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Frailty and cognitive status evaluation can better predict mortality in older adults?
Aprahamian, Ivan; Suemoto, Claudia Kimie; Aliberti, Márlon Juliano Romero; de Queiroz Fortes Filho, Sileno; de Araújo Melo, Juliana; Lin, Sumika Mori; Filho, Wilson Jacob.
Afiliação
  • Aprahamian I; Division of Geriatrics, Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil; Department of Internal Medicine, Faculty of Medicine of Jundiaí, Jundiaí, Brazil. Electronic address: ivan.aprahamian@gmail.com.
  • Suemoto CK; Division of Geriatrics, Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil.
  • Aliberti MJR; Division of Geriatrics, Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil.
  • de Queiroz Fortes Filho S; Division of Geriatrics, Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil.
  • de Araújo Melo J; Division of Geriatrics, Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil.
  • Lin SM; Division of Geriatrics, Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil.
  • Filho WJ; Division of Geriatrics, Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil.
Arch Gerontol Geriatr ; 77: 51-56, 2018.
Article em En | MEDLINE | ID: mdl-29669268
OBJECTIVES: to evaluate the improvement in one-year mortality prediction after adding a 2-min cognitive screening to a simple 1-min frailty detection instrument. Secondary outcomes were new activities of daily living (ADL) disability and falls. DESIGN: Prospective cohort study. SETTING: A geriatric day-hospital for intermediate care. PARTICIPANTS: A total of 701 older adults with an acute or decompensated disease (79.5 (8.3) years, 64% female). MEASUREMENTS: A rapid and simple frailty evaluation was performed using the FRAIL questionnaire. The presence of cognitive impairment was defined by previous diagnosis of dementia or a score of five or less on an education-corrected 10-point cognitive screening tool. RESULTS: Frail participants with normal (hazard risk [HR] 4.0, 95% confidence interval [CI], 1.73-9.25) and impaired cognition had a higher risk of death (HR 4.38, 95% CI, 1.95-9.87) than robust participants. The presence of cognitive impairment increased the risk of death in prefrail (HR 3.60, 95% CI, 1.55-8.34) and robust participants (HR 3.49, 95% CI, 1.22-9.96). Cognitive impairment was associated with an increased risk of incident ADL disability in all frailty categories. The presence of cognitive impairment was associated with a significantly higher risk of fall in robust seniors. The predictive accuracy of the FRAIL scale was lower than expected (between 0.58 and 0.69), and a small improvement was observed after adding the cognitive screening (between 0.61 and 0.72). CONCLUSION: Despite of significant results in predicting relevant clinical events, the present combination of the FRAIL and 10-CS scales may not be ideal in clinical practice.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Avaliação Geriátrica / Disfunção Cognitiva / Fragilidade Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Aged80 / Female / Humans / Male País/Região como assunto: America do sul / Brasil Idioma: En Revista: Arch Gerontol Geriatr Ano de publicação: 2018 Tipo de documento: Article País de publicação: Holanda
Texto completo
Adicionar na Minha BVS
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XML
PubMed Links
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Avaliação Geriátrica / Disfunção Cognitiva / Fragilidade Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Aged80 / Female / Humans / Male País/Região como assunto: America do sul / Brasil Idioma: En Revista: Arch Gerontol Geriatr Ano de publicação: 2018 Tipo de documento: Article País de publicação: Holanda