Skip to main content
Top
Published in: BMC Geriatrics 1/2021

Open Access 01-12-2021 | Research

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

Authors: Hong Lyu, Chuanxia Wang, Hong Jiang, Ping Wang, Jingjing Cui

Published in: BMC Geriatrics | Issue 1/2021

Login to get access

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.
Literature
1.
go back to reference Knuuti J, Wijns W, Saraste A, et al. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J. 2020;41(3):407–77.PubMedCrossRef Knuuti J, Wijns W, Saraste A, et al. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J. 2020;41(3):407–77.PubMedCrossRef
2.
go back to reference Steg P-G, Bhatt D-L, Wilson P-W, et al. One-year cardiovascular event rates in outpatients with atherothrombosis. JAMA. 2007;297(11):1197–206.PubMedCrossRef Steg P-G, Bhatt D-L, Wilson P-W, et al. One-year cardiovascular event rates in outpatients with atherothrombosis. JAMA. 2007;297(11):1197–206.PubMedCrossRef
3.
go back to reference Mozaffarian D, Benjamin E-J, Go A-S, et al. Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. Circulation. 2016;133(4):e38–e360.PubMed Mozaffarian D, Benjamin E-J, Go A-S, et al. Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. Circulation. 2016;133(4):e38–e360.PubMed
4.
go back to reference Yang F, Chen Q-W. Evaluation of frailty and influencing factors in old people in hospital institution: Evidence for a phenotype of frailty. Medicine (Baltimore). 2018;97(3):e9634.CrossRef Yang F, Chen Q-W. Evaluation of frailty and influencing factors in old people in hospital institution: Evidence for a phenotype of frailty. Medicine (Baltimore). 2018;97(3):e9634.CrossRef
5.
go back to reference Fried L-P, Tangen C-M, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146–56.PubMedCrossRef Fried L-P, Tangen C-M, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146–56.PubMedCrossRef
6.
go back to reference Kanwar A, Singh M, Lennon R, et al. Frailty and health-related quality of life among residents of long-term care facilities. J Aging Health. 2013;25(5):792–802.PubMedPubMedCentralCrossRef Kanwar A, Singh M, Lennon R, et al. Frailty and health-related quality of life among residents of long-term care facilities. J Aging Health. 2013;25(5):792–802.PubMedPubMedCentralCrossRef
7.
go back to reference Damluji A-A, Chung S-E, Xue Q-L, et al. Physical Frailty Phenotype and the Development of Geriatric Syndromes in Older Adults with Coronary Heart Disease. Am J Med. 2021;134(5):662–71.PubMedCrossRef Damluji A-A, Chung S-E, Xue Q-L, et al. Physical Frailty Phenotype and the Development of Geriatric Syndromes in Older Adults with Coronary Heart Disease. Am J Med. 2021;134(5):662–71.PubMedCrossRef
8.
go back to reference Feng Z, Lugtenberg M, Franse C, et al. Risk factors and protective factors associated with incident or increase of frailty among community-dwelling older adults: A systematic review of longitudinal studies. PLoS One. 2017;12(6):e178383. Feng Z, Lugtenberg M, Franse C, et al. Risk factors and protective factors associated with incident or increase of frailty among community-dwelling older adults: A systematic review of longitudinal studies. PLoS One. 2017;12(6):e178383.
9.
go back to reference Ekerstad N, Swahn E, Janzon M, et al. Frailty is independently associated with short-term outcomes for elderly patients with non-ST-segment elevation myocardial infarction. Circulation. 2011;124(22):2397–404.PubMedCrossRef Ekerstad N, Swahn E, Janzon M, et al. Frailty is independently associated with short-term outcomes for elderly patients with non-ST-segment elevation myocardial infarction. Circulation. 2011;124(22):2397–404.PubMedCrossRef
10.
go back to reference Alonso S-GL, Sanmartin M, Pascual I-M, et al. Frailty is an independent prognostic marker in elderly patients with myocardial infarction. Clin Cardiol. 2017;40(10):925–31.CrossRef Alonso S-GL, Sanmartin M, Pascual I-M, et al. Frailty is an independent prognostic marker in elderly patients with myocardial infarction. Clin Cardiol. 2017;40(10):925–31.CrossRef
11.
