Avaliação multidimensional da saúde de idosos com câncer de próstata e o The Vulnerable Elders Survey 13 (VES-13) como instrumento de triagem em oncogeriatria / Multidimensional assessment of health of elderly patients with prostate cancer and The Vulnerable Elders Survey 13 (VES-13) as a screening tool in oncogeriatria

RESUMO

A realização de uma avaliação multidimensional em idosos é recomendada antes da definição do tratamento oncológico. Em anos recentes, tem sido proposta a utilização de instrumentos de triagem, tais como o The Vulnerable Elderly Survey 13 (VES-13), que possibilitam identificar os indivíduos hígidos, reservando a avaliação multidimensional apenas para aqueles com maior probabilidade de alterações da saúde global.Objetivos: Realizar a adaptação transcultural do VES-13 para utilização na população idosa brasileira com câncer e avaliar as propriedades psicométricas da versão brasileira do VES-13; Caracterizar a condição de saúde global de idosos com câncer de próstata por meio de uma Avaliação Geriátrica Multidimensional (AGM) e avaliar a acurácia do VES-13 como instrumento de triagem em oncogeriatria; Analisar as dimensões da saúde global associadas à vulnerabilidade e avaliar o poder discriminatório do VES-13 para novas composições de AGM constituídas com as dimensões associadas à vulnerabilidade na população de estudo...

ABSTRACT

A multidimensional assessment is recommended for older adults before the definition of cancer treatment. In recent years, the use of screening tools, such as The Vulnerable Elderly Survey 13 (VES-13), which allow to identify healthy individuals, is being proposed in order to preserve the multidimensional evaluation only for those most likely to have deficiencies in their global health .Objectives: To perform the cross-cultural adaptation of the VES-13 for use in the elderly population with cancer and evaluate the psychometric properties of the Brazilian version of the VES-13; To characterize the overall health status of elderly patients with prostate cancer through a Multidimensional Geriatric Assessment (AGM) and evaluate the accuracy of VES-13 as a screening tool in geriatric oncology; To analyze the global health dimensions associated with vulnerability and to evaluate the discriminatory power of VES-13 for new AGM models, composed with the dimensions associated with vulnerability in this population. (...) Conclusions: The Brazilian version of VES-13 was adequate and was well understood by seniors and their psychometric properties were considered consistent. Given that sensitivity and negative predictive value are the most important elements for a good screening tool in geriatric oncology, the alternative cut-off point for the VES-13 seems to be the most appropriate for identifying vulnerable individuals in younger and healthy populations, like the one in this study. For populations with characteristics similar to those observed in this study, an AGM composition including ADLs functionality, IADLs functionality, emotional state, comorbidity, nutritional status and use of medications seems to be the most suitable as the gold standard for assessing the accuracy of VES-13...