# Clinical-Functional Vulnerability of Older Adults in Primary Care in a Brazilian Municipality: Associated Factors

## TL;DR

This study examines factors linked to health vulnerability in older adults in Brazil, finding that low income, poor nutrition, and low health literacy are significant contributors.

## Contribution

The study identifies specific socioeconomic and health-related factors associated with clinical-functional vulnerability in older adults within primary care settings in Brazil.

## Key findings

- Lower income, poor chewing, malnutrition risk, and low health literacy were significantly associated with clinical-functional vulnerability.
- Approximately 44% of participants were at moderate or high risk of clinical-functional vulnerability.
- Targeted interventions in primary health care could help prevent or delay frailty progression in older adults.

## Abstract

Objective: The objective of this study was to assess clinical-functional vulnerability (CFV) and associated factors in community-dwelling older adults treated in primary care. Methods: A cross-sectional study was conducted with non-institutionalized elderly individuals ≥60 years randomly selected from five Health Units in Jundiaí/SP, Brazil, in 2023. Sociodemographic data, health behaviors, and data on oral health (number of teeth; chewing: good/fair/poor), cognitive function (10-CS), nutritional status (MNA), health literacy (HLS-14), sarcopenia (SARC-F+CC) and frailty (IVCF-20) were collected. Descriptive and bivariate analyses between the outcome (CFV) and the independent variables were performed using the chi-squared test and binary logistic regression models (p < 0.05). Results: A total of 211 older adults participated in this study; 72% were female and the mean age was 70.41 years (±7.45). Regarding CFV, a high risk was identified in 9.5% of the participants (n = 19), a moderate risk in 34.6% (n = 73), and a low risk in 55.9% (n = 118). After adjusting the regression model, the following variables were associated with CFV: lower income (OR = 1.90; 95%CI: 1.02–3.55), poor (OR = 5.18; 95%CI: 2.13–12.63) and fair (OR = 2.36; 95%CI: 1.10–5.05) chewing, risk of malnutrition or malnourished (OR = 2.36; 95%CI: 1.23–5.52), and low literacy (OR = 1.86; 95%CI: 1.09–3.45). Conclusion: Socioeconomic factors, nutritional status (underweight or malnourished), poor or fair chewing, and low health literacy were associated with CFV among older people. Strengthening primary health care through targeted interventions may help prevent frailty or delay its progression. Understanding the predictors of frailty can guide health professionals, managers, and researchers in designing preventive and health promotion strategies, as well as public policies within Primary Health Care.