Mortality in community-dwelling elderly: coefficient and associated factors.

OBJECTIVE: Analyze the coefficient, associated factors, and causes of mortality in community-dwelling elderly. METHOD: Longitudinal and analytical study. Data collection, at baseline, was performed in the elderly's home. The first wave occurred after 42 months. Complementary data collection identified the cause of death. Variables analyzed: demographic, social, economic, and clinical. Logistic regression was used for data analysis. RESULTS: The coefficient of mortality was 7.9%. The variables associated with mortality were longevity, inability to read, absence of religious practice, stroke, consultation, and hospitalization in the last 12 months. The main groups of primary causes of death were ill-defined and unspecified causes of mortality, respiratory system diseases, and neoplasms. CONCLUSION: The coefficient of mortality in community-dwelling elderly was lower than national and international studies investigated.

Mortality in community-dwelling elderly: coefficient and associated factors / Mortalidad en la mayoría comunitaria: coeficiente y factores associados / Mortalidade em idosos comunitários: coeficiente e fatores associados

ABSTRACT Objective: Analyze the coefficient, associated factors, and causes of mortality in community-dwelling elderly. Method: Longitudinal and analytical study. Data collection, at baseline, was performed in the elderly's home. The first wave occurred after 42 months. Complementary data collection identified the cause of death. Variables analyzed: demographic, social, economic, and clinical. Logistic regression was used for data analysis. Results: The coefficient of mortality was 7.9%. The variables associated with mortality were longevity, inability to read, absence of religious practice, stroke, consultation, and hospitalization in the last 12 months. The main groups of primary causes of death were ill-defined and unspecified causes of mortality, respiratory system diseases, and neoplasms. Conclusion: The coefficient of mortality in community-dwelling elderly was lower than national and international studies investigated.

RESUMEN Objetivo: Analizar el coeficiente, los factores relacionados y las causas de mortalidad en ancianos comunitarios. Método: Estudio longitudinal y analítico. La recogida de datos, en la línea de base, ha sido realizada en el domicilio del anciano. La primera onda ocurrió tras 42 meses. Realizó recogida complementar para identificación de la causa de la muerte. Variables analizadas: demográficas, sociales, económicas y clínicas. Para análisis de los datos, se utilizó regresión logística. Resultados: El coeficiente de mortalidad fue 7,9%. Las variables relacionadas a la mortalidad fueron: longevidad, no saber leer, ausencia de práctica religiosa, accidente vascular encefálico, realización de consulta e internación en los últimos 12 meses. Los principales equipos de causas básicas de muerte fueron causas mal definidas y las no especificadas de mortalidad; enfermedades del aparato respiratorio; y neoplasias. Conclusión: El coeficiente de mortalidad en ancianos comunitarios se mostró menor en comparación a los estudios nacionales e internacionales investigados.

RESUMO Objetivo: Analisar o coeficiente, os fatores associados e as causas de mortalidade em idosos comunitários. Método: Estudo longitudinal e analítico. A coleta de dados, na linha de base, foi realizada no domicílio do idoso. A primeira onda ocorreu após 42 meses. Realizou-se coleta complementar para identificação da causa da morte. Variáveis analisadas: demográficas, sociais, econômicas e clínicas. Para análise dos dados, foi utilizada regressão logística. Resultados: O coeficiente de mortalidade foi 7,9%. As variáveis associadas à mortalidade foram: longevidade, não saber ler, ausência de prática religiosa, acidente vascular encefálico, realização de consulta e internação nos últimos 12 meses. Os principais grupos de causas básicas de morte foram causas mal definidas e as não especificadas de mortalidade; doenças do aparelho respiratório; e neoplasias. Conclusão: O coeficiente de mortalidade em idosos comunitários mostrou-se menor em comparação aos estudos nacionais e internacionais investigados.