12.
go back to reference Afilalo J, Alexander K-P, Mack M-J, et al. Frailty assessment in the cardiovascular care of older adults. J Am Coll Cardiol. 2014;63(8):747–62.PubMedCrossRef Afilalo J, Alexander K-P, Mack M-J, et al. Frailty assessment in the cardiovascular care of older adults. J Am Coll Cardiol. 2014;63(8):747–62.PubMedCrossRef
13.
go back to reference Suzuki S, Hashizume N, Kanzaki Y, et al. Prognostic significance of serum albumin in patients with stable coronary artery disease treated by percutaneous coronary intervention. PLoS One. 2019;14(7):e219044. Suzuki S, Hashizume N, Kanzaki Y, et al. Prognostic significance of serum albumin in patients with stable coronary artery disease treated by percutaneous coronary intervention. PLoS One. 2019;14(7):e219044.
14.
go back to reference Woo J, Leung J, Morley J-E. Comparison of frailty indicators based on clinical phenotype and the multiple deficit approach in predicting mortality and physical limitation. J Am Geriatr Soc. 2012;60(8):1478–86.PubMedCrossRef Woo J, Leung J, Morley J-E. Comparison of frailty indicators based on clinical phenotype and the multiple deficit approach in predicting mortality and physical limitation. J Am Geriatr Soc. 2012;60(8):1478–86.PubMedCrossRef
15.
go back to reference Ye B, Gao J, Fu H. Associations between lifestyle, physical and social environments and frailty among Chinese older people: a multilevel analysis. BMC Geriatr. 2018;18(1):314.PubMedPubMedCentralCrossRef Ye B, Gao J, Fu H. Associations between lifestyle, physical and social environments and frailty among Chinese older people: a multilevel analysis. BMC Geriatr. 2018;18(1):314.PubMedPubMedCentralCrossRef
16.
go back to reference Ferraz M-B, Quaresma M-R, Aquino L-R, et al. Reliability of pain scales in the assessment of literate and illiterate patients with rheumatoid arthritis. J Rheumatol. 1990;17(8):1022–4.PubMed Ferraz M-B, Quaresma M-R, Aquino L-R, et al. Reliability of pain scales in the assessment of literate and illiterate patients with rheumatoid arthritis. J Rheumatol. 1990;17(8):1022–4.PubMed
17.
go back to reference Molina L-R, Munoz D-B, Martinez-de L-I-J, et al. Is the Spanish short version of Mini Nutritional Assessment (MNA-SF) valid for nutritional screening of the elderly? Nutr Hosp. 2019;36(2):290–5. Molina L-R, Munoz D-B, Martinez-de L-I-J, et al. Is the Spanish short version of Mini Nutritional Assessment (MNA-SF) valid for nutritional screening of the elderly? Nutr Hosp. 2019;36(2):290–5.
18.
go back to reference Lin E, Tsai S-J, Kuo P-H, et al. The ADAMTS9 gene is associated with cognitive aging in the elderly in a Taiwanese population. PLoS One. 2017;12(2):e172440. Lin E, Tsai S-J, Kuo P-H, et al. The ADAMTS9 gene is associated with cognitive aging in the elderly in a Taiwanese population. PLoS One. 2017;12(2):e172440.
19.
go back to reference Acosta Q-CO, Garcia-Flores R, Echeverria-Castro S-B. The Geriatric Depression Scale (GDS-15): Validation in Mexico and Disorder in the State of Knowledge. Int J Aging Hum Dev. 2020;937:029,323. Acosta Q-CO, Garcia-Flores R, Echeverria-Castro S-B. The Geriatric Depression Scale (GDS-15): Validation in Mexico and Disorder in the State of Knowledge. Int J Aging Hum Dev. 2020;937:029,323.
