Estudo de comorbidades em residentes de uma instituição de longa permanência para idosos, de Ponta Grossa – Paraná: relação pressão intracraniana, um possível novo sinal vital

Abstract

The elderly population has increased in Brazil and worldwide; thus, diseases and physiological changes related to aging become increasingly common. Loss of different functions is frequent in the elderly, which results in major geriatric syndromes: cognitive disability, postural instability, immobility and communicative disability. Several authors have sought to reduce the progression of diseases in the elderly and some of them suggest the possibility that some diseases may have their development related to high intracranial pressure (ICP). However, little has been confirmed about this due to the invasiveness of the techniques currently used to assess ICP. Therefore, the objective of this study was to evaluate the comorbidities of residents at the Long-Term Care Facility for the Elderly (LTCFE) in the city of Ponta Grossa - Paraná and to verify if there is a relationship between them and the PIC. The ICP monitoring was carried out using the brain4care® Methodology - in which a non-invasive sensor is placed in contact with the scalp in the parietal region, avoiding discomfort and complications for the volunteer, reducing risks and facilitating further studies of this parameter. The PIC of 91 volunteers - men and women between 56 and 97 years old - was monitored for 5 minutes and the data were treated in brain4care® Analytics software, defining the mean amplitude for the P1 and P2 peaks (morphological analysis of the PIC; reason P2/P1). The data obtained from medical records, as well as the clinical and laboratory data were tabulated and the prevalence of each of the changes or diseases was calculated, as well as the mean and standard deviation for the values of P1, P2 and laboratory data. After the results obtained, statistical analysis was performed with significance defined at p <0.05. There was a high prevalence of changes in ICP among the elderly in the LTCFE (89%), which may indicate this parameter as a new vital sign to be monitored. Other morbidities were highly prevalent, especially arterial hypertension (50%), depression (27%), diabetes (24%) and dementia (14%). Polypharmacy was a condition observed for most of the elderly. The changes in ICP may be related to the polytherapy practiced, but the effects of different drugs on ICP need to be better studied. Thus, the ICP seems to be an important parameter for the clinical evaluation of the elderly and its use is suggested as a new vital sign to be monitored.