Mortality in community-dwelling elderly: coefficient and associated factors / Mortalidad en la mayoría comunitaria: coeficiente y factores associados / Mortalidade em idosos comunitários: coeficiente e fatores associados

ABSTRACT Objective: Analyze the coefficient, associated factors, and causes of mortality in community-dwelling elderly. Method: Longitudinal and analytical study. Data collection, at baseline, was performed in the elderly's home. The first wave occurred after 42 months. Complementary data collection identified the cause of death. Variables analyzed: demographic, social, economic, and clinical. Logistic regression was used for data analysis. Results: The coefficient of mortality was 7.9%. The variables associated with mortality were longevity, inability to read, absence of religious practice, stroke, consultation, and hospitalization in the last 12 months. The main groups of primary causes of death were ill-defined and unspecified causes of mortality, respiratory system diseases, and neoplasms. Conclusion: The coefficient of mortality in community-dwelling elderly was lower than national and international studies investigated.

RESUMEN Objetivo: Analizar el coeficiente, los factores relacionados y las causas de mortalidad en ancianos comunitarios. Método: Estudio longitudinal y analítico. La recogida de datos, en la línea de base, ha sido realizada en el domicilio del anciano. La primera onda ocurrió tras 42 meses. Realizó recogida complementar para identificación de la causa de la muerte. Variables analizadas: demográficas, sociales, económicas y clínicas. Para análisis de los datos, se utilizó regresión logística. Resultados: El coeficiente de mortalidad fue 7,9%. Las variables relacionadas a la mortalidad fueron: longevidad, no saber leer, ausencia de práctica religiosa, accidente vascular encefálico, realización de consulta e internación en los últimos 12 meses. Los principales equipos de causas básicas de muerte fueron causas mal definidas y las no especificadas de mortalidad; enfermedades del aparato respiratorio; y neoplasias. Conclusión: El coeficiente de mortalidad en ancianos comunitarios se mostró menor en comparación a los estudios nacionales e internacionales investigados.

RESUMO Objetivo: Analisar o coeficiente, os fatores associados e as causas de mortalidade em idosos comunitários. Método: Estudo longitudinal e analítico. A coleta de dados, na linha de base, foi realizada no domicílio do idoso. A primeira onda ocorreu após 42 meses. Realizou-se coleta complementar para identificação da causa da morte. Variáveis analisadas: demográficas, sociais, econômicas e clínicas. Para análise dos dados, foi utilizada regressão logística. Resultados: O coeficiente de mortalidade foi 7,9%. As variáveis associadas à mortalidade foram: longevidade, não saber ler, ausência de prática religiosa, acidente vascular encefálico, realização de consulta e internação nos últimos 12 meses. Os principais grupos de causas básicas de morte foram causas mal definidas e as não especificadas de mortalidade; doenças do aparelho respiratório; e neoplasias. Conclusão: O coeficiente de mortalidade em idosos comunitários mostrou-se menor em comparação aos estudos nacionais e internacionais investigados.

Frailty in community-dwelling older people: comparing screening instruments.

OBJECTIVE: To compare the Edmonton Frail Scale (EFS) and Clinical-Functional Vulnerability Index-20 (CFVI-20) instruments regarding degree of agreement and correlation and compare descriptive models with frailty-associated variables in community-dwelling older people in Brazil. METHODS: Cross-sectional study, nested in a population-based and household cohort. Baseline sampling was calculated based on a probabilistic approach by conglomerate in two stages. In the first stage, census tract was used as sampling unit. In the second, the number of households was defined according to the population density of individuals aged ≥ 60 years. The Kappa statistic evaluated the agreement between instruments and Pearson's coefficient their correlation. Factors associated with frailty and high risk of clinical-functional vulnerability were identified by multiple analysis of Poisson regression with robust variance. RESULTS: Kappa statistics was 0.599 and Pearson's correlation coefficient 0.755 (p < 0.001). The EFS found a 28.2% prevalence of frailty, and the CFVI-20 found a 19.5% prevalence of high risk of clinical-functional vulnerability. Age equal to or greater than 80 years, history of stroke, polypharmacy, negative self-perceived health, fall in the past 12 months, and hospitalization in the past 12 months were variables associated with frailty in both instruments after multiple analysis. Less than four years of education, osteoarticular disease, and weight loss were associated with frailty only by EFS, and having a caregiver was associated with a high risk of clinical-functional vulnerability only by CFVI-20. CONCLUSIONS: Although the analyses show moderate agreement and strong positive correlation between the instruments, the indicated prevalence of frailty is discrepant. Our results attest the need to standardize the instrument for assessing frailty in community-dwelling older people.

