Síndrome de fragilidade: prevalência e comparação com os 5 IS da geriatria

Abstract

Introduction: The growing population aging determines expressive changes in the epidemiological profile, with the increase of chronic-degenerative diseases, which generates, in a progressive way, a reduction in the functional capacity and quality of life of the elderly population. Accordingly, the impairment of cognitive functions generates the loss of global functionality in the elderly and, consequently, the geriatric syndromes: cognitive insufficiency, postural instability, incontinence, immobility and iatrogenic disorders. In the same way, with the objective of organizing the health management of the elderly, the concept of frailty syndrome arises, which corresponds to a state of vulnerability, associated with an increased risk of mortality and adverse health events, such as dependence, disability, falls, acute illnesses, hospitalizations and institutionalization. Therefore, the relevance of geriatric syndromes and the fragility of the elderly's health becomes clear, especially regarding the need for adaptations in social policies. Objective: Identify and relate the prevalence of frailty syndrome and geriatric syndromes (cognitive insufficiency, iatrogenic disorders, postural instability, incontinence and immobility) in elderly patients in follow-up at the geriatric clinic. Method: This is an observational, cross-sectional and analytical study, based on data collection from 128 elderly people treated between March and June 2021 at the geriatric clinic of the Medical Specialties Center (CEMEC – CESUPA). The instruments used included a self-authored questionnaire and scales commonly used in geriatric consultations – Daily Living Activity Scale, Timed get up and go and adapted Edmonton Frail Scale. Results: 128 elderly people were studied, with a mean age of 74.8 ± 8.9 years (95%CI 73.3 – 76.4), ranging between 60 and 103 years; 75.1% (97/128; p<0.0001) were female. The prevalence of frailty was 46.5%, with 38.3% mild frailty, 36.7% moderate frailty and 25% severe frailty. There was an association between this syndrome and the presence of cognitive impairment (p=0.0063), postural instability (p<0.0001) and immobility. Analyzing the relationship between geriatric syndromes and gender, an association was found between female gender and postural instability (p=0.0135). Among patients with postural instability and immobility, there was a lower proportion of young elderly (60 to 69 years old) and a higher proportion of elderly between 80 to 99 years old (p=0.0093). Regarding the frailty syndrome, there was no relationship between this and gender (p=0.8386); however, there was a higher prevalence in elderly aged between 80 and 99 years. Conclusion: frailty syndrome was identified in about half of the population studied, having an association with age and with three of the geriatric syndromes: cognitive impairment, postural instability and immobility. Postural instability was the most frequent geriatric syndrome, followed by immobility. In comparison, iatrogenic disorders and incontinence had the lowest prevalence.