Multidimensionality of vulnerability in older adults: critical synthesis of Brazilian evidence based on a scoping review

Abstract

Vulnerability in older adults has become a central theme in Brazilian geriatrics, especially considering the growing interest in tools that enable early identification of clinical, functional, and social risks. This review aims to identify and analyze the factors associated with vulnerability in older adults in Brazil. This is a scoping review, conducted according to the recommendations of the Joanna Briggs Institute and the PRISMA guidelines. Searches were conducted in the PubMed, Scopus, Web of Science, SciELO, and LILACS databases, as well as in gray literature, including studies published between 2020 and 2025. Nine studies were identified that comprised the final sample, with a predominance of cross-sectional designs and samples ranging from 31 to 653 participants. The most used instruments were the Clinical-Functional Vulnerability Index, the Edmonton Frailty Scale, and the Vulnerable Elders Survey. The prevalence of vulnerability or frailty ranged from 19.5% to 74.3%. The most frequently associated factors included age 80 years or older, polypharmacy, comorbidities, falls, recent hospitalizations, functional dependence, cognitive impairment, depressive symptoms, negative self-perception of health, low education, lower income, nutritional changes, and oral health limitations. Vulnerability in older adults in Brazil is multifactorial and multidimensional, influenced by clinical, functional, psychological, and socioeconomic conditions.