Frailty in community-dwelling older people: comparing screening instruments / Fragilidade em idosos comunitários: comparando instrumentos de triagem

ABSTRACT OBJECTIVE: To compare the Edmonton Frail Scale (EFS) and Clinical-Functional Vulnerability Index-20 (CFVI-20) instruments regarding degree of agreement and correlation and compare descriptive models with frailty-associated variables in community-dwelling older people in Brazil. METHODS: Cross-sectional study, nested in a population-based and household cohort. Baseline sampling was calculated based on a probabilistic approach by conglomerate in two stages. In the first stage, census tract was used as sampling unit. In the second, the number of households was defined according to the population density of individuals aged ≥ 60 years. The Kappa statistic evaluated the agreement between instruments and Pearson's coefficient their correlation. Factors associated with frailty and high risk of clinical-functional vulnerability were identified by multiple analysis of Poisson regression with robust variance. RESULTS: Kappa statistics was 0.599 and Pearson's correlation coefficient 0.755 (p < 0.001). The EFS found a 28.2% prevalence of frailty, and the CFVI-20 found a 19.5% prevalence of high risk of clinical-functional vulnerability. Age equal to or greater than 80 years, history of stroke, polypharmacy, negative self-perceived health, fall in the past 12 months, and hospitalization in the past 12 months were variables associated with frailty in both instruments after multiple analysis. Less than four years of education, osteoarticular disease, and weight loss were associated with frailty only by EFS, and having a caregiver was associated with a high risk of clinical-functional vulnerability only by CFVI-20. CONCLUSIONS: Although the analyses show moderate agreement and strong positive correlation between the instruments, the indicated prevalence of frailty is discrepant. Our results attest the need to standardize the instrument for assessing frailty in community-dwelling older people.

RESUMO OBJETIVO: Comparar os instrumentos Edmonton Frail Scale (EFS) e Índice de Vulnerabilidade Clínico-Funcional-20 (IVCF-20) quanto ao grau de concordância e de correlação, bem como comparar modelos descritivos com variáveis associadas à fragilidade em idosos brasileiros comunitários. MÉTODOS: Estudo transversal, aninhado a uma coorte de base populacional e domiciliar. A amostragem na linha de base foi probabilística, por conglomerados, em dois estágios. No primeiro, utilizou-se como unidade amostral o setor censitário. No segundo, definiu-se o número de domicílios segundo a densidade populacional de indivíduos com idade ≥ a 60 anos. A estatística Kappa analisou a concordância, e o coeficiente de Pearson avaliou a correlação entre os instrumentos. Os fatores associados à fragilidade e ao alto risco de vulnerabilidade clínico-funcional foram identificados por análise múltipla de regressão de Poisson com variância robusta. RESULTADOS: A estatística Kappa foi 0,599, e o coeficiente de correlação de Pearson foi de 0,755 (p < 0,001). A prevalência da fragilidade foi de 28,2% pela EFS, e a prevalência do alto risco de vulnerabilidade clínico-funcional foi de 19,5% pelo IVCF-20. As variáveis associadas à fragilidade, após análise múltipla, em ambos os instrumentos, foram: idade igual ou superior a 80 anos, histórico de acidente vascular encefálico, polifarmácia, autopercepção negativa de saúde, queda nos últimos 12 meses e internação nos últimos 12 meses. Escolaridade inferior a quatro anos, doença osteoarticular e perda de peso foram associadas a fragilidade apenas pela EFS, enquanto possuir cuidador esteve associado a alto risco de vulnerabilidade clínico-funcional somente pelo IVCF-20. CONCLUSÕES: Embora as análises revelem concordância moderada e forte correlação positiva entre os instrumentos, a prevalência de fragilidade apontada é discrepante. O resultado destaca a necessidade de padronizar o instrumento para aferir a fragilidade em idosos comunitários.