Prevalência e preditores da síndrome de fragilidade em idosos durante e após hospitalização

Abstract

Frailty is a dynamic process characterized by changes among its conditions. Hospitalization constitutes a potential risk factor for the development of frailty and may negatively influence the changes in the conditions after discharge. This study aimed to describe the sociodemographic, clinical, health, functional capacity and quality of life (QOL) of the elderly according to the condition of frailty; estimate the prevalence of frailty condition; describe the changes in the conditions of frailty after one year of hospital discharge (HD); identify the predictors of change of frailty conditions in the elderly after one year of HD according to improvement, stability and worsening groups; characterize the elderly with impairment of the frailty phenotype (FF) components according to groups of improvement, stability and worsening of the condition of frailty; verify the predictors of change of FF components after one year of HD according to groups of improvement, stability and worsening; verify the condition of frailty according to groups of improvement, stability and worsening as predictors of QOL changes and verify the FF components according to groups of improvement, stability and worsening as predictors of QOL changes. Longitudinal survey, conducted with 129 elderly. Were used: form characterization of demographic data, economic and health; Mini Mental State Examination; Scales (Geriatric Depression shortened, Katz, Lawton and Brody); World Health Organization Quality of Life - Bref, World Health Organization Quality of Life Assessment for Older Adults and FF. We proceeded to the descriptive analysis, chi-square tests, ANOVA and models of multinomial logistic regression and multiple linear (p <0.05). At admission, the highest prevalence was for pre-frail elderly and after one year of HD there was a decrease of pre-frail and frail and increase in non-frail. Following, the highest percentage of the frail elderly moved to the condition of pre-frailty and there was no non-frail elderly who change to frail. The outcome death had a higher percentage of the frail elderly and pre-frail. No predictors were identified for changing the condition of frailty in groups of improvement and worsening. In the group of improvement of frailty condition, all components decreased the percentage of commitment, in turn, the inverse occurred with the worsening group. The variables increase the number of morbidities and increase dependence in instrumental activities of daily living were predictive of worsening the components: self-reported exhaustion and/or fatigue and unintended weight loss, respectively. The decrease in the scores of the indicative for depression was predictive of the improvement on the low level of physical activity component. The improvement of the condition of frailty was associated with a higher QOL scores in the social participation facet. The worsening group, the impairment of the component slow in walking speed was associated with lower QoL scores in the environment domain and the improvement of muscle strength was not followed by increased scores on the death and dying facets. These results contribute to the development of early interventions directed to the elderly's needs, in preventing or stagnating the frailty condition.