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INTRODUCTION: The COVID-19 pandemic has disproportionately affected individuals residing in Long-Term Care Facilities (LTCFs), necessitating tailored strategies to manage outbreaks. This study examines the outcomes of the ILPI BH project, a collaborative effort between the Municipal Health Department and the Hospital das Clínicas of the Federal University of Minas Gerais, designed to mitigate COVID-19 spread within LTCFs. METHODS: Prospective cohort of secondary data: 1,794 old residents in 99 long-term care facilities of Belo Horizonte, Brazil, were followed from May 2020 to January 2021. The study analyzed the prevention strategies, residents' clinical data, and the characteristics of the long-term care facilities, correlating these variables with the number of infections, hospitalizations, and deaths from COVID-19. It checked absolute numbers and rates of incidence, hospitalization, mortality, and lethality. RESULTS: There have been 58 COVID-19 outbreaks in long-term care facilities. There were 399 cases among residents, 96 hospitalizations for COVID-19 and 48 deaths from COVID-19 (2.7 % of the cohort), with a case fatality rate of 12 %. After multivariate analysis, the intrinsic variables to residents associated with higher mortality risk were higher degree of frailty (OR=1.08; p = 0.004) and the fact of living in a long-term care facility with a considerable proportion of residents' coverage by health plans (OR = 1.01; p = 0.028). Early geriatric follow-up showed an association with a reduction in the number of hospitalizations due to COVID-19. CONCLUSION: The correct classification of the degree of frailty of institutionalized older people seems to have been relevant for predicting mortality from COVID-19. The extensive assistance by private health plans, contrary to what is supposed, did not result in better health protection. Early geriatric follow-up was beneficial and may be an attractive strategy in the face of health emergencies that affect long-term care facilities to reduce hospital admissions.

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Abstract Introduction The COVID-19 pandemic has disproportionately affected individuals residing in Long-Term Care Facilities (LTCFs), necessitating tailored strategies to manage outbreaks. This study examines the outcomes of the ILPI BH project, a collaborative effort between the Municipal Health Department and the Hospital das Clínicas of the Federal University of Minas Gerais, designed to mitigate COVID-19 spread within LTCFs. Methods Prospective cohort of secondary data: 1,794 old residents in 99 long-term care facilities of Belo Horizonte, Brazil, were followed from May 2020 to January 2021. The study analyzed the prevention strategies, residents' clinical data, and the characteristics of the long-term care facilities, correlating these variables with the number of infections, hospitalizations, and deaths from COVID-19. It checked absolute numbers and rates of incidence, hospitalization, mortality, and lethality. Results There have been 58 COVID-19 outbreaks in long-term care facilities. There were 399 cases among residents, 96 hospitalizations for COVID-19 and 48 deaths from COVID-19 (2.7 % of the cohort), with a case fatality rate of 12 %. After multivariate analysis, the intrinsic variables to residents associated with higher mortality risk were higher degree of frailty (OR=1.08; p = 0.004) and the fact of living in a long-term care facility with a considerable proportion of residents' coverage by health plans (OR = 1.01; p = 0.028). Early geriatric follow-up showed an association with a reduction in the number of hospitalizations due to COVID-19. Conclusion The correct classification of the degree of frailty of institutionalized older people seems to have been relevant for predicting mortality from COVID-19. The extensive assistance by private health plans, contrary to what is supposed, did not result in better health protection. Early geriatric follow-up was beneficial and may be an attractive strategy in the face of health emergencies that affect long-term care facilities to reduce hospital admissions.

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OBJECTIVE: To determine the self-perceived health status and clinical-functional vulnerability of the elderly attended at a Reference Center of Minas Gerais, Brazil and to evaluate the association between these variables through the Clinical-Functional Vulnerability Index (IVCF-20) instrument. METHOD: This is an epidemiological, retrospective study of 311 medical records. Statistical analyses were performed using the Stata program; the evaluations were by Pearson's Chi-square test and Poisson regression models. RESULTS: The majority of the elderly presented negative self-perceived health status(70.10%); there was statistical significance between negative self-perceived health and the variables of mood and recent hospitalization. CONCLUSION: Perceived health status influences the morbidity and mortality of the elderly. Mood disorders and recent hospitalizations directly interfere with active aging.

