Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.
Cardiology. 2023;148(6):574-580. doi: 10.1159/000533361. Epub 2023 Aug 5.
Frailty and atrial fibrillation (AF) are common aging problems and increasing globally. The association(s) between frailty and AF has been inconclusive. The purpose of this prospective population-based cohort was to investigate the associations between frailty and incident AF in older men and women.
In total 839 participants, women (n = 458) and men (n = 381), aged 61-74 years from the Kuopio Ischaemic Heart Disease Risk Factor Study were included (March 1, 1998, to December 31, 2001). At the baseline, frailty prevalence was 49.3% (n = 414), and non-frailty 50.7% (n = 425) of the total population. Frailty was ascertained with the presence of 3-5 and prefrailty 1-2 of the following criteria: weight loss (highest 20% over 7 years), self-reported tiredness, weakness (measured by handgrip strength), slow walking speed (walking pace), and low physical activity (lowest 20%). AF events were obtained by record linkages from the national computerized hospitalization registry in Finland up to December 31, 2019. Multivariate Cox proportional hazard regression estimated the hazard ratio (HR) of incident events, adjusted for potential confounders.
During the mean follow-up of 14.2 years, 288 AF cases (169 women; 119 men) occurred. After adjustment for possible confounders, the HRs (95% confidence intervals [CIs]) for AF was 1.46 (1.48-1.85) in the frail population, compared to the non-frail group. The association was observed only among older frail women (multivariable-adjusted HR 1.78, 95% CI [1.28-2.48]) (p for interaction = 0.04). No statistically significant associations were observed between frailty and future AF incident among men (multivariable-adjusted HRs 1.12, 95% CI (0.77-1.63)).
In this population-based epidemiological cohort, the risk of developing AF was increased in women affected by frailty at baseline but not in men.
衰弱和心房颤动（AF）是常见的老龄化问题，且在全球范围内呈上升趋势。衰弱与 AF 之间的关联尚无定论。本前瞻性人群队列研究的目的是调查老年男女衰弱与 AF 发病之间的关系。
共纳入 839 名参与者，其中女性（n=458）和男性（n=381），年龄 61-74 岁，来自库奥皮奥缺血性心脏病风险因素研究（1998 年 3 月 1 日至 2001 年 12 月 31 日）。在基线时，衰弱的患病率为 49.3%（n=414），总人群中无衰弱的患病率为 50.7%（n=425）。通过以下标准的 3-5 项和前衰弱的 1-2 项来确定衰弱：体重减轻（7 年内最高的 20%）、自我报告的疲劳、虚弱（通过握力测量）、缓慢的步行速度（步行速度）和低体力活动（最低的 20%）。通过芬兰国家计算机化住院登记系统的记录链接获取 AF 事件，直至 2019 年 12 月 31 日。多变量 Cox 比例风险回归估计了发病事件的风险比（HR），并调整了潜在混杂因素。
在平均 14.2 年的随访期间，发生了 288 例 AF 病例（169 例女性；119 例男性）。在调整可能的混杂因素后，与非衰弱组相比，衰弱人群的 AF 风险 HR（95%置信区间[CI]）为 1.46（1.48-1.85）。仅在年龄较大的衰弱女性中观察到这种关联（多变量调整后的 HR 1.78，95%CI [1.28-2.48]）（p 交互=0.04）。在男性中，未观察到衰弱与未来 AF 事件之间存在统计学显著关联（多变量调整后的 HRs 1.12，95%CI（0.77-1.63））。
在这项基于人群的流行病学队列研究中，基线时衰弱的女性发生 AF 的风险增加，但男性则不然。
