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Caracter?sticas funcionais da fragilidade em longevos

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Previous issue date: 2013-03-11 / Introduction : Frailty is a common clinical syndrome in the elderly, which causes major health hazards, disabilities, hospitalizations, and result in high risk of mortality. Clarify their causes is of fundamental importance for the prevention of frailty and its treatment, especially for high risk groups such as the oldest old. Objectives : Associate functional decline (Activities of Daily Living - ADL) with Frailty Syndrome in the oldest old (&#8805; 90 years). Methods : The oldest-old were identified through home visits and outpatient geriatric unit of a university hospital in Porto Alegre, RS. Socioeconomic variables were evaluated, diagnosed or self-reported presence of comorbidities, self-reported falls in the previous three months, self-rated health and Katz for ADL. For data analysis, the sample was divided into two groups according to the classification of Frailty: Frail and non- Frail. Percentage differences between categorical variables (gender, marital status) were calculated by creating cross tables between the variables and tested by chi-square. The differences of the means of numerical variables were tested by ANOVA. The odds associated with the risk of having or not Frailty (dependent variable) was calculated and tested by logistic regression for variables independently observing the alpha error of 5% for statistical significance and 10% for indicative of significance. Results : A total of 36 oldest-old, 26 women and 10 men with 19 Frail and 17 non-Frail. Among the demographic variables and life habits, the weekly alcohol intake was significantly more frequent among the non-Frail. Energy expenditure and self-reported health were also significantly higher among non-Frails. While the Frail oldest old presented with a indicative of significance of larger number of comorbidities and significantly greater degree of dependence for ADL, being incontinence the most significant component. No socio-demographic and economic factor was associated with frailty. In univariate regression analysis some variables were indicative of significance (p> 0.05 and <0.1) as predictors of Fragility: self-rated health, functionality, gender, age, BMI, MMSE, weekly use of alcohol, income percapta and MET. In the final multiple regression 7 showed that weekly use of alcohol (p = 0.0451), self-rated health (p = 0.0003) and ADL (p = 0.0224) are independent determinants of Frailty in the oldest old respondents. Conclusion : Although this study has evaluated a small sample, brings a good support to as important a sample of the oldest old. It was possible to draw a functional profiling of the oldest old, having found significant differences between the groups of non-brittle and fragile. We concluded that the higher the level of functional dependence and lower self-rated health the higher was the level of frailty of the oldest old. / Introdu??o : Fragilidade ? uma s?ndrome cl?nica comum em idosos, que ocasiona grandes riscos para a sa?de, incapacidades, hospitaliza??es e como consequ?ncia grande risco de mortalidade. Esclarecer suas causas ? de fundamental import?ncia para a preven??o da Fragilidade e seu tratamento, principalmente para grupos de alto risco como os idosos longevos. Objetivos : Associar os decl?nios funcionais (Atividades de Vida Di?ria - AVD), com a s?ndrome de Fragilidade em longevos (&#8805;90 anos). M?todos : Os longevos foram identificados atrav?s de visita domiciliar e do ambulat?rio de servi?o de geriatria de hospital universit?rio em Porto Alegre, RS. Foram avaliadas vari?veis socioecon?micas, diagn?stico ou autorrelato da presen?a comorbidades, autorrelato de quedas nos ?ltimos 3 meses, autoavalia??o de sa?de e ?ndice de Katz para AVD. Para a an?lise dos dados, a amostra foi separada em dois grupos, de acordo com a classifica??o da Fragilidade: fr?gil e n?o-fr?gil. Diferen?as percentuais entre as vari?veis categ?ricas (g?nero, estado civil) foram calculadas atrav?s da cria??o de tabelas de cruzamento entre as vari?veis e testadas pelo Qui-quadrado. As diferen?as das m?dias das vari?veis num?ricas foram testadas pela ANOVA. A chance associada ao risco de ter ou n?o Fragilidade (vari?vel dependente) foi calculada e testada pela regress?o log?stica para as vari?veis independente observando o erro alfa de 5% para signific?ncia estat?stica e de 10% para indicativo de signific?ncia. Resultados : Foram avaliados 36 longevos, 26 mulheres e 10 homens sendo 19 fr?geis e 17 n?o fr?geis. Entre as vari?veis demogr?ficas e de h?bito de vida, a ingesta alco?lica semanal foi significativamente mais frequente entre os longevos n?o-fr?geis. Tamb?m foram significativamente maiores para os idosos n?o-fr?geis o gasto energ?tico e a autopercep??o de sa?de. J? os longevos fr?geis apresentaram um n?mero de comorbidades com indicativo de signific?ncia e significativamente maior grau de depend?ncia para as AVD, sendo o componente mais significativo a incontin?ncia. Nenhum fator s?cio-demogr?fico e econ?mico foi associado com a fragilidade. Na an?lise de regress?o univariada algumas vari?veis foram indicativas de signific?ncia (p >=0,05 e <0,1) como preditoras de Fragilidade: autopercep??o de 5 sa?de, funcionalidade, g?nero, idade, IMC, MEEM, uso semanal de ?lcool, renda percapta e MET. No modelo final de regress?o m?ltipla observou-se que o uso semanal de ?lcool (p=0,0451), autopercep??o de sa?de (p=0.0003) e AVD (p=0,0224) s?o fatores determinantes e independentes de Fragilidade nos longevos pesquisados. Conclus?o : Apesar de este estudo ter avaliado uma amostra pequena, traz um bom respaldo por ser incomum com amostra de longevos. Considerou-se poss?vel tra?ar o perfil funcional dos mesmos, tendo-se encontrado diferen?as significativas entre os grupos de fr?geis e n?o-fr?geis. Concluiu-se que, quanto maiores os n?veis depend?ncia funcional e mais baixa autopercep??o de sa?de maior ? o n?vel de Fragilidade dos longevos.

Identiferoai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/2705
Date11 March 2013
CreatorsRibeiro, Andr?
ContributorsB?s, ?ngelo Jos? Gon?alves
PublisherPontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Gerontologia Biom?dica, PUCRS, BR, Instituto de Geriatria e Gerontologia
Source SetsIBICT Brazilian ETDs
LanguagePortuguese
Detected LanguageEnglish
Typeinfo:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis
Formatapplication/pdf
Sourcereponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS
Rightsinfo:eu-repo/semantics/openAccess
Relation4438661476953179033, 500, 600, 2296420844541114010

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