Clinical-functional vulnerability in older adults and its impact on primary health care actions

Pricila Cristina Correa Ribeiro,Vanessa Cunha Barros,Juliana Do Carmo Reis,André Luiz Almeida Damaso,Andréia Cleide Costa E Neves

doi:10.5020/18061230.2019.8366

Abstract

Objective: To describe the prevalence of clinical-functional vulnerability among older adults cared for in a Primary Health Care Unit (PHCU). Methods: This is a retrospective epidemiological study performed through the review of medical records of 950 elderly users of a PHCU in the northeast region of Belo Horizonte, between August 2016 and July 2017. The score obtained with use of the Clinical-functional Vulnerability Index (IVCF-20) evidenced the clinical-functional vulnerability of the older adults. The PHCU health professionals had been trained and had been implementing the IVCF-20 since the end of 2015. In 2016, the application of IVCF-20 was intensified following training of psychology undergraduates who participated in the Health Work Education Program (Programa de Educacao pelo Trabalho para a Saude - PET-Saude). Descriptive statistics was applied to IVCF-20 data to verify the frequency of frail older adults and individuals at risk for frailty. Pearson's chi-square test was used to verify association between the IVCF-20 classification and the Family Health Teams. Results: Of 950 older adults included in the study, 49.37% (n=469) had mild clinical-functional vulnerability, considered robust; 28.84% (n=274) had moderate vulnerability, considered at risk for frailty; and 21.79% (n=207) had high vulnerability, regarded as frail. Conclusion: A high prevalence of clinical-functional vulnerability (mild, moderate, and high) was observed among older adults attended to at primary health care services. Screening with IVCF-20 can prove useful for early identification of vulnerable older adults and to indicate the focus of health promotion and preventive interventions.

Highlights

Population aging is a phenomenon observed in our society and is considered an achievement of humanity in the twentieth century
Fragilization refers to the functional decline that falls on those needs; biological, individual, and social factors are related to this process, which results in loss of autonomy or independence in activities of daily living
The medical records of 950 older adults were analyzed, covering 49.28% of the elderly population cared for in the Primary Health Care Unit (PHCU), being 621 (65.37%) women and 329 (34.63%) men. The distribution of this sample according to gender and age was described in Table I, according to the Family Health Teams (FHT) that serves this population at the PHCU

Summary

Introduction

Population aging is a phenomenon observed in our society and is considered an achievement of humanity in the twentieth century. According to the Ministry of Health[2], about 30% of the elderly can be classified as frail or at risk of frailty, which means greater vulnerability, more frequent states of disability, functional dependencies, or health conditions that represent the need for access and more qualified care within SUS. Health in the elderly comprises maintaining independence for satisfaction of biopsychosocial needs even with advancement of age or when pathological conditions are present[4]. Fragilization refers to the functional decline that falls on those needs; biological, individual, and social factors are related to this process, which results in loss of autonomy or independence in activities of daily living. It is important to consider the elderly comprehensively through the multiplicity of aspects that influence health and quality of life, such as the preservation of functional capacity, autonomy, social participation, cognition, and self-perception of health status[5]

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Results

Conclusion