Evaluarea complexă a sindromului de fragilitate la vârstnicii din instituţiile medico-sanitaro publice şi azil

Abstract

Introducere. Procesul de îmbătrânire antrenează o serie de schimbări fiziologice de vârstă şi fiziopatologice, inclusiv sindroamele geriatrice, aşa ca fragilitatea (SF), care se caracterizează printr-o scădere a funcţionalităţii însoţită de creşterea vulnerabilităţii. Scopul lucrării. Evaluarea particularităţilor clinice şi paraclinice a sindromului de fragilitate la vârstnici. Material şi metode. Studiul de tip descriptiv a inclus 613 vârstnici (72,76±0,26 ani), cu vârsta > 65 ani, evaluaţi conform examinării clinice, evaluării geriatrice complexe (EGC) - Katz, Lawton, Tinetti, MMSE, Hamilton, screening SF - Criterii Fried, severitatea sindromului - prin CFS, SPPB, Indexul de comorbiditate Charlson (CCI), precum şi investigaţii de laborator. Rezultatele au fost analizate în Soft Statistica 7. Rezultate. Datele studiului au relevat următoarele rezultate, conform criteriilor screening SF - vârstnici fragili - 47,53%, vârstnici pre-fragili - 29,39%, vârstnici robuşti - 23,07%; conform EGC - Katz - 10,50±0,09, Lawton -12,70±0,16, Tinetti - 20,62±0,27, MMSE - 25,14±0,16, CCI - 4,22±0,08, SPPB - 7,77±0,14 puncte. în lotul general a prevalat patologia cardiovasculară - 96,25%, osteoarticulară - 74,25% şi digestivă - 41,61%. Din parametrii de laborator examinaţi: albumina serica - valoare minimă 23 g/1, creatin- kinaza - max. 347 U/L, 25-OH-Vitamina D valoarea min. 4,98 ng/ml, parathormon max. 229 pg/ml, PCR înalt sensibila - 0,27-12,9 mg/L, ceea ce a raportat cauze cardiovasculare la vârstnicii chestionaţi. Conform CFS - fragili sever, fragili foarte sever şi stare terminală au fost 11 cazuri, vârstnicii au prezentat diverse grade de severitate a sindromului de fragilitate. Concluzii. Rezultatele studiului dezvăluie statutul funcţional ca fiind unul dintre cele mai afectate aspecte pe fundalul condiţiei fizice alterate, cum ar fi sindromul de fragilitate.

Background. The aging process induces a series of age-related physiological and pathophysiological changes, including geriatric syndromes such as frailty (FS), which is characterized by a decrease of functionality accompanied by an increase of vulnerability. Purpose of the study. Evaluation of clinical and paraclinical particularities of frailty syndrome in the elderly. Material and methods. The descriptive study included 613 elderly (72.76±0.26 years), aged >65 years, evaluated according to clinical examination, complex geriatric assessment (EGC) - Katz, Lawton, Tinetti, MMSE, Hamilton, SF screening - Fried criteria, severity of the syndrome - by CFS, SPPB, Charlson Comorbidity Index (CCI), as well as laboratory investigations. The results were analyzed in Soft Statistica 7. Results. The study data revealed the following results, according to SF screening criteria - frail elderly - 47.53%, pre-frail elderly - 29.39%, robust elderly - 23.07%; according to EGC - Katz - 10.50±0.09, Lawton - 12.70±0.16, Tinetti - 20.62±0.27, MMSE - 25.14±0.16, CCI - 4.22±0.08, SPPB - 7.77±0.14 points. In the general group, cardiovascular pathology prevailed - 96.25%, osteoarticu- lar - 74.25% and digestive - 41.61%. From the laboratory parameters examined: serum albumin - minimum value 23 g/1, creatinekinase - max. 347 U/L, 25-OH-Vitamin D value min. 4.98 ng/ml, parathormone max. 229 pg/ml, high-sensi- tivity PCR - 0.27-12.9 mg/L, which reported cardiovascular causes in the elderly surveyed. According to CFS - severely frail, very severely frail and terminal condition there were 11 cases, the elderly presented various degrees of severity of the frailty syndrome. Conclusions. The results of the study reveal the functional status as one of the most affected aspects against the background of the altered physical condition, such as the frailty syndrome.