20.
go back to reference Baek S, Piao J, Jin Y, et al. Validity of the Morse Fall Scale implemented in an electronic medical record system. J Clin Nurs. 2014;23(17–18):2434–40.PubMedCrossRef Baek S, Piao J, Jin Y, et al. Validity of the Morse Fall Scale implemented in an electronic medical record system. J Clin Nurs. 2014;23(17–18):2434–40.PubMedCrossRef
21.
go back to reference Bouwstra H, Smit E-B, Wattel E-M, et al. Measurement Properties of the Barthel Index in Geriatric Rehabilitation. J Am Med Dir Assoc. 2019;20(4):420–5.PubMedCrossRef Bouwstra H, Smit E-B, Wattel E-M, et al. Measurement Properties of the Barthel Index in Geriatric Rehabilitation. J Am Med Dir Assoc. 2019;20(4):420–5.PubMedCrossRef
22.
go back to reference Caprini J-A. Thrombosis risk assessment as a guide to quality patient care. Dis Mon. 2005;51(2–3):70–8.PubMedCrossRef Caprini J-A. Thrombosis risk assessment as a guide to quality patient care. Dis Mon. 2005;51(2–3):70–8.PubMedCrossRef
23.
go back to reference Walker D-M, Gale C-P, Lip G, et al. Editor’s Choice - Frailty and the management of patients with acute cardiovascular disease: A position paper from the Acute Cardiovascular Care Association. Eur Heart J Acute Cardiovasc Care. 2018;7(2):176–93.PubMedCrossRef Walker D-M, Gale C-P, Lip G, et al. Editor’s Choice - Frailty and the management of patients with acute cardiovascular disease: A position paper from the Acute Cardiovascular Care Association. Eur Heart J Acute Cardiovasc Care. 2018;7(2):176–93.PubMedCrossRef
24.
go back to reference Afilalo J, Karunananthan S, Eisenberg M-J, et al. Role of frailty in patients with cardiovascular disease. Am J Cardiol. 2009;103(11):1616–21.PubMedCrossRef Afilalo J, Karunananthan S, Eisenberg M-J, et al. Role of frailty in patients with cardiovascular disease. Am J Cardiol. 2009;103(11):1616–21.PubMedCrossRef
25.
go back to reference Ekerstad N, Swahn E, Janzon M, et al. Frailty is independently associated with 1-year mortality for elderly patients with non-ST-segment elevation myocardial infarction. Eur J Prev Cardiol. 2014;21(10):1216–24.PubMedCrossRef Ekerstad N, Swahn E, Janzon M, et al. Frailty is independently associated with 1-year mortality for elderly patients with non-ST-segment elevation myocardial infarction. Eur J Prev Cardiol. 2014;21(10):1216–24.PubMedCrossRef
26.
go back to reference Minglei Z, Xiaohong L, Lin K. Correlation between frailty and coronary heart disease in the elderly. Chin J Geriatr. 2015;34(9):951–5. Minglei Z, Xiaohong L, Lin K. Correlation between frailty and coronary heart disease in the elderly. Chin J Geriatr. 2015;34(9):951–5.
27.
go back to reference Mello A-C, Engstrom E-M, Alves L-C. Health-related and socio-demographic factors associated with frailty in the elderly: a systematic literature review. Cad Saude Publica. 2014;30(6):1143–68.CrossRef Mello A-C, Engstrom E-M, Alves L-C. Health-related and socio-demographic factors associated with frailty in the elderly: a systematic literature review. Cad Saude Publica. 2014;30(6):1143–68.CrossRef
28.
go back to reference Alexander K-P, Newby L-K, Cannon C-P, et al. Acute coronary care in the elderly, part I: Non-ST-segment-elevation acute coronary syndromes: a scientific statement for healthcare professionals from the American Heart Association Council on Clinical Cardiology: in collaboration with the Society of Geriatric Cardiology. Circulation. 2007;115(19):2549–69.PubMedCrossRef Alexander K-P, Newby L-K, Cannon C-P, et al. Acute coronary care in the elderly, part I: Non-ST-segment-elevation acute coronary syndromes: a scientific statement for healthcare professionals from the American Heart Association Council on Clinical Cardiology: in collaboration with the Society of Geriatric Cardiology. Circulation. 2007;115(19):2549–69.PubMedCrossRef
29.
