Frailty and spatialization of older adults in the city of Uberlândia with IVCF-20.

OBJECTIVE: To describe the functional clinical profile of elderly people linked to primary health care, using the Functional Clinical Vulnerability Index (IVCF-20) and to spatialize those with the greatest functional decline by primary health care units in the municipality of Uberlândia, in the state of Minas Gerais (MG), in the year 2022. METHODS: A cross-sectional study with secondary data from the Municipal Health Department of Uberlândia-MG. The variables were compared using Student's t-test, Mann Whitney test, Pearson's chi-square, and multinomial logistic regression to obtain the independent effect of each variable. The significance level adopted was 5% (p < 0.05). The georeferenced database in ArcGIS® was used. RESULTS: 47,182 older adults were evaluated with a mean age of 70.3 years (60 to 113 years), 27,138 of whom were women (57.52%), with a clear predominance of low-risk or robust older adults (69.40%). However, 11.09% are high-risk older adults and 19.52% are at risk of frailty. Older men had independently lower odds of moderate and high risk compared to older women (OR = 0.53; p < 0.001). A high prevalence of polypharmacy was observed, 21.40% of the older adult population, particularly in frail older adults, with a prevalence of 63.08%. There was a greater distribution of frail older adults around the central region of the municipality and in health units with a larger coverage area. The IVCF-20 made it possible to screen frailty in primary health care. CONCLUSION: The instrument is capable of stratifying the risk of older adults in health care networks through primary health care, enabling the application of individualized preventive, promotional, palliative, or rehabilitative interventions, according to the clinical functional stratum of the older adult and the compromised functional domains. Risk stratification and spatial distribution of the frailest older adults can be a good strategy for qualifying health professionals with the aim of maximizing the autonomy and independence of the older adults.

Frailty and spatialization of older adults in the city of Uberlândia with IVCF-20 / Fragilidade e espacialização de pessoas idosas do município de Uberlândia com IVCF-20

ABSTRACT OBJECTIVE To describe the functional clinical profile of elderly people linked to primary health care, using the Functional Clinical Vulnerability Index (IVCF-20) and to spatialize those with the greatest functional decline by primary health care units in the municipality of Uberlândia, in the state of Minas Gerais (MG), in the year 2022. METHODS A cross-sectional study with secondary data from the Municipal Health Department of Uberlândia-MG. The variables were compared using Student's t-test, Mann Whitney test, Pearson's chi-square, and multinomial logistic regression to obtain the independent effect of each variable. The significance level adopted was 5% (p < 0.05). The georeferenced database in ArcGIS® was used. RESULTS 47,182 older adults were evaluated with a mean age of 70.3 years (60 to 113 years), 27,138 of whom were women (57.52%), with a clear predominance of low-risk or robust older adults (69.40%). However, 11.09% are high-risk older adults and 19.52% are at risk of frailty. Older men had independently lower odds of moderate and high risk compared to older women (OR = 0.53; p < 0.001). A high prevalence of polypharmacy was observed, 21.40% of the older adult population, particularly in frail older adults, with a prevalence of 63.08%. There was a greater distribution of frail older adults around the central region of the municipality and in health units with a larger coverage area. The IVCF-20 made it possible to screen frailty in primary health care. CONCLUSION The instrument is capable of stratifying the risk of older adults in health care networks through primary health care, enabling the application of individualized preventive, promotional, palliative, or rehabilitative interventions, according to the clinical functional stratum of the older adult and the compromised functional domains. Risk stratification and spatial distribution of the frailest older adults can be a good strategy for qualifying health professionals with the aim of maximizing the autonomy and independence of the older adults.

RESUMO OBJETIVO Descrever o perfil clínico funcional dos idosos vinculados à atenção primária à saúde, por meio do Índice de Vulnerabilidade Clínico Funcional (IVCF-20) e realizar a espacialização dos de maior declínio funcional por unidades de atenção primária à saúde no município de Uberlândia-MG, no ano de 2022. MÉTODOS Estudo transversal com dados secundários da Secretaria Municipal de Saúde de Uberlândia-MG. As variáveis foram comparadas através de testes de t de Student, Mann Whitney, qui-quadrado de Pearson e regressão logística multinomial para obter o efeito independente de cada variável. O nível de significância adotado foi de 5% (p < 0,05). Utilizou-se o banco de dados georreferenciado no ArcGIS®. RESULTADOS Foram avaliados 47.182 idosos com idade média de 70,3 anos (60 a 113 anos), sendo 27.138 mulheres (57,52%) e observou-se franco predomínio de idosos de baixo risco ou robustos (69,40%). Todavia, 11,09% são idosos de alto risco e 19,52% estão em risco de fragilização. Idosos do sexo masculino tiveram chance independentemente inferior de risco moderado e alto comparados às mulheres idosas (OR = 0,53; p < 0,001). Foi observado alta prevalência de polifarmácia, 21,40% da população idosa, particularmente nos idosos frágeis, com prevalência de 63,08%. Houve maior distribuição dos idosos frágeis em torno da região central do município e nas unidades de saúde com maior área de abrangência. O IVCF-20 permitiu realizar o rastreio da fragilidade na atenção primária à saúde. CONCLUSÃO O instrumento é capaz de estratificar o risco dos idosos nas redes de atenção à saúde pela atenção primária à saúde, possibilitando a aplicação de intervenções preventivas, promocionais, paliativas ou reabilitadoras individualizadas, conforme o estrato clínico funcional do idoso e os domínios funcionais comprometidos. A estratificação de risco e a distribuição espacial dos idosos mais frágeis pode ser uma boa estratégia de qualificação dos profissionais de saúde com o objetivo de maximizar a autonomia e independência dos idosos.