Avaliação da vulnerabilidade em saúde e cognição em idosos da atenção primária à saúde: uma proposta de implementação de manual para aplicação

Abstract

Introduction: the elderly population growth creates new challenges for the health public policies. The aging is associated by important physiological changes, which may cause cognitive and function incapacibilities. Objectives: to estimate the prevalence of vulnerability in health of the elderly population's assisted by the family health teams of the primary health care of the southern health region of the Federal District; analyzing the association between the functional and cognitive decline of an elderly person; to correlate the main comorbidities, the amount of medicines used and the vulnerability in health; training the communitarian health agents for the pplicability at the questionary's residence ' Vulnerable Elders Survey (VES-13)' e '10 point cognitive screener (10-CS Edu)'; to create an explicative manual for the utilization of the questionaries by the APS' professionals. Method: two products were proposed: 1- Article: cross-sectional, of populational based with the quantitative approach, realized on residences of the comprehensiveness area of the family's health teams of Gama in Distrito Federal, at the March to November period of 2018. 2- Guide: this is a synthesized tutorial for the application of VES-13 and 10-CS Edu, elaborated based on the practical application of the questionnaires after the data collection. Results: the final sample was constituted by 311 elderly people. The prevalence of the vulnerability in health was 38%. It was observed significant association between the vulnerability in health and the conjugal state (p=0.039), the schooling (0.001), comorbidities (p=0.018) and polypharmacy (p=0.002). The factors associated to the most vulnerability in health were: lowest score on 10-CS Edu, utilization of 5 more medicines and higher age. Developed products: article entitled “Evaluation of health vulnerability and cognition in elderly in primary health care” and the guide entitled "Evaluation of the functional and cognitive capacity on elderly of the primary health care: Guide of orientation for the application of VES-13 e 10-CS Edu". Conclusion: The study demonstrated a high prevalence of vulnerability in health in the elderly population of the community. The outcomes demonstrated that the vulnerability in health is associated on the cognitive decline, however other studies must be realized to verify if the cognitive interventions may diminish the vulnerability in health. The application manual of vulnerability in health assessment tools and cognition developed to guide health professionals will contribute to better health care for the elderly.