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ABSTRACT Objective: To determine the self-perceived health status and clinical-functional vulnerability of the elderly attended at a Reference Center of Minas Gerais, Brazil and to evaluate the association between these variables through the Clinical-Functional Vulnerability Index (IVCF-20) instrument. Method: This is an epidemiological, retrospective study of 311 medical records. Statistical analyses were performed using the Stata program; the evaluations were by Pearson's Chi-square test and Poisson regression models. Results: The majority of the elderly presented negative self-perceived health status(70.10%); there was statistical significance between negative self-perceived health and the variables of mood and recent hospitalization. Conclusion: Perceived health status influences the morbidity and mortality of the elderly. Mood disorders and recent hospitalizations directly interfere with active aging.

RESUMEN Objetivo: Conocer la percepción de salud y la vulnerabilidad clínico-funcional de mayores atendidos en un Centro de Referencia de Minas Gerais y evaluar la asociación entre esas variables a través del instrumento Índice de Vulnerabilidad Clínico Funcional (IVCF-20). Método: Se trata de un estudio epidemiológico, retrospectivo de análisis de 311 prontuarios. Los análisis estadísticos fueron realizados con auxilio del programa Stata; las evaluaciones fueron hechas a través del test Qui-quadrado de Pearson y modelos de regresión de Poisson. Resultados: La mayoría de los mayores presentó su percepción negativa de salud (70,10%); hubo significancia estadística entre la percepción de uno mismo negativa en salud y la variable humor y hospitalización reciente. Conclusión: Las percepciones del estado de salud influencian en la mortalidad de los mayores. Los trastornos de humor e internaciones recientes interfieren directamente en el envejecimiento activo.

RESUMO Objetivo: Conhecer a autopercepção de saúde e a vulnerabilidade clínico-funcional de idosos atendidos em um Centro de Referência de Minas Gerais e avaliar a associação entre essas variáveis através do instrumento Índice de Vulnerabilidade Clínico Funcional (IVCF-20). Método: Trata-se de um estudo epidemiológico, retrospectivo de análise de 311 prontuários. As análises estatísticas foram realizadas com auxílio do programa Stata; as avaliações foram feitas através do teste Qui-quadrado de Pearson e modelos de regressão de Poisson. Resultados: A maioria dos idosos apresentou autopercepção negativa de saúde (70,10%); houve significância estatística entre a autopercepção negativa em saúde e a variável humor e hospitalização recente. Conclusão: As percepções do estado de saúde influenciam na morbimortalidade dos idosos. Os transtornos de humor e internações recentes interferem diretamente no envelhecimento ativo.

