Meu SciELO
Serviços Personalizados
Journal
Artigo
Indicadores
Citado por SciELO
Acessos
Links relacionados
Citado por Google
Similares em SciELO
Similares em Google
Compartilhar
Revista Clínica de Medicina de Familia
versão On-line ISSN 2386-8201versão impressa ISSN 1699-695X
Resumo
NIETO ROJAS, Isabel et al. Functional decline: incidence and value of several prediction rules in older persons living in community. Rev Clin Med Fam [online]. 2018, vol.11, n.3, pp.137-143. Epub 01-Out-2019. ISSN 2386-8201.
Objective:
To investigate the incidence of functional decline (FD) experienced in 3 months, and the usefulness of different prediction rules.
Design:
Multicenter, prospective, cohort study (subgroups based on the FD risk according to prediction rules), with a follow-up period of 3 months.
Location:
Primary care. Health area.
Participants:
Non-institutionalized patients aged ≥ 70, excluding those who present communication problems, dependence in ≥ 3 basic activities, terminally ill, or refusing to participate. Sample size for an estimated FD incidence of 15 %, precision 2 %, confidence level 95 %, and expected loss 10 %. Stratified sampling: first stage by cluster sampling and second stage by systematic sampling (1/15) of lists ordered by age.
Main measures:
At the beginning: morbidity and socio-demographic variables, Katz index (basic activities), Lawton-Brody index (instrumental activities), and 3-month prediction rules for FD (SHERPA, TRST, ISAR-PC and Inouye). After 3 months: FD (loss of ≥ 1 basic or instrumental activities according to Katz and Lawton-Brody, institutionalization, or death).
Results:
462 patients complete the study (losses: 3.75 %). Mean age 77.9 years old (SD: 6.3), 54.7 % women, mean number of pathologies 4.4 (SD: 2.2) and mean number of drugs 5.6 (SD: 3.3).
Incidence of FD after 3 months 9.4 % (CI95 %: 6.8-12.0 %), of which 0.7 % loss of basic activities; 3.7 % loss of instrumental activities; 3.4 % loss of basic and instrumental activities; 0.2 % institutionalization; and 0.4 % death.
The relative risk (RR) found in high-risk/risk groups according to the prediction rules examined was: SHERPA 1.98 (CI95 %: 0.84-2.85; p>0.05); TRST 2.21 (CI95 %: 1.24-3.95; p<0.01); ISAR-PC 2.68 (CI95 %: 1.807 - 6.70; p<0.05); and Inouye 2.03 (CI95 %: 1.10 - 3.74; p<0.05).
Conclusions:
Low incidence of FD compared to other studies. Relative usefulness of FD prediction rules
Palavras-chave : Aged; Functional decline; Prediction.