Centro Colaborador Planificação da Atenção à Saúde Uberlândia. Conselho Nacional de Secretários de Saúde. Uberlândia, MG, Brazil.
Universidade Federal de Minas Gerais. Faculdade de Medicina. Departamento de Clínica Médica. Belo Horizonte, MG, Brazil.
Rev Saude Publica. 2024 Apr 15;57Suppl 3(Suppl 3):9s. doi: 10.11606/s1518-8787.2023057005273. eCollection 2024.
To describe the functional clinical profile of elderly people linked to primary health care, using the Functional Clinical Vulnerability Index (IVCF-20) and to spatialize those with the greatest functional decline by primary health care units in the municipality of Uberlândia, in the state of Minas Gerais (MG), in the year 2022.
A cross-sectional study with secondary data from the Municipal Health Department of Uberlândia-MG. The variables were compared using Student's t-test, Mann Whitney test, Pearson's chi-square, and multinomial logistic regression to obtain the independent effect of each variable. The significance level adopted was 5% (p < 0.05). The georeferenced database in ArcGIS® was used.
47,182 older adults were evaluated with a mean age of 70.3 years (60 to 113 years), 27,138 of whom were women (57.52%), with a clear predominance of low-risk or robust older adults (69.40%). However, 11.09% are high-risk older adults and 19.52% are at risk of frailty. Older men had independently lower odds of moderate and high risk compared to older women (OR = 0.53; p < 0.001). A high prevalence of polypharmacy was observed, 21.40% of the older adult population, particularly in frail older adults, with a prevalence of 63.08%. There was a greater distribution of frail older adults around the central region of the municipality and in health units with a larger coverage area. The IVCF-20 made it possible to screen frailty in primary health care.
The instrument is capable of stratifying the risk of older adults in health care networks through primary health care, enabling the application of individualized preventive, promotional, palliative, or rehabilitative interventions, according to the clinical functional stratum of the older adult and the compromised functional domains. Risk stratification and spatial distribution of the frailest older adults can be a good strategy for qualifying health professionals with the aim of maximizing the autonomy and independence of the older adults.
使用功能临床脆弱性指数（IVCF-20）描述与初级保健相关的老年人的功能临床特征，并通过 2022 年米纳斯吉拉斯州乌贝兰迪亚市的初级保健单位对功能下降最大的老年人进行空间定位。
这是一项使用米纳斯吉拉斯州乌贝兰迪亚市卫生局的二级数据进行的横断面研究。使用学生 t 检验、曼-惠特尼检验、皮尔逊卡方检验和多项逻辑回归对变量进行比较，以获得每个变量的独立影响。采用的显著性水平为 5%（p<0.05）。使用 ArcGIS®中的地理参考数据库。
评估了 47182 名老年人，平均年龄为 70.3 岁（60 至 113 岁），其中 27138 名为女性（57.52%），明显以低风险或健壮的老年人为主（69.40%）。然而，11.09%的老年人属于高风险，19.52%的老年人有脆弱的风险。与女性老年人相比，男性老年人独立具有较低的中危和高危风险（OR=0.53；p<0.001）。观察到老年人普遍存在多药治疗，占老年人总人口的 21.40%，尤其是在脆弱的老年人中，患病率为 63.08%。脆弱的老年人在该市中心区域和覆盖面积较大的卫生单位周围分布更为广泛。IVCF-20 可以在初级保健中筛查老年人的脆弱性。
该工具能够通过初级保健对老年人在医疗保健网络中的风险进行分层，根据老年人的临床功能层次和受影响的功能领域，为老年人提供个性化的预防、促进、姑息或康复干预措施。脆弱老年人的风险分层和空间分布可以作为一种很好的策略，使卫生专业人员能够对其进行资格认证，以提高老年人的自主性和独立性。