go back to reference Siriwardhana D-D, Weerasinghe M-C, Rait G, et al. Prevalence of frailty in rural community-dwelling older adults in Kegalle district of Sri Lanka: a population-based cross-sectional study. BMJ Open. 2019;9(1):e26314.CrossRef Siriwardhana D-D, Weerasinghe M-C, Rait G, et al. Prevalence of frailty in rural community-dwelling older adults in Kegalle district of Sri Lanka: a population-based cross-sectional study. BMJ Open. 2019;9(1):e26314.CrossRef
30.
go back to reference Law M-R, Cheng L, Ashra K, et al. The consequences of patient charges for prescription drugs in Canada: a cross-sectional survey. CMAJ open. 2018;6(1):E63–70.PubMedPubMedCentralCrossRef Law M-R, Cheng L, Ashra K, et al. The consequences of patient charges for prescription drugs in Canada: a cross-sectional survey. CMAJ open. 2018;6(1):E63–70.PubMedPubMedCentralCrossRef
31.
go back to reference Liljas AEM, Carvalho L-A, Papachristou E, et al. Self-Reported Hearing Impairment and Incident Frailty in English Community-Dwelling Older Adults: A 4-Year Follow-Up Study. J Am Geriatr Soc. 2017;65(5):958–65.PubMedCrossRef Liljas AEM, Carvalho L-A, Papachristou E, et al. Self-Reported Hearing Impairment and Incident Frailty in English Community-Dwelling Older Adults: A 4-Year Follow-Up Study. J Am Geriatr Soc. 2017;65(5):958–65.PubMedCrossRef
32.
go back to reference Gordon S-J, Baker N, Kidd M, et al. Pre-frailty factors in community-dwelling 40–75 year olds: opportunities for successful ageing. BMC Geriatr. 2020;20(1):96.PubMedPubMedCentralCrossRef Gordon S-J, Baker N, Kidd M, et al. Pre-frailty factors in community-dwelling 40–75 year olds: opportunities for successful ageing. BMC Geriatr. 2020;20(1):96.PubMedPubMedCentralCrossRef
33.
go back to reference G Livingston, Huntley J, Sommerlad A, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet, 2020, 396(10248): 413–446. G Livingston, Huntley J, Sommerlad A, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet, 2020, 396(10248): 413–446.
34.
go back to reference D’Haese PSC, De Bodt M, Van Rompaey V, et al. Awareness of Hearing Loss in Older Adults: Results of a Survey Conducted in 500 Subjects Across 5 European Countries as a Basis for an Online Awareness Campaign. Inquiry. 2018;55:46958018759421.PubMed D’Haese PSC, De Bodt M, Van Rompaey V, et al. Awareness of Hearing Loss in Older Adults: Results of a Survey Conducted in 500 Subjects Across 5 European Countries as a Basis for an Online Awareness Campaign. Inquiry. 2018;55:46958018759421.PubMed
35.
36.
go back to reference Jurschik P, Botigue T, Nuin C, et al. Association between Mini Nutritional Assessment and the Fried frailty index in older people living in the community. Med Clin (Barc). 2014;143(5):191–5.CrossRef Jurschik P, Botigue T, Nuin C, et al. Association between Mini Nutritional Assessment and the Fried frailty index in older people living in the community. Med Clin (Barc). 2014;143(5):191–5.CrossRef
37.
go back to reference Sacha J, Sacha M, Sobon J, et al. Is It Time to Begin a Public Campaign Concerning Frailty and Pre-frailty? A Review Article. Front Physiol. 2017:8484. Sacha J, Sacha M, Sobon J, et al. Is It Time to Begin a Public Campaign Concerning Frailty and Pre-frailty? A Review Article. Front Physiol. 2017:8484.
38.
go back to reference Iwasaki M, Motokawa K, Watanabe Y, et al. A Two-Year Longitudinal Study of the Association between Oral Frailty and Deteriorating Nutritional Status among Community-Dwelling Older Adults. Int J Environ Res Public Health. 2020:18(1). Iwasaki M, Motokawa K, Watanabe Y, et al. A Two-Year Longitudinal Study of the Association between Oral Frailty and Deteriorating Nutritional Status among Community-Dwelling Older Adults. Int J Environ Res Public Health. 2020:18(1).
