Fragilidade em idosos comunitários: comparando instrumentos de triagem
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | por eng |
Título da fonte: | Revista de Saúde Pública |
Texto Completo: | https://www.revistas.usp.br/rsp/article/view/179940 |
Resumo: | OBJECTIVE: To compare the Edmonton Frail Scale (EFS) and Clinical-Functional Vulnerability Index-20 (CFVI-20) instruments regarding degree of agreement and correlation and compare descriptive models with frailty-associated variables in community-dwelling older people in Brazil. METHODS: Cross-sectional study, nested in a population-based and household cohort. Baseline sampling was calculated based on a probabilistic approach by conglomerate in two stages. In the first stage, census tract was used as sampling unit. In the second, the number of households was defined according to the population density of individuals aged ≥ 60 years. The Kappa statistic evaluated the agreement between instruments and Pearson’s coefficient their correlation. Factors associated with frailty and high risk of clinical-functional vulnerability were identified by multiple analysis of Poisson regression with robust variance. RESULTS: Kappa statistics was 0.599 and Pearson’s correlation coefficient 0.755 (p < 0.001). The EFS found a 28.2% prevalence of frailty, and the CFVI-20 found a 19.5% prevalence of high risk of clinical-functional vulnerability. Age equal to or greater than 80 years, history of stroke, polypharmacy, negative self-perceived health, fall in the past 12 months, and hospitalization in the past 12 months were variables associated with frailty in both instruments after multiple analysis. Less than four years of education, osteoarticular disease, and weight loss were associated with frailty only by EFS, and having a caregiver was associated with a high risk of clinical-functional vulnerability only by CFVI-20. CONCLUSIONS: Although the analyses show moderate agreement and strong positive correlation between the instruments, the indicated prevalence of frailty is discrepant. Our results attest the need to standardize the instrument for assessing frailty in communitydwelling older people. |
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Fragilidade em idosos comunitários: comparando instrumentos de triagemFrailty in community-dwelling older people: comparing screening instrumentsIdosoFragilidade, EpidemiologiaReprodutibilidade dos TestesFatores de RiscoInquéritos EpidemiológicosInstrumentaçãoAgedFrailty, EpidemiologyReproducibility of ResultsRisk FactorsHealth Surveys, InstrumentationOBJECTIVE: To compare the Edmonton Frail Scale (EFS) and Clinical-Functional Vulnerability Index-20 (CFVI-20) instruments regarding degree of agreement and correlation and compare descriptive models with frailty-associated variables in community-dwelling older people in Brazil. METHODS: Cross-sectional study, nested in a population-based and household cohort. Baseline sampling was calculated based on a probabilistic approach by conglomerate in two stages. In the first stage, census tract was used as sampling unit. In the second, the number of households was defined according to the population density of individuals aged ≥ 60 years. The Kappa statistic evaluated the agreement between instruments and Pearson’s coefficient their correlation. Factors associated with frailty and high risk of clinical-functional vulnerability were identified by multiple analysis of Poisson regression with robust variance. RESULTS: Kappa statistics was 0.599 and Pearson’s correlation coefficient 0.755 (p < 0.001). The EFS found a 28.2% prevalence of frailty, and the CFVI-20 found a 19.5% prevalence of high risk of clinical-functional vulnerability. Age equal to or greater than 80 years, history of stroke, polypharmacy, negative self-perceived health, fall in the past 12 months, and hospitalization in the past 12 months were variables associated with frailty in both instruments after multiple analysis. Less than four years of education, osteoarticular disease, and weight loss were associated with frailty only by EFS, and having a caregiver was associated with a high risk of clinical-functional vulnerability only by CFVI-20. CONCLUSIONS: Although the analyses show moderate agreement and strong positive correlation between the instruments, the indicated prevalence