IDENTIFICATION AND MONITORING OF FRAILTY SYNDROME IN ELDERLY PEOPLE CARED FOR IN BASIC HEALTH UNITS IN THE MUNICIPALITY OF SANTOS/SP: RATIONALE AND DESIGN OF THE 10-YEAR PROSPECTIVE LONGITUDINAL STUDY Sheila de Melo Borges

Abstract

The study of frailty in elderly people has gained emphasis in recent decades because it is a multidimensional syndrome that involves a complex interaction of clinical, biological, psychiatric and social factors. It is, therefore, a geriatric syndrome that results in a state of greater vulnerability associated with a high risk of negative adverse health outcomes, such as falls, fractures, morbidities, disability, hospitalization, institutionalization and death. Therefore, clinical evaluation of this condition in different profiles of elderly people is necessary, especially in primary health care services (PHC), as it is a level of health care considered the gateway to the Unified Health System (SUS), responsible for monitoring health in the territory where people live, facilitating access to longitudinal and comprehensive care for the population. In this sense, prospective studies are necessary and can contribute to monitoring health indicators. Therefore, the objectives of this project are: 1) identify and monitor the tracking of frailty syndrome in elderly people using Basic Health Units (UBS) in the city of Santos after ten years of data collection from the previously carried out frailty project; 2) Analyze the relationship between different health conditions (clinical, physical, functional, cognitive, emotional and social) with frailty in this assessment period; 3) Check possible frailty outcomes, such as mortality, immobility and institutionalization over these years. For this, the same research protocol applied between 2014 and 2016 will be used, referring to a cross-sectional thematic project entitled “Frailty Syndrome”: identification and monitoring of vulnerability in elderly users of Basic Health Units in the city of Santos/ SP”, in which he used the following instruments to assess frailty: Study of Osteoporotic Fractures (SOF) and Edmonton Frail Scale (EFS). Clinical, cognitive, emotional and physical-functional assessments will also be carried out, most of which are based on the elderly person's notebook and the basic care notebook, both reference instruments for monitoring vulnerability in elderly people, recommended by the Ministry of Health. Health and other instruments recommended by the Comprehensive Geriatric Assessment (AGA). In the previous cross-sectional thematic project, 305 elderly people were evaluated in seven UBS followed by UBS in the city of Santos after consultations, exams, educational activities and/or medication withdrawal. In the present study, with prospective follow-up, we intend to call the participants of the previously carried out research and invite them for a reassessment, reaching a sample of 136 people. In the event of death, institutionalization and other conditions that prevent the participant from being re-evaluated, this information will be recorded for research purposes with the aim of analyzing outcomes. This study aims to contribute to a better understanding of frailty and its consequences in elderly people using PHC, given the importance of this level of health care for health promotion in our public health system and the need for health care for those gerontes.