AUTOCUIDADO E FRAGILIDADE EM ADULTOS DE MEIA-IDADE E PESSOAS IDOSAS

Abstract

Population aging has been a reality in developed countries for decades and is related to changes in the epidemiological profile. Frailty syndrome is a complex condition that associates senescence factors with a gradual decline in biological systems. Frailty may be related to a reduced capacity for self-care. This work aims to longitudinally evaluate the relationships between self-care and frailty in middle-aged and older adults registered in Family Health Units (USF) in the city of Três Lagoas/MS. The project was approved by the ethics committee. The dissertation is structured into two articles. Both were quantitative, analytical and with a longitudinal design, with the first data collection carried out in 2018/2019 and the second in 2021. The first article aimed to evaluate the sociodemographic and health factors related to the worsening and improvement of frailty in middle-aged and older adults over a two-year period, before and during the COVID-19 pandemic. It was carried out with 200 individuals aged 45 years or over. Data collection included sociodemographic and health characterization and assessment of frailty using the self-reported instrument. The sample was predominantly composed of women, aged 60 to 74 years, with low education, physically inactive and with depressive symptoms. In the frailty assessment, 58.5% of participants emained in the same category, 23.5% improved and 18.0% worsened after two years. There was an association between worsening frailty and an increase in the number of medications in use. The improvement in frailty was related to younger age. The second article aimed to evaluate whether pre-frail or frail middle-aged and older adults have worse self-care over a two-year period. The sample includes 197 individuals aged 45 or over, assessed based on sociodemographic data, self-reported frailty instrument and Self-Care Capacity Assessment Scale (ASAS-R). The sample was mostly female, aged 60 to 74, with low education and frail. There was no significant association between the self-care outcome and frailty assessed two years earlier. It is concluded that frailty is a reversible condition, especially in younger older adults; and that the increase in the number of medications in use is associated with worsening frailty. Furthermore, the promotion of self-care is highlighted as an important factor in maintaining quality of life and longevity among frail or non-frail patients, with a view to preserving independence.