of frailty is discrepant. Our results attest the need to standardize the instrument for assessing frailty in communitydwelling older people.OBJETIVO: Comparar os instrumentos Edmonton Frail Scale (EFS) e Índice de Vulnerabilidade Clínico-Funcional-20 (IVCF-20) quanto ao grau de concordância e de correlação, bem como comparar modelos descritivos com variáveis associadas à fragilidade em idosos brasileiros comunitários. MÉTODOS: Estudo transversal, aninhado a uma coorte de base populacional e domiciliar. A amostragem na linha de base foi probabilística, por conglomerados, em dois estágios. No primeiro, utilizou-se como unidade amostral o setor censitário. No segundo, definiu-se o número de domicílios segundo a densidade populacional de indivíduos com idade ≥ a 60 anos. A estatística Kappa analisou a concordância, e o coeficiente de Pearson avaliou a correlação entre os instrumentos. Os fatores associados à fragilidade e ao alto risco de vulnerabilidade clínicofuncional foram identificados por análise múltipla de regressão de Poisson com variância robusta. RESULTADOS: A estatística Kappa foi 0,599, e o coeficiente de correlação de Pearson foi de 0,755 (p < 0,001). A prevalência da fragilidade foi de 28,2% pela EFS, e a prevalência do alto risco de vulnerabilidade clínico-funcional foi de 19,5% pelo IVCF-20. As variáveis associadas à fragilidade, após análise múltipla, em ambos os instrumentos, foram: idade igual ou superior a 80 anos, histórico de acidente vascular encefálico, polifarmácia, autopercepção negativa de saúde, queda nos últimos 12 meses e internação nos últimos 12 meses. Escolaridade inferior a quatro anos, doença osteoarticular e perda de peso foram associadas a fragilidade apenas pela EFS, enquanto possuir cuidador esteve associado a alto risco de vulnerabilidade clínicofuncional somente pelo IVCF-20. CONCLUSÕES: Embora as análises revelem concordância moderada e forte correlação positiva entre os instrumentos, a prevalência de fragilidade apontada é discrepante. O resultado destaca a necessidade de padronizar o instrumento para aferir a fragilidade em idosos comunitários.Universidade de São Paulo. Faculdade de Saúde Pública2020-12-15info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdftext/xmlhttps://www.revistas.usp.br/rsp/article/view/17994010.11606/s1518-8787.2020054002114Revista de Saúde Pública; Vol. 54 (2020); 119Revista de Saúde Pública; Vol. 54 (2020); 119Revista de Saúde Pública; v. 54 (2020); 1191518-87870034-8910reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USPporenghttps://www.revistas.usp.br/rsp/article/view/179940/166511https://www.revistas.usp.br/rsp/article/view/179940/166512https://www.revistas.usp.br/rsp/article/view/179940/166513Copyright (c) 2020 Revista de Saúde Públicahttp://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessCarneiro, Jair AlmeidaSouza, Andressa Samantha OliveiraMaia, Luciana ColaresCosta, Fernanda Marques daMoraes, Edgar Nunes deCaldeira, Antônio Prates2020-12-15T05:33:10Zoai:revistas.usp.br:article/179940Revistahttps://www.revistas.usp.br/rsp/indexONGhttps://www.revistas.usp.br/rsp/oairevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2020-12-15T05:33:10Revista de Saúde Pública - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Fragilidade em idosos comunitários: comparando instrumentos de triagem Frailty in community-dwelling older people: comparing screening instruments |
title |
Fragilidade em idosos comunitários: comparando instrumentos de triagem |
spellingShingle |
Fragilidade em idosos comunitários: comparando instrumentos de triagem Carneiro, Jair Almeida Idoso Fragilidade, Epidemiologia Reprodutibilidade dos Testes Fatores de Risco Inquéritos Epidemiológicos Instrumentação Aged Frailty, Epidemiology Reproducibility of Results Risk Factors Health Surveys, Instrumentation |
title_short |
Fragilidade em idosos comunitários: comparando instrumentos de triagem |
title_full |
Fragilidade em idosos comunitários: comparando instrumentos de triagem |
title_fullStr |
Fragilidade em idosos comunitários: comparando instrumentos de triagem |
title_full_unstemmed |
Fragilidade em idosos comunitários: comparando instrumentos de triagem |
title_sort |
Fragilidade em idosos comunitários: comparando instrumentos de triagem |
author |
Carneiro, Jair Almeida |
author_facet |
