Universidade Estadual de Montes Claros. Centro de Ciências Biológicas e da Saúde. Departamento de Saúde Mental e Saúde Coletiva. Montes Claros, MG, Brasil.
Universidade Estadual de Montes Claros. Centro de Ciências Biológicas e da Saúde. Montes Claros, MG, Brasil.
Rev Saude Publica. 2020 Nov 23;54:119. doi: 10.11606/s1518-8787.2020054002114. eCollection 2020.
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.
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.
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.
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 community-dwelling older people.
比较埃德蒙顿虚弱量表（EFS）和临床功能脆弱指数-20 （CFVI-20）两种工具，评估其在巴西社区居住的老年人中在衰弱相关变量方面的一致性和相关性，并比较其描述性模型。
这是一项横断面研究，嵌套在基于人群和家庭的队列研究中。基于概率方法，通过两阶段整群抽样进行基线抽样。在第一阶段，以普查区为抽样单位；在第二阶段，根据≥60 岁人群的人口密度确定家庭数量。采用 Kappa 统计量评估两种工具之间的一致性，采用 Pearson 相关系数评估其相关性。采用稳健方差的多分析泊松回归确定与衰弱和临床功能脆弱高风险相关的因素。
Kappa 统计量为 0.599，Pearson 相关系数为 0.755（p＜0.001）。EFS 发现衰弱的患病率为 28.2%，CFVI-20 发现临床功能脆弱高风险的患病率为 19.5%。年龄≥80 岁、中风史、多种药物治疗、自我感知健康状况差、过去 12 个月内跌倒和过去 12 个月内住院治疗是两种工具在多因素分析中与衰弱相关的变量。受教育程度少于 4 年、骨关节炎和体重减轻仅与 EFS 有关，而有照顾者仅与 CFVI-20 有关。
尽管分析表明两种工具之间具有中度一致性和较强的正相关，但衰弱的指示患病率存在差异。我们的研究结果表明，需要标准化用于评估社区居住老年人衰弱的工具。