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OBJECTIVE: To evaluate the adequacy of the Clinical-Functional Vulnerability Index-20, a rapid triage instrument to test vulnerability in Brazilian older adults, for the use in primary health care. METHODS: The study included convenience sample of 397 patients aged older than or equal to 60 years attended at Centro de Referência para o Idoso (Reference Center for Older Adults) and of 52 older adults the same age attended at the community. The results of the questionnaire, consisting of 20 questions, were compared with those of the Comprehensive Geriatric Assessment, considered a reference for identifying frail older adults. Spearman's correlation was evaluated in the Clinical-Functional Vulnerability Index-20 with the Comprehensive Geriatric Assessment; the validity was verified by the area under the ROC curve; reliability was estimated by the percentage of agreement among evaluators and by the kappa coefficient, both with quadratic weighted. The cut-off point was obtained based on the higher accuracy criterion. Cronbach's alpha, a measure of internal consistency, was estimated. RESULTS: The Spearman's correlation coefficient was high and positive for both groups (0.792 for older adults attended at the Reference Center and 0.305 for older adults from the community [p < 0.001]). The area under the ROC curve for older adults attended at the Reference Center was substantial (0.903). The cut-off point obtained was six, and older adults with scores in Clinical-Functional Vulnerability Index-20 above that value had strong possibility of being frail. For older adults from the community, the quadratic weighted agreement among evaluators was 99.5%, and the global quadratic weighted kappa coefficient was 0.94. Cronbach's alpha was high for older adults attended at the Reference Center (0.861) and those attended at the community (0.740). CONCLUSIONS: The Clinical-Functional Vulnerability Index-20 questionnaire, in the sample examined, turned out to be positively correlated with the Comprehensive Geriatric Assessment, in addition to the results indicating a high degree of validity and reliability. Thus, the Clinical-Functional Vulnerability Index-20 proves to be viable as a triage instrument in the primary health care that identifies frail older adults (older adults at risk of weakening and frail older adults). OBJETIVO: Avaliar a adequação do Índice de Vulnerabilidade Clínico-Funcional-20 , instrumento de triagem rápida de vulnerabilidade em idosos brasileiros, para utilização pela atenção básica. O estudo incluiu amostra de conveniência de 397 pacientes com idade maior ou igual a 60 anos atendidos em um Centro de Referência para o Idoso e de 52 idosos da mesma idade atendidos na comunidade. Os resultados do questionário, constituído por 20 perguntas, foram comparados com aqueles da Avaliação Geriátrica Ampla, considerada referência para identificação do idoso frágil. Foi avaliada a correlação de Spearman do Índice de Vulnerabilidade Clínico-Funcional-20 com a Avaliação Geriátrica Ampla; a validade foi verificada pela área sob a curva ROC; a confiabilidade foi estimada pelo percentual de concordância entre avaliadores e coeficiente kappa, ambos com ponderação quadrática. Obteve-se ponto de corte com base no critério de maior acurácia. O alfa de Cronbach, medida de consistência interna, foi calculado. O coeficiente de correlação de Spearman foi elevado e positivo em ambos os grupos (0,792 para idosos atendidos no Centro de Referência para o Idoso e 0,305 para idosos da comunidade [p < 0,001]). A área sob a curva ROC para idosos atendidos no Centro de Referência para o Idoso foi substancial (0,903). O ponto de corte obtido foi seis e idosos com pontuação no Índice de Vulnerabilidade Clínico-Funcional-20 acima desse valor tinham forte possibilidade de serem frágeis. Para idosos da comunidade, a concordância ponderada quadrática entre avaliadores foi 99,5% e o coeficiente kappa ponderado quadrático global, 0,94. O alfa de Cronbach foi elevado para idosos atendidos no Centro de Referência para o Idoso (0,861) e da comunidade (0,740). CONCLUSÕES: O questionário do Índice de Vulnerabilidade Clínico-Funcional-20, na amostra analisada, mostrou ser positivamente correlacionado com a Avaliação Geriátrica Ampla, além de os resultados indicarem alto grau de validade e confiabilidade. Assim, o Índice de Vulnerabilidade Clínico-Funcional-20 se mostra viável como instrumento de rastreio na atenção básica que identifica o idoso com fragilidade (idoso em risco de fragilização e idoso frágil).

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ABSTRACT OBJECTIVE To evaluate the adequacy of the Clinical-Functional Vulnerability Index-20, a rapid triage instrument to test vulnerability in Brazilian older adults, for the use in primary health care. METHODS The study included convenience sample of 397 patients aged older than or equal to 60 years attended at Centro de Referência para o Idoso (Reference Center for Older Adults) and of 52 older adults the same age attended at the community. The results of the questionnaire, consisting of 20 questions, were compared with those of the Comprehensive Geriatric Assessment, considered a reference for identifying frail older adults. Spearman's correlation was evaluated in the Clinical-Functional Vulnerability Index-20 with the Comprehensive Geriatric Assessment; the validity was verified by the area under the ROC curve; reliability was estimated by the percentage of agreement among evaluators and by the kappa coefficient, both with quadratic weighted. The cut-off point was obtained based on the higher accuracy criterion. Cronbach's alpha, a measure of internal consistency, was estimated. RESULTS The Spearman's correlation coefficient was high and positive for both groups (0.792 for older adults attended at the Reference Center and 0.305 for older adults from the community [p < 0.001]). The area under the ROC curve for older adults attended at the Reference Center was substantial (0.903). The cut-off point obtained was six, and older adults with scores in Clinical-Functional Vulnerability Index-20 above that value had strong possibility of being frail. For older adults from the community, the quadratic weighted agreement among evaluators was 99.5%, and the global quadratic weighted kappa coefficient was 0.94. Cronbach's alpha was high for older adults attended at the Reference Center (0.861) and those attended at the community (0.740). CONCLUSIONS The Clinical-Functional Vulnerability Index-20 questionnaire, in the sample examined, turned out to be positively correlated with the Comprehensive Geriatric Assessment, in addition to the results indicating a high degree of validity and reliability. Thus, the Clinical-Functional Vulnerability Index-20 proves to be viable as a triage instrument in the primary health care that identifies frail older adults (older adults at risk of weakening and frail older adults).

