino (p=0,038), mais jovens (p=0,021), ativos fisicamente (p<0,001), com boa e excelente autopercepção do estado de saúde (p<0,001), sem incontinência urinária (p=0,013) e fecal (p=0,048) e ausência de sintomas depressivos (p=0,043). Quanto ao modelo de regressão de Cox, constatou-se que a fragilidade (p=0,040), o sexo masculino (p=0,030), a idade acima de 80 anos (p=0,009) e a incontinência fecal (p=0,020) foram preditores para o óbito. Conclui-se que houve alterações na prevalência de fragilidade, visto que na segunda avaliação a prevalência de idosos frágeis diminuiu. Contudo, a maioria dos participantes se manteve na condição de pré-fragilidade. Verificou-se ainda a relação da fragilidade com a mortalidade, tal condição foi preditora de óbito em idosos em contexto de alta vulnerabilidade social.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)CAPES: Código de Financiamento 001porUniversidade Federal de São CarlosCâmpus São CarlosPrograma de Pós-Graduação em Enfermagem - PPGEnfUFSCarAttribution-NonCommercial-NoDerivs 3.0 Brazilhttp://creativecommons.org/licenses/by-nc-nd/3.0/br/info:eu-repo/semantics/openAccessIdoso fragilizadoSaúde do idosoMortalidadeVulnerabilidade socialFrail elderlyHealth of the elderlyMortalitySocial vulnerabilityCIENCIAS DA SAUDE::ENFERMAGEMCIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONALCIENCIAS DA SAUDEFragilidade e mortalidade de idosos em contexto de alta vulnerabilidade social: um estudo prospectivoFrailty and mortality of the elderly in context of high social vulnerability: a prospective studyinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesis600600538950e5-b3a5-4b19-8dd0-85d6b0bb5065reponame:Repositório Institucional da UFSCARinstname:Universidade Federal de São Carlos (UFSCAR)instacron:UFSCARORIGINALTese Ana Laura C Menezes.pdfTese Ana Laura C Menezes.pdfTese apresentada ao Programa de Pós-Graduação em Enfermagem da Universidade Federal de São Carlos, para obtenção do título de Doutor em Ciências da saúde.application/pdf3820514https://repositorio.ufscar.br/bitstream/ufscar/14105/4/Tese%20Ana%20Laura%20C%20Menezes.pdf7a3b525932fc07db54a82fb1020af7e4MD54carta-comprovante.pdfcarta-comprovante.pdfCarta comprovante assinada pela orientadoraapplication/pdf85581https://repositorio.ufscar.br/bitstream/ufscar/14105/5/carta-comprovante.pdf897f7c48403e3c75b19a5b85c224d882MD55CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8811https://repositorio.ufscar.br/bitstream/ufscar/14105/6/license_rdfe39d27027a6cc9cb039ad269a5db8e34MD56TEXTTese Ana Laura C Menezes.pdf.txtTese Ana Laura C Menezes.pdf.txtExtracted texttext/plain284498https://repositorio.ufscar.br/bitstream/ufscar/14105/7/Tese%20Ana%20Laura%20C%20Menezes.pdf.txtc5bd6a406c212d72ef9f7165a738278aMD57carta-comprovante.pdf.txtcarta-comprovante.pdf.txtExtracted texttext/plain1140https://repositorio.ufscar.br/bitstream/ufscar/14105/9/carta-comprovante.pdf.txt61771ef7c420d2c8d84caec934a79bd6MD59THUMBNAILTese Ana Laura C Menezes.pdf.jpgTese Ana Laura C Menezes.pdf.jpgIM Thumbnailimage/jpeg6108https://repositorio.ufscar.br/bitstream/ufscar/14105/8/Tese%20Ana%20Laura%20C%20Menezes.pdf.jpg0fb85d3220e18d77da73d802b4f9946dMD58carta-comprovante.pdf.jpgcarta-comprovante.pdf.jpgIM Thumbnailimage/jpeg6816https://repositorio.ufscar.br/bitstream/ufscar/14105/10/carta-comprovante.pdf.jpgb0293bca50b6bb9c0a2a77d9f92ee878MD510ufscar/141052023-09-18 18:32:09.064oai:repositorio.ufscar.br:ufscar/14105Repositório InstitucionalPUBhttps://repositorio.ufscar.br/oai/requestopendoar:43222023-09-18T18:32:09Repositório Institucional da UFSCAR - Universidade Federal de São Carlos (UFSCAR)false |
dc.title.por.fl_str_mv |
Fragilidade e mortalidade de idosos em contexto de alta vulnerabilidade social: um estudo prospectivo |
dc.title.alternative.eng.fl_str_mv |
Frailty and mortality of the elderly in context of high social vulnerability: a prospective study |
title |
Fragilidade e mortalidade de idosos em contexto de alta vulnerabilidade social: um estudo prospectivo |
spellingShingle |
Fragilidade e mortalidade de idosos em contexto de alta vulnerabilidade social: um estudo prospectivo Menezes, Ana Laura Costa Idoso fragilizado Saúde do idoso Mortalidade Vulnerabilidade social Frail elderly Health of the elderly Mortality Social vulnerability CIENCIAS DA SAUDE::ENFERMAGEM CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL CIENCIAS DA SAUDE |
title_short |
Fragilidade e mortalidade de idosos em contexto de alta vulnerabilidade social: um estudo prospectivo |
title_full |
Fragilidade e mortalidade de idosos em contexto de alta vulnerabilidade social: um estudo prospectivo |
title_fullStr |
Fragilidade e mortalidade de idosos em contexto de alta vulnerabilidade social: um estudo prospectivo |
title_full_unstemmed |
Fragilidade e mortalidade de idosos em contexto de alta vulnerabilidade social: um estudo prospectivo |
title_sort |
Fragilidade e mortalidade de idosos em contexto de alta vulnerabilidade social: um estudo prospectivo |
author |
Menezes, Ana Laura Costa |
author_facet |
Menezes, Ana Laura Costa |
author_role |
author |
dc.contributor.authorlattes.por.fl_str_mv |
http://lattes.cnpq.br/8695772348526600 |
dc.contributor.author.fl_str_mv |
Menezes, Ana Laura Costa |
dc.contributor.advisor1.fl_str_mv |
Orlandi, Fabiana de Souza |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/7395879552721664 |
