Abstract
BackgroundFrailty 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).MethodsA 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.ResultsThe 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).ConclusionsThe 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.
Highlights
Frailty is an expression of vulnerability and decline of physical, mental, and social activities, more commonly found in older adults
Frailty in patients with chronic coronary syndrome (CCS) In this study, we identified 30.3 and 69.7% of 218 CCS patients with and without frailty according to the FRAIL scale, respectively
This study showed that aging, out-of-pocket, hearing dysfunction, lower Mini Nutrition Assessment Shor-Form (MNA-SF) score, higher GDS-15 score, and higher Caprini score significantly increased the riskof frailty in CCS patients by multiple logistic regression analysis
Summary
Frailty is an expression of vulnerability and decline of physical, mental, and social activities, more commonly found in older adults. Little investigation has been conducted on the prevalence and determinants of frailty in older adult patients with chronic coronary syndrome (CCS). Coronary artery disease (CAD) is a major cause of morbidity and mortality worldwide. Chronic coronary syndrome (CCS) is defined by the different evolutionary stages of CAD [1] but does not include cases with clinical manifestations dominated by acute coronary syndrome (ACS). It emphasizes that the stability of nonacute coronary heart disease is only relative, and there is a risk of progression to ACS at any time, which leads to cardiovascular events [2]. Physical, psychological and other factors are the traditional risk factors of frailty [8]
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