39.
40.
go back to reference Borges M-K, Aprahamian I, Romanini C-V, et al. Depression as a determinant of frailty in late life. Aging Ment Health. 2020:1–7. Borges M-K, Aprahamian I, Romanini C-V, et al. Depression as a determinant of frailty in late life. Aging Ment Health. 2020:1–7.
41.
go back to reference Shimada H, Lee S, Takehiko D, et al. Prevalence of Psychological Frailty in Japan: NCGG-SGS as a Japanese National Cohort Study. J Clin Med. 2019;8(10):1554.PubMedCentralCrossRef Shimada H, Lee S, Takehiko D, et al. Prevalence of Psychological Frailty in Japan: NCGG-SGS as a Japanese National Cohort Study. J Clin Med. 2019;8(10):1554.PubMedCentralCrossRef
42.
go back to reference von Kanel R. A psychocardiology update on depression and coronary heart disease. Praxis (Bern 1994). 2014;103(2):85–93.CrossRef von Kanel R. A psychocardiology update on depression and coronary heart disease. Praxis (Bern 1994). 2014;103(2):85–93.CrossRef
43.
go back to reference Watkins L-L, Koch G-G, Sherwood A, et al. Association of anxiety and depression with all-cause mortality in individuals with coronary heart disease. J Am Heart Assoc. 2013;2(2):e68.CrossRef Watkins L-L, Koch G-G, Sherwood A, et al. Association of anxiety and depression with all-cause mortality in individuals with coronary heart disease. J Am Heart Assoc. 2013;2(2):e68.CrossRef
44.
go back to reference Lutsey P-L, B-Gwen W, Misialek J-R, et al. Long-Term Association of Venous Thromboembolism With Frailty, Physical Functioning, and Quality of Life: The Atherosclerosis Risk in Communities Study. J Am Heart Assoc. 2020;9(12):e15656.CrossRef Lutsey P-L, B-Gwen W, Misialek J-R, et al. Long-Term Association of Venous Thromboembolism With Frailty, Physical Functioning, and Quality of Life: The Atherosclerosis Risk in Communities Study. J Am Heart Assoc. 2020;9(12):e15656.CrossRef
45.
go back to reference Folsom A-R, Boland L-L, Cushman M, et al. Frailty and risk of venous thromboembolism in older adults. J Gerontol A Biol Sci Med Sci. 2007;62(1):79–82.PubMedCrossRef Folsom A-R, Boland L-L, Cushman M, et al. Frailty and risk of venous thromboembolism in older adults. J Gerontol A Biol Sci Med Sci. 2007;62(1):79–82.PubMedCrossRef
46.
go back to reference Gharacholou S-M, Roger V-L, Lennon R-J, et al. Comparison of frail patients versus nonfrail patients >/=65 years of age undergoing percutaneous coronary intervention. Am J Cardiol. 2012;109(11):1569–75.PubMedPubMedCentralCrossRef Gharacholou S-M, Roger V-L, Lennon R-J, et al. Comparison of frail patients versus nonfrail patients >/=65 years of age undergoing percutaneous coronary intervention. Am J Cardiol. 2012;109(11):1569–75.PubMedPubMedCentralCrossRef
47.
go back to reference Wang Y, Yah W, Song Q. Frailty and risk factors in elderly patients with acute myocardial infarction. J Nurs Sci. 2020;35(17):36–40. Wang Y, Yah W, Song Q. Frailty and risk factors in elderly patients with acute myocardial infarction. J Nurs Sci. 2020;35(17):36–40.
Metadata
Title
Prevalence and determinants of frailty in older adult patients with chronic coronary syndrome: a cross-sectional study
Authors
Hong Lyu
Chuanxia Wang
Hong Jiang
Ping Wang
Jingjing Cui
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2021
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-021-02426-0

Other articles of this Issue 1/2021

BMC Geriatrics 1/2021 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine