Prevalence and determinants of frailty in older adult patients with chronic coronary syndrome: a cross-sectional study

Abstract

Background Frailty is an expression of vulnerability and decline of physical, mental, and social activities, more commonly found in older adults. It is also closely related to the occurrence and poor prognosis of coronary artery disease (CAD). Little investigation has been conducted on the prevalence and determinants of frailty in older adult patients with chronic coronary syndrome (CCS). Methods A cross-sectional study was conducted, simple random sampling was used in this study. 218 older adults (age ≥ 60 years) with CCS with an inpatient admission number ending in 6 were randomly selected who hospitalized in Department of Geriatric Cardiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, China, between January and December 2018. For measurement and assessment, we used the 5-item FRAIL scale (fatigue, resistance, ambulation, illnesses, and loss of weight), demographic characteristics, Barthel Index(BI), Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS-15), Mini Nutrition Assessment Shor-Form (MNA-SF), Morse Fall Scale (MFS), Caprini risk assessment, polypharmacy, and Numerical Rating Scale (NRS). Multivariate logistic regression analysis was used to confirme determinants. Results The FRAIL scale showed 30.3% of the subjects suffered from frailty. Determinants were aging (OR1.12; 95% CI 1.04 ~ 1.62), out-of-pocket (OR18.93; 95% CI 1.11 ~ 324.07), hearing dysfunction (OR9.43; 95% CI 1.61 ~ 55.21), MNA-SF score (OR0.71; CI 0.57 ~ 0.89), GDS-15 score (OR1.35; 95% CI 1.11 ~ 1.64), and Caprini score (OR1.34; 95% CI 1.06 ~ 1.70). Conclusions The FRAIL scale confirmed that the prevalence of frailty in patients with CCS was slightly lower than CAD. Aging, malnutrition, hearing dysfunction, depression, and VTE risk were significantly associated with frail for older adult patients with CCS. A comprehensive assessment of high-risk patients can help identify determinants for frailty progression. In the context of CCS, efforts to identify frailty are needed, as are interventions to limit or reverse frailty status in older CCS patients.

A relationship among the blood serum levels of interleukin‐6, albumin, and 25‐hydroxyvitamin D and frailty in elderly patients with chronic coronary syndrome

“…Our results showed that the prevalence of frailty among the studied elderly patients in China with CCS was 37.5%, thus suggesting that the prevalence of frailty was higher in elderly patients with CCS. Certain confirmation for our results comes from a cross‐sectional study in Eastern China 23 where the prevalence of frailty in 208 elderly patients (≥60 years old) with CCS was 30.3%. This estimation was slightly lower than our results; we consider that the difference in the frailty assessment tools and the regional differences between Eastern and Western China could be a possible explanation for this difference.…”

Frailty Syndrome in Older Adults with Cardiovascular Diseases–What Do We Know and What Requires Further Research?

“…There is a strong intersection of FS and coronary artery disease (CAD) [ 20 , 21 , 57 ]. For example, the Women’s Health Initiative Study showed that women with CAD are more likely to develop de novo FS within six years than women without CAD [ 57 ].…”

“…For example, the Women’s Health Initiative Study showed that women with CAD are more likely to develop de novo FS within six years than women without CAD [ 57 ]. Lyu et al reported that the prevalence of FS in patients with chronic coronary syndrome was about 30%, and age, malnutrition, hearing dysfunction, depression, and venous thromboembolism risk were significantly associated with FS [ 20 ]. Moreover, about half of patients with non-ST-elevation myocardial infarction have FS, which is associated with an increased risk of recurrent myocardial infarction, revascularization, hospitalization, bleeding, stroke, dialysis, and mortality, compared to patients without FS [ 22 ].…”

“…Determining the best and optimal methods to identify frailty to develop individualized models of care [ 2 ], as well as develop interventions to reduce or reverse frailty status [ 20 , 54 ];…”

“…Comprehensive evaluation of high-risk patients to identify determinants of frailty progression [ 20 ];…”