Perfil da pessoa idosa internada em um hospital universitário

Abstract

Due to the disease profile, older people exhibit a high rate of disability and increased use of health services, resulting in elevated system costs. Hospitalization of older people is an essential resource in healthcare, but it may be associated with a loss of functional capacity, increased frailty, and cognitive decline. Multidimensional and interdisciplinary strategies are necessary to optimize care during hospitalization and facilitate the transition back home. Objective: To characterize the sociodemographic and clinical profile of hospitalized older people and to examine the association between health demands, cognition, functionality, and depression according to age group. Method: This quantitative, cross-sectional study was conducted with individuals aged 60 years or older who were hospitalized in the adult/older people medical clinic unit at the University Hospital of the Federal University of São Carlos. Data were collected using a protocol that included sociodemographic characterization and health data, evaluation of cognitive performance using the 10-Point Cognitive Screener (10- CS), assessment of dependence in basic activities of daily living (BADL) using the Katz Scale, evaluation of dependence in instrumental activities of daily living (IADL) using the Lawton & Brody Scale, and assessment of depressive symptoms using the Geriatric Depression Scale (GDS). A Poisson regression model with robust variance was used to analyze the association between age group and the Katz, Lawton & Brody, and 10-CS scales (recategorized into binary form), while Fisher’s Exact Test was employed to analyze associations between multimorbidity, polypharmacy, and the presence of depressive symptoms, as well as the association between age group and the three response levels of the evaluation scales (10-CS, Katz, and Lawton & Brody), with a significance level of 5% (p ≤ 0.05) and a 95% confidence interval. Results: The sample comprised 51 participants with a mean age of 73.7 years (±9.7), of whom 56.9% were women. There was a predominance of older people who were married or living with a partner, white, and retired, with an average of 7.35 (±4.5) years of schooling. The presence of five or more comorbidities was identified in 60.8% of the sample, and polypharmacy was present in 67.2%, with an average of 5.5 medications taken daily. Regarding hospitalization, the main complaint was dyspnea (21.6%), with respiratory diseases being the primary reason for hospitalization (33.3%) and unspecified pneumonia the main diagnosis (21.6%). A significant association was found between age and cognitive function (p = 0.02), BADL (p < 0.01), and IADL (p = 0.03), while no significant association was observed between multimorbidity, polypharmacy, and depressive symptoms. Conclusion: The identified profile is characterized by a predominance of older people, mostly white and female, with low educational attainment, who live with a partner and exhibit a high prevalence of multimorbidity and polypharmacy. In the vast majority of individuals, a probable cognitive deficit was observed, alongside the absence of depressive symptoms, maintenance of autonomy in basic activities of daily living, and partial dependence in instrumental activities. The associations between the degree of dependence and cognitive decline underscore the need for recurrent assessments and the implementation of protocols during hospitalization, aiming to maintain functionality and prevent cognitive decline. This profile supports the establishment of indicators and the development of strategies for the proper management of chronic comorbidities, physical frailty, risk of delirium, and the potential loss of functionality frequently associated with the hospitalization of older people.