File
Yang M-T1, Wu Y-W2, Chan D-C3, Tsauo J-Y1,4, Chien M-Y1
1National Taiwan University, School and Graduate Institute of Physical Therapy, Taipei, Taiwan, 2National Taiwan University Hospital, Department of Internal Medicine, Taipei, Taiwan, 3National Taiwan University Hospital Chu-Tung Branch, Hsinchu, Taiwan, 4National Taiwan University Hospital, Physical Therapy Center, Taipei, Taiwan
Background: Atrial fibrillation (AF) is one of the most common arrhythmias. Previous studies have suggested that there were deleterious effects of AF on elderly, including decreased cognitive function, independence, and increased rate of frailty. However, few studies focused on the relationship between AF and frailty in community-dwelling elderly.
Purpose: The purpose of the study was to investigate the relationship between AF and frailty in community-dwelling elderly.
Methods: This was a cross-sectional study design. Elderly ≥ 65 years old were recruited from National Taiwan University Hospital and communities in Taipei. Elderly with following diseases were excluded: neuromuscular diseases, diseases affecting balance, heart failure, and other arrhythmias. The elderly with AF were confirmed by electrocardiogram recordings or medical diagnosis. Frailty assessments were using both Cardiovascular Health Study (CHS) frailty phenotype and Edmonton Frail Scale (EFS). Both US and Taiwan criteria were used to identified CHS frailty. Physical function assessments included grip strength, walking speed, and timed up and go test. The statistical analyses included independent t test, chi square analysis, and multiple logistic regression. The α level was set at 0.05.
Results: The study included 207 community-dwelling elderly, 38 of them were patients with AF. Compared with regular heart rhythm (RHR) group, there was a significant higher percentage of non-robust elderly in AF group, either by Taiwan (50% vs 24%, p = 0.001) and US (69% vs. 37%, p 0.001) criteria. In EFS, significantly higher percentages in making mistake in the cognitive test (39% vs 25%, p = 0.006), been admitted to hospital (26% vs 9%, p = 0.014) and usage of ≥ 5 different medications (42% vs 17%, p = 0.001) were shown in AF group. In addition, there were significant differences in grip strength of male subjects (26.76 ± 8.25 vs 32.96 ± 6.85 kilograms, p = 0.006), walking speed (1.05 ± 0.25 vs 1.19 ± 0.25 meter/second, p = 0.003), and timed up and go test (8.82 ± 2.44 vs 7.04 ± 1.94 seconds, p 0.001) between groups. The multiple logistic regression model showed that AF was an independent predictor for non-robust community-dwelling elderly (odds ratio: 3.84, 95% confidence interval: 1.81 - 8.14, p 0.001).
Conclusion(s): There were significant differences of frailty status and physical function between patients with AF and without AF. In addition, AF was an independent predictor of non-robust community-dwelling elderly.
Implications: Our results indicated that there were deleterious effects of AF on frailty status and physical function in community-dwelling elderly without severe complications. It suggested that regular examination of frailty status in elderly with AF should be incorporated in clinical practice for prevention and early intervention for frailty.
Keywords: Atrial fibrillation, Frailty, Physical function
Funding acknowledgements: Unfunded.
Purpose: The purpose of the study was to investigate the relationship between AF and frailty in community-dwelling elderly.
Methods: This was a cross-sectional study design. Elderly ≥ 65 years old were recruited from National Taiwan University Hospital and communities in Taipei. Elderly with following diseases were excluded: neuromuscular diseases, diseases affecting balance, heart failure, and other arrhythmias. The elderly with AF were confirmed by electrocardiogram recordings or medical diagnosis. Frailty assessments were using both Cardiovascular Health Study (CHS) frailty phenotype and Edmonton Frail Scale (EFS). Both US and Taiwan criteria were used to identified CHS frailty. Physical function assessments included grip strength, walking speed, and timed up and go test. The statistical analyses included independent t test, chi square analysis, and multiple logistic regression. The α level was set at 0.05.
Results: The study included 207 community-dwelling elderly, 38 of them were patients with AF. Compared with regular heart rhythm (RHR) group, there was a significant higher percentage of non-robust elderly in AF group, either by Taiwan (50% vs 24%, p = 0.001) and US (69% vs. 37%, p 0.001) criteria. In EFS, significantly higher percentages in making mistake in the cognitive test (39% vs 25%, p = 0.006), been admitted to hospital (26% vs 9%, p = 0.014) and usage of ≥ 5 different medications (42% vs 17%, p = 0.001) were shown in AF group. In addition, there were significant differences in grip strength of male subjects (26.76 ± 8.25 vs 32.96 ± 6.85 kilograms, p = 0.006), walking speed (1.05 ± 0.25 vs 1.19 ± 0.25 meter/second, p = 0.003), and timed up and go test (8.82 ± 2.44 vs 7.04 ± 1.94 seconds, p 0.001) between groups. The multiple logistic regression model showed that AF was an independent predictor for non-robust community-dwelling elderly (odds ratio: 3.84, 95% confidence interval: 1.81 - 8.14, p 0.001).
Conclusion(s): There were significant differences of frailty status and physical function between patients with AF and without AF. In addition, AF was an independent predictor of non-robust community-dwelling elderly.
Implications: Our results indicated that there were deleterious effects of AF on frailty status and physical function in community-dwelling elderly without severe complications. It suggested that regular examination of frailty status in elderly with AF should be incorporated in clinical practice for prevention and early intervention for frailty.
Keywords: Atrial fibrillation, Frailty, Physical function
Funding acknowledgements: Unfunded.
Topic: Cardiorespiratory; Older people; Health promotion & wellbeing/healthy ageing
Ethics approval required: Yes
Institution: National Taiwan University Hospital
Ethics committee: Research Ethics Committee
Ethics number: 201711083RIND / NCT03420326
All authors, affiliations and abstracts have been published as submitted.
