Relação entre cognição, sintomas depressivos e fragilidade em pessoas idosas

Abstract

In recent years, the population has been experiencing a marked aging process. Understanding the various characteristics of the aging process helps in caring for the elderly population. The functionality of the elderly is directly affected by frailty, which, in turn, is defined as increased vulnerability. Studies show that cognitive disability and physical frailty have a significant association between them. Therefore, this research aims to evaluate the cognitive factors and depressive symptoms associated with frailty and loss of autonomy in elderly people treated at a geriatrics outpatient clinic of a highly complex tertiary care hospital. The study is characterized as a cross-sectional observational study with a quantitative and qualitative approach. The research is part of a larger project entitled “Risk factors for the development of frailty in the elderly” and has CEP opinion number 5,572,399. Statistical analysis of the data was performed using the SPSS Program (Statistics Package for the Social Sciences) version 22.0. Clinical and sociodemographic data are described by absolute (N) and relative (%) frequency. Tests were also performed for analysis of trends and association between categorical variables using Pearson's chi-square test. Tests were performed to verify associations between scores on the frailty scale, related to the cognition and depression scales. For all analyses, p<0.05 was used as a reference. The study sample consisted of medical records of 36 elderly patients treated at the Geriatrics outpatient clinic. In view of the sociodemographic profile of the population studied, the predominance of males should be highlighted, with the majority aged between 70 and 79 years, with low education, most with incomplete primary school, followed by illiterates. The sample, for the most part, did not have cognitive complaints and did not use drugs related to dementia. As for the use of medication for depressive symptoms and other mood disorders, most of the sample used them. There was a predominance of elderly people considered pre-frail, followed by frail. When analyzing the cognitive scales, most of the sample presented scores below the expected scores. It was also found that there is an association between the Frail Scale and the Semantic Verbal Fluency Test, the Clock Drawing Test and the Brief Battery of Cognitive Screening, in the areas of Immediate Memory and Late Memory. It is worth mentioning that there was no association between the Frail scale and the presence of depressive symptoms, assessed by the Geriatic Depression Scale - 15. An integrative review was also carried out in order to identify the cognitive assessments most used during the diagnosis of cognitive frailty, which include: Mini Mental State Examination, Digit Span and Montreal Cognitive Assessment. The results presented brought important data and associations regarding frailty and cognitive impairment in the elderly. It is hoped that these data will contribute to the development of scales that address cognitive frailty and specific care for the elderly population, in order to direct, improve and qualify the care offered by health professionals, aiming at aging with autonomy, independence and quality of life.