Comparação de três instrumentos de avaliação da síndrome da fragilidade em idosos institucionalizados

Abstract

INTRODUCTION: There are currently several instruments for the evaluation of the frailty syndrome in the older people. However, it is not known which is the best instrument to be used in the environment of nursing homes. OBJECTIVE: To compare the application and results of instruments for evaluating the frailty syndrome in older people residents of nursing homes. METHODS: A crosssectional, observational study, conducted at a private hospital in the city of São Paulo, Brazil. Older people residents of nursing homes, aged 60 years and older, of both sexes, were included; and excluded those who refused to participate in the survey or who were not present at the institution. In the evaluation of the older people, sociodemographic, clinical data and time of institutionalization were collected. Three frailty syndrome evaluation instruments, the Frailty Phenotype (CHS), the Edmonton Frail Scale (EFS) and the Clinical Frailty Scale (CFS) were applied. RESULTS: The study included 27 older peoples, mean age 83 years and mean institutionalization time of 30 months. The CHS presented substantial concordance (Kappa = 0.632) and moderate (Kappa = 0.562) for the EFS and CFS, respectively, whereas between EFS and CFS there was a weak agreement (Kappa = 0.276). There was a significant and moderate correlation between all frailty assessment instruments. CONCLUSION: The CHS was the instrument that showed greater agreement with the other instruments, and was the most adequate for the identification of the frailty syndrome in this environment.