Análise da relação de fatores biopsicossociais e os desfechos clínicos de hospitalização e óbito de idosos: segunda onda do estudo FIBRA-JF

Abstract

Due to the physiological changes that occur during aging, the elderly are more likely to develop chronic pathological conditions, largely responsible for the clinical outcomes of hospitalization and death in these individuals. However, these outcomes seem to be influenced not only by biological and physiological aspects, but also by psychosocial variables. The objective of this longitudinal study was to analyze the relationship between biopsychosocial factors and clinical outcomes of hospitalization and death in the elderly assessed by the first wave of the FIBRA-JF study. The sample of the present study was differentiated according to each of the proposed secondary objectives. Regarding death, 340 elderly were analyzed from the information collected in the first wave. Data analysis was performed using an adjusted logistic regression model, using the Stepwise method to select variables. Subsequently, the odds ratios (OR) were calculated with the 95% probability confidence intervals. In the hospitalization study, 122 subjects were investigated. Variables obtained in the first wave were used, together with the addition of two scales applied exclusively in this wave two. Data analysis in this outcome was performed on an exploratory basis, using a univariate model to verify the association between each of the independent variables and hospitalization. This verification was performed using Pearson's chi-square for categorical variables and independent t-test for numerical variables. Given the aspects analyzed, it was found that age, income, being responsible for family support, frailty, diabetes, subjective health perception, cognitive performance and depression were relevant in the model that best described the death of the elderly. Regarding hospitalization, number of medications used, number of medical appointments in the last year and factors related to the functional capacity of the elderly were associated with this event. From the results found, it is possible to highlight the multidimensionality of factors that may influence the experience of the main clinical outcomes of old age. In this sense, special attention should be given to psychosocial aspects. As future perspectives, it is expected that other longitudinal cohort and epidemiological studies will be carried out, so that health actions and strategies can be established to reduce risks and provide greater longevity and quality of life for this population.