Índice de Vulnerabilidade Clínico-Funcional-20: proposta de classificação e hierarquização entre os idosos identificados como frágeis

Edgar Nunes Moraes; Juliana Alves Carmo; Carla Jorge Machado; Flávia Lanna Moraes

doi:10.23925/1984-4840.2020v22i1a7

Authors

Edgar Nunes Moraes Universidade Federal de Minas Gerais. Belo Horizonte (MG), Brasil. http://orcid.org/0000-0002-8923-1029
Juliana Alves Carmo Universidade Federal de Minas Gerais. Belo Horizonte (MG), Brasil. http://orcid.org/0000-0003-3888-8319
Carla Jorge Machado Universidade Federal de Minas Gerais. Belo Horizonte (MG), Brasil. http://orcid.org/0000-0002-6871-0709
Flávia Lanna Moraes Prefeitura de Belo Horizonte. Belo Horizonte (MG), Brasil. http://orcid.org/0000-0002-2638-0553

DOI:

https://doi.org/10.23925/1984-4840.2020v22i1a7

Keywords:

health of the elderly, frail elderly, geriatric assessment, health services.

Abstract

Objective: The aim of this study was to identify which elderly patients at risk of functional clinical vulnerability should be referred to specialized geriatric-gerontological care, based on the Clinical-Functional Vulnerability Index (IVCF-20) compared to the comprehensive geriatric evaluation, used as the gold standard. Method: The study was cross-sectional, in which the results obtained in the IVCF-20 were compared with the results verified in AGA (Broad Geriatric Evaluation). Considering that elderly people with scores above 6 are at risk of clinical-functional vulnerability, the objective was to define, among these, from which score the elderly would be considered at high risk of vulnerability, based on a high specificity (equal or greater than 95%) and a sensitivity of not less than 50%. Results: A cutoff point of 15 points was identified, with sensitivity of 52% and specificity of 98%. Conclusion: The high specificity obtained indicates that, probably, few elderly at risk with a score equal to or greater than 15 would be unnecessarily referred to specialized gerontological care, thus optimizing the use of health resources.

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References

Mendes EV. As redes de atenção à saúde. 2a ed. Brasília (DF): Organização Pan-Americana de Saúde; 2011 [acesso em 2 jan. 2016]. Disponível em: http://bvsms.saude.gov.br/bvs/publicacoes/redes_de_atencao_saude.pdf

Hébert R. A revolução do envelhecimento. Ciênc Saúde Coletiva. 2015;20(12):3618. https://doi.org/10.1590/1413-812320152012.22542015

Kojima G, Liljas AEM, Iliffe S. Frailty syndrome: implications and challenges for health care policy. Risk Manag Health Policy. 2019;14(12):23-30. https://doi.org/10.2147/RMHP.S168750

Boult C, Wieland GD. Comprehensive primary care for older patients with multiple chronic conditions. JAMA. 2010;304(17):1936-43. https://doi.org/10.1001/jama.2010.1623

Stone ME, Lin J, Dannefer D, Kelley-Moore JA. The continued eclipse of heterogeneity in gerontological research. J Gerontol B. 2017;72(1):162-7. https://doi.org/10.1093/geronb/gbv068

Veras RP. Gerenciamento de doença crônica: equívoco para o grupo etário dos idosos. Rev Saúde Pública. 2012;46(6):929-34. https://doi.org/10.1590/S0034-89102012000600001.

Moraes EN. Atenção à saúde do idoso: aspectos conceituais. Brasília (DF): Organização Pan-Americana da Saúde; 2012 [acesso em 30 dez. 2015]. Disponível em: http://pesquisa.bvsalud.org/portal/resource/pt/lil-713328

Costa EFA, Monego ET. Avaliação Geriátrica Ampla (AGA). Rev UFG. 2003;5(2):. [acesso em 09 fev. 2019];5(2):11-5. Disponível em: https://www.revistas.ufg.br/revistaufg/article/view/49768

Pialoux T, Goyard J, Lesourd B. Screening tools for frailty in primary health care: a systematic review. Geriatr Gerontol Int. 2012;12(2):189-97. https://doi.org/10.1111/j.1447-0594.2011.00797.x

Caldas CP, Veras RP, Motta LP, Lima KC, Kisse CBS, Trocado CVM, et al. Rastreamento de risco de perda funcional: uma estratégia fundamental para a organização da Rede de Atenção ao Idoso. Ciênc Saúde Coletiva. 2013;18(12):3495-3506. https://doi.org/10.1590/S1413-81232013001200006

