Instituto de Gerontología, Universidad Peruana Cayetano Heredia, Lima, Perú.
Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Perú.
PLoS One. 2024 Oct 24;19(10):e0312498. doi: 10.1371/journal.pone.0312498. eCollection 2024.
BACKGROUND/OBJECTIVES: Frailty is a common condition among older adults and is associated with an increased risk of adverse health outcomes, including mortality, disability, dysmobility, falls, and hospitalization. In patients with atrial fibrillation (AF), these risks are further exacerbated. However, evidence linking AF and frailty, particularly in the South American context, is limited. This study aimed to assess frailty and other geriatric conditions in older outpatients with atrial fibrillation in a resource-limited setting in Lima, Peru.
In this cross-sectional study, we included adults aged 60 years and older diagnosed with atrial fibrillation who were attending outpatient check-ups. Patients who were hospitalized, receiving chemotherapy induction, or presenting with acute infections or exacerbations were excluded. Standardized questionnaires were used to assess frailty, cognitive impairment, and functional dependence. Statistical analysis was performed using R Studio version 4.3.1, with a significance level set at p < 0.05.
Among the 200 patients who agreed to participate (mean age 74.76 ± 8.42 years, 41% females), 28.5% exhibited frailty, and 46.5% were classified as prefrail. Frailty and prefrailty were significantly associated with older age (p<0.01), female gender (p = 0.01), illiteracy (p<0.01), heart failure (p<0.01), falls (p<0.05), cognitive impairment (p<0.01), and functional dependence (p<0.01). Multivariate analysis revealed significant associations between frailty and cognitive impairment (p<0.05), frailty and functional dependence (p<0.05), and cognitive impairment and functional dependence (p<0.05).
One-third of older outpatients with atrial fibrillation were identified as frail, while half were classified as prefrail. In this population, frailty frequently coexists with cognitive impairment and functional dependence, highlighting the need for timely screening and the implementation of evidence-based interventions for individuals with atrial fibrillation in resource-limited settings.
背景/目的:衰弱是老年人中常见的一种状况,与不良健康结局的风险增加有关,包括死亡率、残疾、活动能力下降、跌倒和住院。在患有心房颤动(AF)的患者中,这些风险进一步加剧。然而,在资源有限的秘鲁利马,关于 AF 与衰弱之间的关联,特别是在南美洲背景下的证据有限。本研究旨在评估资源有限环境下,老年门诊心房颤动患者的衰弱和其他老年病状况。
在这项横断面研究中,我们纳入了年龄在 60 岁及以上、被诊断为心房颤动并正在接受门诊检查的成年人。排除了住院、接受化疗诱导或出现急性感染或恶化的患者。使用标准化问卷评估衰弱、认知障碍和功能依赖。使用 R Studio 版本 4.3.1 进行统计分析,显著性水平设为 p<0.05。
在同意参与的 200 名患者中(平均年龄 74.76 ± 8.42 岁,41%为女性),28.5%表现出衰弱,46.5%为衰弱前期。衰弱和衰弱前期与年龄较大(p<0.01)、女性(p=0.01)、文盲(p<0.01)、心力衰竭(p<0.01)、跌倒(p<0.05)、认知障碍(p<0.01)和功能依赖(p<0.01)显著相关。多变量分析显示,衰弱与认知障碍(p<0.05)、衰弱与功能依赖(p<0.05)以及认知障碍与功能依赖(p<0.05)之间存在显著关联。
三分之一的老年门诊心房颤动患者被认定为衰弱,而一半的患者被归类为衰弱前期。在这一人群中,衰弱常与认知障碍和功能依赖并存,这突显了在资源有限的环境下,及时对心房颤动患者进行筛查和实施基于证据的干预措施的必要性。