Cruz Danielle Teles da, Vieira Marcel de Toledo, Bastos Ronaldo Rocha, Leite Isabel Cristina Gonçalves
Universidade Federal de Juiz de Fora. Faculdade de Medicina. Departamento de Saúde Coletiva. Juiz de Fora, MG, Brasil.
Universidade Federal de Juiz de Fora. Departamento de Estatística. Juiz de Fora, MG, Brasil.
Rev Saude Publica. 2017;51:106. doi: 10.11606/S1518-8787.2017051007098. Epub 2017 Nov 17.
To analyze if demographic and socioeconomic factors and factors related to health and health services are associated with frailty in community-dwelling older adults.
This is a cross-sectional study with 339 older adults (60 years old or more) living in Juiz de Fora, State of Minas Gerais, Brazil, in 2015. A household survey was carried out and frailty was evaluated using the Edmonton Frail Scale. For the analysis of the factors associated with outcome, a theoretical model of determination was constructed with three hierarchical blocks: block 1 with demographic and socioeconomic characteristics, block 2 with the health of the older adult (divided into three sub-levels: 2.1 self-reported health variables, 2.2 self-perceived health variables, and 2.3 geriatric syndromes), and block 3 with characteristics related to health services. The variables were adjusted in relation to each other within each block; those with significance level ≤ 0.20 were included in the Poisson regression model and adjusted to a higher level, considering a level of significance of 5%.
The prevalence of frailty among older adults was 35.7% (95%CI 30.7-40.9). Of the total, 42.2% did not present frailty; 22.1% were apparently vulnerable. Among the frail ones, 52.9% presented mild frailty, 32.2% moderate frailty, and 14.9% severe frailty. Frailty was associated with difficulty walking, need for an auxiliary device to walk, presence of caregiver, depressive disorders, and functional dependence to perform instrumental activities of daily living.
Frailty is frequent among the older population and it is associated with health variables of the three sub-levels that make up block 2 of the theoretical hierarchical model of determination: self-reported health variables, self-perceived health variables, and geriatric syndromes.
分析人口统计学和社会经济因素以及与健康和卫生服务相关的因素是否与社区居住的老年人的衰弱相关。
这是一项横断面研究,于2015年对巴西米纳斯吉拉斯州茹伊斯迪福拉市的339名60岁及以上的老年人进行。开展了一项家庭调查,并使用埃德蒙顿衰弱量表评估衰弱情况。为了分析与结果相关的因素,构建了一个具有三个层次块的理论决定模型:块1包含人口统计学和社会经济特征,块2包含老年人的健康状况(分为三个子层次:2.1自我报告的健康变量、2.2自我感知的健康变量和2.3老年综合征),块3包含与卫生服务相关的特征。各块内的变量相互调整;显著性水平≤0.20的变量纳入泊松回归模型,并在考虑5%显著性水平的情况下调整到更高层次。
老年人中衰弱的患病率为35.7%(95%置信区间30.7 - 40.9)。总体中,42.2%没有衰弱;22.1%明显脆弱。在衰弱者中,52.9%表现为轻度衰弱,32.2%为中度衰弱,14.9%为重度衰弱。衰弱与行走困难、需要辅助行走设备、有护理人员、抑郁症以及在进行日常生活工具性活动时的功能依赖相关。
衰弱在老年人群中很常见,并且与构成理论层次决定模型块2的三个子层次的健康变量相关:自我报告的健康变量、自我感知的健康变量和老年综合征。