Banca de DEFESA: LUIZ EDUARDO LIMA DE ANDRADE

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : LUIZ EDUARDO LIMA DE ANDRADE
DATE: 17/12/2021
TIME: 09:00
LOCAL: VIDEOCONFERÊNCIA
TITLE:

Mapping and comparison of instruments for screening and stratification of frail Community-dwelling older people

KEY WORDS:

Frailty, aged, community-dwelling, primary health care, Frailty older.

PAGES: 134
BIG AREA: Ciências da Saúde
AREA: Fisioterapia e Terapia Ocupacional
SUMMARY:

Introdution: Frailty in the older people represents a state of physiological vulnerability related to age, produced by the reduction of homeostatic reserve and the body's ability to face a varied number of negative health outcomes. Early recognition of this syndrome is important, as it identifies older people at higher risk of unfavorable outcomes. Objective: Map valid instruments in the literature for screening and stratification of frailty in community-dwelling older people, in addition to comparing them to find the best option. Methods: Article 1 - This is a scoping review carried out through the search for instruments available in the literature for assessment and frailty stratification in community-dwelling older people. The searches were carried out in 5 Medline, LILACS, Scopus, Web of Science and CINAHL databases, with the following search strategy: frail OR frailty AND “independent living” OR “community dwelling” AND aging OR elderly AND “Observational Study”. A search of the gray literature was also performed in order to identify additional relevant studies. Data were presented and analyzed descriptively. Article 2 – This is a methodological study to assess the discriminative validity of the Vulnerable Elderly Survey-13 (VES-13) and Clinical Functional Vulnerability Index-20 (CFVI-20) instruments compared to the Frailty Phenotype. It was carried out with community elderly aged 60 years and over, of both genders, residing in Parnamirim, in the northeast region of Brazil. The comparison of frail and non-frail groups, identified through the Frailty Phenotype, was analyzed using Student's t test and effect size for each instrument score. To investigate the correlation between the three instruments, Pearson's correlation was performed. Discriminative validity was tested by analyzing the ROC curve, in addition to calculating the accuracy of the instruments. Results: Article 1 - 55 studies were selected for the final analysis of this research. Seventeen instruments were analyzed, with Fried's frailty criteria being the most used method, being present in 25 studies (45.5%). Regarding the assessment domains, 6 instruments assess only physical issues, four assess physical, psychological and social issues, and the other instruments have more than three domains for assessing frailty. Article 2 - A total of 732 elderly people were evaluated, among which 17.1% presented themselves as frail according to the Frailty Phenotype. The Pearson correlation found between Frailty Phenotype and CFVI-20 was 0.53 (p<0.001), whereas for VES-13 this value was 0.42 (p-value<0.001). The difference between the means of the frail and non-frail groups in the VES-13 and CFVI-20 scores with the Phenotype were significant (p<0.001), with an effect size of 0.95 and 1.26, respectively. The instruments proved to be valid to discriminate frail from non-frail elderly (p<0.001), the FCVI-20 had an AUC of 0.81 and the VES-13 of 0.75. Conclusions: The assessment of frailty in community-dwelling older people can be performed using several instruments. The scope review serves as a guiding guide for professionals in the field of geriatrics, demonstrating 17 instruments applicable to the context of community-dwelling older people, pointing out advantages and disadvantages in deciding on the instrument to be used. The instruments VES-13 and CFVI-20 have good discriminative validity for assessing frailty in community-dwelling older people, being better for identifying frail than non-frail elderly. When comparing these tools, the CFVI-20 proved to be better than the VES-13.

BANKING MEMBERS:
Presidente - 1460020 - ALVARO CAMPOS CAVALCANTI MACIEL
Externa à Instituição - DANIELE SIRINEU PEREIRA - UFMG
Externo à Instituição - DIEGO DE SOUSA DANTAS - UFPE
Externo ao Programa - 1674532 - DIMITRI TAURINO GUEDES
Interna - 3885543 - SAIONARA MARIA AIRES DA CAMARA