dc.contributor.authorID.fl_str_mv |
cf3eeca2-a00a-4053-9f86-f9490c80d907 |
contributor_str_mv |
Orlandi, Fabiana de Souza |
dc.subject.por.fl_str_mv |
Idoso fragilizado Saúde do idoso Mortalidade Vulnerabilidade social |
topic |
Idoso fragilizado Saúde do idoso Mortalidade Vulnerabilidade social Frail elderly Health of the elderly Mortality Social vulnerability CIENCIAS DA SAUDE::ENFERMAGEM CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL CIENCIAS DA SAUDE |
dc.subject.eng.fl_str_mv |
Frail elderly Health of the elderly Mortality Social vulnerability |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE::ENFERMAGEM CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL CIENCIAS DA SAUDE |
description |
Frailty is a multidimensional syndrome and a predictor of adverse outcomes in the elderly. The aim of this study was to identify changes in the levels of frailty and its relationship with mortality in the elderly in a context of high social vulnerability. This is a prospective cohort study. Two assessment surveys were carried out: one at the baseline (2015) and another after 36 months (2018) in the municipality of São Carlos - SP. For data collection, we used the Phenotype of Fragility, instruments for sociodemographic characterization, health conditions and mortality. The data were analyzed using the software R version 3.5.3 in R-Studio, in which descriptive analyzes were performed, where the quantitative variables were presented in the form of median and the qualitative variables in the form of absolute frequency. Kruskal-Wallis test was also performed; Equality of proportions test; Multinomial logistic regression; Kaplan-Meier survival analysis and Cox Regression. The project to which this study is linked was authorized by the Ethics Committee of the Federal University of São Carlos and the use of the database was authorized. In the first assessment, in 2015, carried out with 346 elderly people, there was a predominance of female elderly (56.4%) and aged between 60-69 years (53.2%). In the second assessment, in 2018, 223 elderly people were reevaluated, who were mostly female (57.4%) and aged between 70 and 79 years old (44.8%). Among those who died, there was a predominance of elderly men (64.5%) and aged between 70 and 79 years (38.7%). Among the fragile assessed in 2015, 36.8% remained in this condition, while 52.5% returned to pre-fragility and 11.8% became non-fragile. In relation to the pre-fragile, 25.4% became non-fragile, 57.9% remained as pre-fragile and 16.7% became fragile. Among those without fragility, 37.9% remained non-fragile, 58.6% became pre-fragile and 3.4% became fragile. In the first assessment, the male gender and the presence of depressive symptoms were configured as factors associated with pre-frailty and frailty. The age group from 70 to 79 years old, on the other hand, was associated with pre-frailty, while lower education and self-rated health were considered to be conditions associated with frailty. While higher education and better health-related quality of life were predictors of pre-frailty and frailty, respectively. Of the elderly who died, 15.6% were frail, 6.2% pre-frail and 3.4% non-frail. In the survival analysis, he identified a higher proportion of non-frail elderly compared to the frail (p = 0.027), as well as for female (p = 0.038), younger (p = 0.021), physically active (p <0.001), with good and excellent self-perception of health status (p <0.001), without urinary (p = 0.013) and fecal incontinence (p = 0.048) and absence of depressive symptoms (p = 0.043). As for the Cox regression model, it was found that frailty (p = 0.040), male gender (p = 0.030), age over 80 years (p = 0.009) and fecal incontinence (p = 0.020) were predictors for death. In conclusion there were changes in the prevalence of frailty, since in the second assessment the prevalence of frail elderly people decreased. However, most participants remained in a pre-fragile condition. There was also a relationship between frailty and mortality, as this condition being a predictor of death in the elderly in a context of high social vulnerability. |
publishDate |
2021 |
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2021-04-13T11:25:32Z |
dc.date.available.fl_str_mv |
2021-04-13T11:25:32Z |
dc.date.issued.fl_str_mv |
2021-01-11 |
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MENEZES, Ana Laura Costa. Fragilidade e mortalidade de idosos em contexto de alta vulnerabilidade social: um estudo prospectivo. 2021. Tese (Doutorado em Enfermagem) – Universidade Federal de São Carlos, São Carlos, 2021. Disponível em: https://repositorio.ufscar.br/handle/ufscar/14105. |
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https://repositorio.ufscar.br/handle/ufscar/14105 |
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MENEZES, Ana Laura Costa. Fragilidade e mortalidade de idosos em contexto de alta vulnerabilidade social: um estudo prospectivo. 2021. Tese (Doutorado em Enfermagem) – Universidade Federal de São Carlos, São Carlos, 2021. Disponível em: https://repositorio.ufscar.br/handle/ufscar/14105. |
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https://repositorio.ufscar.br/handle/ufscar/14105 |
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Universidade Federal de São Carlos Câmpus São Carlos |
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