Jankowska-Polańska Beata, Polański Jacek, Dudek Krzysztof, Sławuta Agnieszka, Mazur Grzegorz, Gajek Jacek
Department of Clinical Nursing, Wroclaw Medical University, 50-367 Wrocław, Poland.
Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wrocław Medical University, 50-367 Wroclaw, Poland.
J Clin Med. 2020 Dec 23;10(1):11. doi: 10.3390/jcm10010011.
The aim of the study was to assess the link between anxiety and depression and frailty syndrome (FS) in patients with atrial fibrillation (AF) with regard to gender differences.
The study was conducted on 158 patients with AF (mean age 70.4 ± 7.6). The study used the hospital anxiety and depression scale (HADS-M), the Athens insomnia scale (AIS) and the Edmonton frailty scale to assess and compare anxiety, depression, and sleep disturbance between frail and non-frail patients with AF.
FS was diagnosed in 53.2% of patients. A comparative analysis showed a statistically significantly higher severity level of anxiety (12.0 ± 2.6 vs. 8.4 ± 2.5, < 0.001) and depression (12.5 ± 2.5 vs. 7.2 ± 3.3, < 0.001) in frail patients compared to non-frail patients. The analysis of the level of anxiety, depression and FS did not show any significant differences between the studied women and men. However, statistically, significant differences were observed when FS occurred, regardless of gender. Anxiety disorders were observed in 75.5% of patients with FS and in 16.7% without frailty, whereas depressive disorders were observed in 73.6% of frail patients and in 4.2% without frailty. In an analysis of the impact of cumulative variables on the level of frailty, the risk of FS in patients with anxiety/depression and sleep disturbance is almost 500 times higher compared to patients without anxiety/depression and sleep disturbance. The risk of frailty in patients with sleep disturbance only is thirteen times higher than in the reference group, i.e., in patients without depression/anxiety and sleep disturbances.
Patients with AF and FS show deeper anxiety, depression and sleep disturbances. Gender does not influence the risk of frailty in AF patients. Frailty in patients with AF is associated with a higher risk of depression, sleep disturbances and anxiety.
本研究旨在评估房颤(AF)患者焦虑和抑郁与衰弱综合征(FS)之间的联系,并探讨性别差异。
本研究纳入了158例房颤患者(平均年龄70.4±7.6岁)。研究采用医院焦虑抑郁量表(HADS-M)、雅典失眠量表(AIS)和埃德蒙顿衰弱量表,对衰弱和非衰弱房颤患者的焦虑、抑郁和睡眠障碍进行评估和比较。
53.2%的患者被诊断为FS。对比分析显示,与非衰弱患者相比,衰弱患者的焦虑严重程度(12.0±2.6 vs. 8.4±2.5,P<0.001)和抑郁严重程度(12.5±2.5 vs. 7.2±3.3,P<0.001)在统计学上显著更高。焦虑、抑郁水平与FS的分析在研究的女性和男性之间未显示出任何显著差异。然而,从统计学上看,无论性别如何,当发生FS时均观察到显著差异。FS患者中75.5%存在焦虑障碍,无衰弱患者中为16.7%;衰弱患者中73.6%存在抑郁障碍,无衰弱患者中为4.2%。在分析累积变量对衰弱水平的影响时,有焦虑/抑郁和睡眠障碍的患者发生FS的风险比无焦虑/抑郁和睡眠障碍的患者高近500倍。仅存在睡眠障碍的患者发生衰弱的风险比参照组(即无抑郁/焦虑和睡眠障碍的患者)高13倍。
房颤合并FS的患者表现出更严重的焦虑、抑郁和睡眠障碍。性别不影响房颤患者的衰弱风险。房颤患者的衰弱与更高的抑郁、睡眠障碍和焦虑风险相关。