RESUMO OBJETIVO Avaliar a adequação do Índice de Vulnerabilidade Clínico-Funcional-20 , instrumento de triagem rápida de vulnerabilidade em idosos brasileiros, para utilização pela atenção básica. O estudo incluiu amostra de conveniência de 397 pacientes com idade maior ou igual a 60 anos atendidos em um Centro de Referência para o Idoso e de 52 idosos da mesma idade atendidos na comunidade. Os resultados do questionário, constituído por 20 perguntas, foram comparados com aqueles da Avaliação Geriátrica Ampla, considerada referência para identificação do idoso frágil. Foi avaliada a correlação de Spearman do Índice de Vulnerabilidade Clínico-Funcional-20 com a Avaliação Geriátrica Ampla; a validade foi verificada pela área sob a curva ROC; a confiabilidade foi estimada pelo percentual de concordância entre avaliadores e coeficiente kappa, ambos com ponderação quadrática. Obteve-se ponto de corte com base no critério de maior acurácia. O alfa de Cronbach, medida de consistência interna, foi calculado. O coeficiente de correlação de Spearman foi elevado e positivo em ambos os grupos (0,792 para idosos atendidos no Centro de Referência para o Idoso e 0,305 para idosos da comunidade [p < 0,001]). A área sob a curva ROC para idosos atendidos no Centro de Referência para o Idoso foi substancial (0,903). O ponto de corte obtido foi seis e idosos com pontuação no Índice de Vulnerabilidade Clínico-Funcional-20 acima desse valor tinham forte possibilidade de serem frágeis. Para idosos da comunidade, a concordância ponderada quadrática entre avaliadores foi 99,5% e o coeficiente kappa ponderado quadrático global, 0,94. O alfa de Cronbach foi elevado para idosos atendidos no Centro de Referência para o Idoso (0,861) e da comunidade (0,740). CONCLUSÕES O questionário do Índice de Vulnerabilidade Clínico-Funcional-20, na amostra analisada, mostrou ser positivamente correlacionado com a Avaliação Geriátrica Ampla, além de os resultados indicarem alto grau de validade e confiabilidade. Assim, o Índice de Vulnerabilidade Clínico-Funcional-20 se mostra viável como instrumento de rastreio na atenção básica que identifica o idoso com fragilidade (idoso em risco de fragilização e idoso frágil).

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Trata-se de um estudo descritivo sobre o perfil deidosos em Montes Claros, Minas Gerais, Brasil, realizado em fonte dedados secundários, com informações obtidas junto aoInstituto Brasileiro de Geografia e Estatística, cujo objetivo foiconhecer o envelhecimento populacional a partir deaspectos demográficos da população. Em relação ao Brasil no ano de2000, 10,54% representa a população total de MinasGerais e 0,18% a de Montes Claro. Em 2010 a população representou10,3% e 0,2%. No ano de 2000 a população idosa, representou 11,18% em Minas Gerais e 0,14% em Montes Claros. Em 2010,esta foi de 11,22% e 0,16%, respectivamente. Verifica-se que em todos os demógrafos estudados existe uma conformidadeem relação ao processo de envelhecimento.

This is a descriptive study on the profile of elderly in Montes Claros, Minas Gerais, Brazil, conducted a source of secondarydata, with information obtained from the BrazilianInstitute of Geography and Statistics, whose objective was to know theaging population from demographics of the population. In relation to Brazil in 2000, 10.54% representsthe totalpopulation of Minas Gerais and 0.18% of the Hills course. In 2010 the population represented 10.3% and0.2%. In 2000 theelderly population, accounted for 11.18% in Ontarioand 0.14% in Montes Claros. In 2010 this was 11.22% and 0.16%respectively. It is noted that in all demographersstudied there is a conformity with the aging process.

Este es un estudio descriptivo sobre el perfil de los ancianos en Montes Claros, Minas Gerais, Brasil,llevó a cabo en unafuente de datos secundarios, con la información obtenida del Instituto Brasileño de Geografía y Estadística, cuyo objetivofue conocer el envejecimiento de la población de demografía de la población. En relación a Brasil en el año 2000,representa 10,54% del total de la población de Minas Gerais y el 0,18% del curso Hills. En 2010 la población representabael 10,3% y 0,2%. En 2000, la población de edad avanzada, representaron el 11,18% en Ontario y 0,14% enMontes Claros. En2010 esto fue 11,22% y 0,16% respectivamente. Se hace notar que en todos los demógrafos estudiados hayunaconformidad con el proceso de envejecimiento.

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