Carneiro, Jair Almeida Souza, Andressa Samantha Oliveira Maia, Luciana Colares Costa, Fernanda Marques da Moraes, Edgar Nunes de Caldeira, Antônio Prates |
author_role |
author |
author2 |
Souza, Andressa Samantha Oliveira Maia, Luciana Colares Costa, Fernanda Marques da Moraes, Edgar Nunes de Caldeira, Antônio Prates |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Carneiro, Jair Almeida Souza, Andressa Samantha Oliveira Maia, Luciana Colares Costa, Fernanda Marques da Moraes, Edgar Nunes de Caldeira, Antônio Prates |
dc.subject.por.fl_str_mv |
Idoso Fragilidade, Epidemiologia Reprodutibilidade dos Testes Fatores de Risco Inquéritos Epidemiológicos Instrumentação Aged Frailty, Epidemiology Reproducibility of Results Risk Factors Health Surveys, Instrumentation |
topic |
Idoso Fragilidade, Epidemiologia Reprodutibilidade dos Testes Fatores de Risco Inquéritos Epidemiológicos Instrumentação Aged Frailty, Epidemiology Reproducibility of Results Risk Factors Health Surveys, Instrumentation |
description |
OBJECTIVE: To compare the Edmonton Frail Scale (EFS) and Clinical-Functional Vulnerability Index-20 (CFVI-20) instruments regarding degree of agreement and correlation and compare descriptive models with frailty-associated variables in community-dwelling older people in Brazil. METHODS: Cross-sectional study, nested in a population-based and household cohort. Baseline sampling was calculated based on a probabilistic approach by conglomerate in two stages. In the first stage, census tract was used as sampling unit. In the second, the number of households was defined according to the population density of individuals aged ≥ 60 years. The Kappa statistic evaluated the agreement between instruments and Pearson’s coefficient their correlation. Factors associated with frailty and high risk of clinical-functional vulnerability were identified by multiple analysis of Poisson regression with robust variance. RESULTS: Kappa statistics was 0.599 and Pearson’s correlation coefficient 0.755 (p < 0.001). The EFS found a 28.2% prevalence of frailty, and the CFVI-20 found a 19.5% prevalence of high risk of clinical-functional vulnerability. Age equal to or greater than 80 years, history of stroke, polypharmacy, negative self-perceived health, fall in the past 12 months, and hospitalization in the past 12 months were variables associated with frailty in both instruments after multiple analysis. Less than four years of education, osteoarticular disease, and weight loss were associated with frailty only by EFS, and having a caregiver was associated with a high risk of clinical-functional vulnerability only by CFVI-20. CONCLUSIONS: Although the analyses show moderate agreement and strong positive correlation between the instruments, the indicated prevalence of frailty is discrepant. Our results attest the need to standardize the instrument for assessing frailty in communitydwelling older people. |
publishDate |
2020 |
dc.date.none.fl_str_mv |
2020-12-15 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/179940 10.11606/s1518-8787.2020054002114 |
url |
https://www.revistas.usp.br/rsp/article/view/179940 |
identifier_str_mv |
10.11606/s1518-8787.2020054002114 |
dc.language.iso.fl_str_mv |
por eng |
language |
por eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/179940/166511 https://www.revistas.usp.br/rsp/article/view/179940/166512 https://www.revistas.usp.br/rsp/article/view/179940/166513 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2020 Revista de Saúde Pública http://creativecommons.org/licenses/by/4.0 info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2020 Revista de Saúde Pública http://creativecommons.org/licenses/by/4.0 |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf application/pdf text/xml |
dc.publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
dc.source.none.fl_str_mv |
Revista de Saúde Pública; Vol. 54 (2020); 119 Revista de Saúde Pública; Vol. 54 (2020); 119 Revista de Saúde Pública; v. 54 (2020); 119 1518-8787 0034-8910 reponame:Revista de Saúde Pública instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Revista de Saúde Pública |
collection |
Revista de Saúde Pública |
repository.name.fl_str_mv |
Revista de Saúde Pública - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
revsp@org.usp.br||revsp1@usp.br |
_version_ |
1800221801825959936 |