The simultaneous occurrence of cognitive decline and physical frailty, defined as cognitive frailty, is indicated as a risk factor for adverse health outcomes, such as occurrence of hospitalizations, decline in functionality and death. At the same time, care stress and burden have been shown as risk factors for such outcomes in caregivers. There is no evidence that conditions, cognitive fragility and stress /burden, have additive effects on outcomes. Thus, the purpose of this study is to analyze the cumulative effects of the cognitive frailty and the stress/burden of older caregiver on outcomes in a four-year follow-up. This research project was proposed due the first data collection (baseline) carried out in 2014 under the Family Health Program of São Carlos, located in the central-western region of the interior of the State of São Paulo. The study comprised the broad geriatric-gerontological evaluation of 702 participants, including 351 caregivers and their 351 elderly care recipients (non-caregivers). At baseline, global cognitive function and specific cognitive functions (ACE-R battery), physical frailty (five criteria of the Fried's phenotype) and the psychological and emotional well-being related to care (Perceived Stress Scale, Zarit Burden Interview) were assessed variables. In addition, the overall health status and the context of care were measured. Cognitive frailty was defined as the concomitant presence of cognitive decline and physical frailty in participants assessed at baseline. Data on the outcomes will be collected in the year 2018 and comprise home visits for the collection of death information, causes and date and occurrence of hospitalizations and falls in the last year for surviving participants, as well the functional assessment by combined Katz Index and Scale of Lawton and Brody. Transversal and longitudinal analyzes will be conducted using logistic regressions for associations between cognitive frailty and stress /burden and the occurrence of hospitalization, falls and functional decline after four years. Death rates will be calculated and Cox regression models will be constructed to test the cumulative effects of baseline variables as risk factors for all-cause mortality.
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