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

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 Educação pelo Trabalho para a Saúde - PET-Saúde). 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. (AU)