Preditores clínicos de fragilidade em usuários de serviço de atenção secundária em geriatria e gerontologia

Abstract

Objective: To analyze the health predictors associated with frailty in the older population treated at a Secondary Care Service in Geriatrics and Gerontology, Belo Horizonte, Minas Gerais state, Brazil. Methods: A cross-sectional observational study involving a sample of 4,323 individuals aged 60 years or older that underwent a clinical-functional evaluation was conducted. Sociodemographic and clinical-functional variables were analyzed and compared against the dependent variable of the study: clinical-functional stratum, as measured by the Visual Frailty Scale, dichotomized into frail and non-frail. Univariate logistic regressions were performed and the variables with p-value <0.2 were submitted to multivariate regression by stepwise and forward methods of selecting variables in the equation. Results: The potential explanatory value of the model was 70.4%. Seven variables were associated with frailty: age (OR 1.016; 95%CI: 1.001–1.028; p<0.001), dementia (OR 5.179; 95%CI: 3.839–5.961; p<0.001), depressive symptoms (OR 1.268; 95%CI: 1.090–1.475; p=0.002), urinary incontinence (OR 1.330; 95%CI: 1.153–1.535; p<0.001), changes in gait speed (OR 1.483; 95%CI: 1.287–1.709; p<0.001), calf circumference (OR 0.956; 95%CI: 0.932–0.982; p=0.001), and BMI (OR 1.026; 95%CI: 1.008–1.044; p=0.005). Conclusion: Advanced age, dementia, depressive symptoms, and continence and gait changes were associated with frailty. The study results reveal an association of reduced calf circumference and increased BMI values with frailty in older adults and that dementia diagnosis had the strongest association with the frailty syndrome.