Hoogendijki EO, Horst HE, Deeg DJH, Frijters DHM, Prins BAH, Jansen APD, et al. The identification of frail older adults in primary care: comparing the accuracy of five simple instruments. Age Ageing. 2013;42(2):262-5. https://doi.org/10.1093/ageing/afs163

Morley EJ, Adams EV. Rapid geriatric assessment. J Am Med Dir Assoc. 2015;16(10):808-12. https://doi.org/10.1016/j.jamda.2015.08.004

Paixão Jr CM, Reichenheim ME. Uma revisão sobre instrumentos de avaliação funcional do idoso. Cad Saúde Pública. 2005;21(1):7-19. https://doi.org/10.1590/S0102-311X2005000100002

Faller JW, Pereira DDN, Souza S, Nampo FK, Orlandi FS, Matumoto S. Instruments for the detection of frailty syndrome in older adults: a systematic review. PLoS One. 2019;14(4):e0216166. https://doi.org/10.1371/journal.pone.0216166

Moraes EN, Carmo JA, Moraes FL, Azevedo RS, Machado CJ, Montilla DE. Índice de Vulnerabilidade Clínico Funcional-20 (IVCF-20): reconhecimento rápido do idoso frágil. Rev Saúde Pública. 2016;50:81. https://doi.org/10.1590/s1518-8787.2016050006963

Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde. Departamento de Atenção Especializada e Temática. Coordenação Saúde da Pessoa Idosa. Diretrizes para o cuidado das pessoas idosas no SUS: proposta de modelo de atenção integral. Brasília (DF): Ministério da Saúde; 2014 [acesso em 1 out. 2016]. Disponível em: http://pesquisa.bvsalud.org/bvsms/resource/pt/mis-37552

Maia FOM, Duarte YAO, Secoli SR, Santos JLF, Lebrão ML. Adaptação transcultural do Vulnerable Elders Survey-13 (VES-13): contribuição para a identificação de idosos vulneráveis. Rev Esc Enferm USP. 2012;46(n. esp.):116-22. https://doi.org/10.1590/S0080-62342012000700017.

Min L, Yoon W, Mariano J, Wenger NS, Elliott MN, Kamberg C, et al. The vulnerable elders-13 survey predicts 5-year functional decline and mortality outcomes in older ambulatory care patients. J Am Geriatr Soc. 2009;57(11):207-76. https://doi.org/10.1111/j.1532-5415.2009.02497.x

Saliba D, Elliot M, Rubenstein LZ, Solomon DH, Young RT, Kamberbg CJ, et al. The Vulnerable Elders Survey: a tool for identifying vulnerable older people in the community. J Am Geriatr Soc. 2001;49(12):1691-9. https://doi.org/10.1046/j.1532-5415.2001.49281.x

Raîche M, Hébert R, Dubois MF. PRISMA-7: A case-finding tool to identify older adults with moderate to severe disabilities. Arch Gerontol Geriatr. 2008;47(1):9-18. https://doi.org/10.1016/j.archger.2007.06.004

Hébert R, Bravo G, Korner-Bitensky N, Voyer L. Predictive validity of a postal questionnaire for screening community-dwelling elderly individuals at risk of functional decline. Age Ageing 1998; 25(2):159-67. https://doi.org/10.1093/ageing/25.2.159

Gobbens RJ, Van Assen MA, Luijkx KG, Wijnen-Sponselee MT, Schols JM. The Tilburg Frailty Indicator: psychometric properties. J Am Med Dir Assoc. 2010; 11(5):344-55. https://doi.org/10.1016/j.jamda.2009.11.003

Santiago LM, Luz LL, Mattos IE, Gobbens RJJ. Adaptação transcultural do instrumento Tilburg Frailty Indicator (TFI) para a população brasileira. Cad Saúde Pública. 2012;28(9):1795-801. https://doi.org/10.1590/S0102-311X2012000900018

Stevernik N, Slaets JPL, Schuurmans H, Lis M, Steverink N, Slaets J, et al. Measuring frailty. development and testing of the Groningen Frailty Indicator (GFI). Gerontologist. 2001;41:236-37.

Moraes EN, Lanna FM, Santos RR, Bicalho MAC, Machado CJ, Romero DE. A New proposal for the clinical-functional categorization of the elderly: Visual Scale of Frailty (VS-Frailty). J Aging Res Clin Pract. 2016;5(1):24-30. https://doi.org/10.14283/jarcp.2016.84

Moraes EN, Lanna FM. Avaliação multidimensional do idoso. 4ª ed. Belo Horizonte: Folium; 2014.

Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60(1):34-42. https://doi.org/10.1016/j.jclinepi.2006.03.012

Marôco J. Análise estatística com o SPSS Statistics. 7ª ed. Portugal: Report Number; 2018.