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Master's Dissertation
DOI
https://doi.org/10.11606/D.100.2020.tde-28072022-164147
Document
Author
Full name
Giselle Layse Andrade Buarque
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2021
Supervisor
Committee
Melo, Ruth Caldeira de (President)
Aquino, Rita de Cássia de
Jacinto, Alessandro Ferrari
Orlandi, Fabiana de Souza
Title in Portuguese
Relação entre relato de dispneia, condições de saúde e síndrome da fragilidade em idosos comunitários: dados do estudo FIBRA
Keywords in Portuguese
Dispneia
Doenças Crônicas não Transmissíveis
Fragilidade
Idoso
Nível de Saúde
Polifarmácia
Abstract in Portuguese
A dispneia é um sintoma presente em diversas doenças crônicas comuns entre os idosos. Como os indivíduos com dispneia tendem a adotar o repouso e, consequentemente, a reduzir o nível de atividade física, é provável que estes tenham maior risco de desenvolver a síndrome da fragilidade, principalmente em idades mais avançadas. Assim, identificar os fatores associados à dispneia em idosos pode ser útil no planejamento da assistência à saúde e no adiamento da fragilidade. Objetivo: Analisar a relação entre o relato de dispneia, condições de saúde e fragilidade em uma amostra de idosos comunitários. Método: tratou-se de uma pesquisa observacional, analítica de corte transversal, que utilizou dados secundários do seguimento do estudo de Fragilidade em Idosos Brasileiros (FIBRA). Com isso, foram analisadas informações de 415 idosos participantes do estudo, realizado nas cidades de Campinas e São Paulo (Distrito de Ermelino Matarazzo). Além dos critérios de inclusão aplicados para o este estudo de seguimento, ou seja, ter participado da primeira onda de coleta de dados e residir na localização geográfica de interesse, foram selecionados também os idosos que pontuaram dentro da nota de corte para a escolaridade no Mini-Exame do Estado Mental e que tivessem respondido à pergunta sobre a presença da dispneia. Para as análises, as seguintes variáveis/escalas do protocolo completo foram selecionadas: sociodemográficas (idade, sexo e escolaridade), relato de dispneia, doenças autorrelatadas, polifarmácia e fenótipo de fragilidade. A associação entre dispneia e as demais variáveis de interesse foi verificada utilizando-se os testes de chi-quadrado de Pearson e de regressão logística. Neste último, calculou-se tanto o odds ratio bruto (b) como o ajustado (a) (idade, sexo e escolaridade). Para todas as análises, o nível de significância adotado foi de 5%. Resultados: A prevalência de dispneia foi de 21,0% na amostra total e de 35,2% entre os frágeis (ORa=2,62). Dentre os componentes do fenótipo de fragilidade, apenas fadiga (ORa = 2,79, p = 0,00) e lentidão da marcha (ORa = 1,89, p = 0,04) apresentaram associação com dispneia. Aqueles com doenças pulmonares (ORa=2,40), cardíacas (ORa=2,05), tumor/câncer (ORa=3,33), depressão (ORa=1,92), multimorbidades (ORa=3,04) e polifarmácia (ORa=2,19) também apresentaram mais chances de ter dispneia. Conclusão: Em idosos residentes na comunidade, a presença da dispneia se associou a diferentes doenças, polifarmácia e fragilidade, mesmo após ajuste para variáveis confundidoras, como idade, sexo e escolaridade. Entre os que relatam dispneia, a fadiga e a lentidão da marcha tiveram maior probabilidade de estarem presentes. O reconhecimento dos fatores associados ao relato de dispneia pode contribuir para a prevenção de desfechos negativos e para o manejo da fragilidade nesta população e, portanto, deve ser foco futuro de estudos envolvendo idosos comunitários.
Title in English
Relationship among dyspnea, health conditions, and frailty in community-dwelling older adults: data from FIBRA study.
Keywords in English
Aged
Dyspnea
Frailty
Health Status
Noncommunicable Diseases
Polypharmacy
Abstract in English
Dyspnea is a symptom present in several chronic diseases that are common among older adults. As individuals with dyspnea tend to adopt rest and, consequently, reduce the level of physical activity, they are likely to be at greater risk of developing frailty, mainly at an older age. Thus, to identify the factors associated with dyspnea in older adults can be useful to the health care planning and to the postponement of frailty. Objective: To analyze the relationship among report of dyspnea, health conditions and frailty phenotype in a sample of community-dwelling older adults. Method: this is an observational, analytical cross-sectional research that used secondary data (second wave) from the Frailty in Brazilian Elderly Study (FIBRA). Data from 415 older adults participants of the second wave of FIBRA study, conducted in the cities of Campinas and São Paulo (Ermelino Matarazzo District), were analyzed. In addition to the inclusion criteria applied to this follow-up study (i.e., having participated in the first wave of data collection and residing in the geographical location of interest), the participants who scored within the cut-off score adjusted for schooling in the Mini-Mental Examination State and, that they had answered the question about the presence of dyspnea were included. For the present study, the following variables/scales were analysed: sociodemographic (age, sex and schooling), report of dyspnea, self-reported diseases, polypharmacy, and frailty phenotype. The association between dyspnea and the other variables of interest was verified using Pearson's chi-square and logistic regression tests. In this, both the crude odds ratio (c) and the adjusted odds ratio (a) (age, sex and education) were calculated. For all analyzes, the significance level was set at 5%. Results: The prevalence of dyspnea was 21.0% in the entire sample and 35.2% in those with frailty (ORa=2.62). Among phenotype components, fatigue (ORa=2.79) and gait slowness (ORa=1.89) showed association with dyspnea. Those with pulmonary diseases (ORa = 2.40), heart disease (ORa=2.05), cancer (ORa=3.33), depression (ORa=1.92), multimorbidities (ORa=3.04), and polypharmacy (ORa = 2.19) were also more likely to have dyspnea. Conclusion: In community-dwelling older adults, dyspnea was associated with different diseases, polypharmacy and frailty. Recognizing the factors associated with the report of dyspnea may contribute to the prevention of negative outcomes and to the management of frailty in this population. In community dwelling older adults, the presence of dyspnea was associated with different diseases, polypharmacy and frailty, even after adjusting for confounding variables, such as age, sex and education. Among those reporting dyspnea, fatigue and slow gait were more likely to be present. The recognition of the factors associated with dyspnea can contribute to the prevention of negative outcomes and to the management of frailty in this population and, therefore, should be a future focus of studies involving community- dwelling older adults.
 
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Publishing Date
2024-04-01
 
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