Association Between Chronic Diseases and Frailty in a Sample of Older Greek Inpatients

Abstract

Introduction: Previous reports have associated frailty with the existence of various chronic diseases. Especially for cardiovascular diseases, this relationship seems to be bidirectional as common pathophysiological mechanisms lead to the progression of both diseases and frailty. The study aimed to examine the relationship between chronic diseases and frailty in a sample of older Greek inpatients Methodology: In 457 consecutively admitted older patients (226, 49.5% females), the median age was 82 years (interquartile range [IQR] 75-89), and demographic factors, medical history, cause of admission, and the degree of frailty assessed with the Clinical Frailty Scale were recorded. The level of frailty was calculated for the pre-hospital status of the patients. Parametric tests and logistic regression analysis were applied to identify diseases independently associated with frailty. Results: Using the scale, 277 patients (60.6%) were classified as frail and 180 as non-frail (39.4%). In univariate analysis, frail patients were more likely to have respiratory disease, dementia, Parkinson's disease, chronic kidney disease (CKD), atrial fibrillation (AFIB), neoplastic disease, depression, stroke, heart failure (HF), and coronary artery disease. In binomial regression analysis, the diseases that were statistically significantly associated with frailty were respiratory diseases ( P = 0.009, odds ratio [OR] = 2.081, 95% confidence interval [CI] 1.198-3.615), dementia ( P ≤ 0.001, OR = 20.326, 95% CI 8.354-49.459), Parkinson's disease ( P = 0.049, OR = 3.920, 95% CI 1.005-15.295), CKD ( P = 0.018, OR = 2.542, 95% CI 1.172-5.512), AFIB ( P = 0.017, OR = 1.863, 95% CI 1.118-3.103), HF ( P = 0.002, OR = 2.411, 95% CI 1.389-4.185), and coronary artery disease ( P = 0.004, OR = 2.434, 95% CI 1.324-4.475). Conclusions: Among diseases independently associated with frailty, chronic diseases such as respiratory diseases, dementia, Parkinson's disease, CKD, and cardiovascular diseases (AFIB, HF, and coronary heart disease) have an important role. Recognizing the diseases that are highly related to frailty may contribute, by their optimal management, to delaying the progression or even reversing frailty in a large proportion of the elderly.