Zhu Ping, Mei Dongmei, Yang Yan, Meng Defang, Hu Yaoyao, Wang Xiaoyan
Department of Cardiology, Affiliated Hospital of Jiangnan University, Wuxi, China.
Wuxi School of Medicine, Jiangnan University, Wuxi, China.
Front Cardiovasc Med. 2025 Jul 18;12:1588288. doi: 10.3389/fcvm.2025.1588288. eCollection 2025.
Frailty has increasingly been recognized as a multidimensional syndrome and is particularly prevalent among older adults with cardiovascular disease. This study aimed to assess the prevalence of multidimensional frailty and identify its key determinants in hospitalized elderly patients with coronary heart disease (CHD), with the goal of informing targeted strategies for early assessment and intervention.
A cross-sectional study was conducted involving 508 patients aged 60 years or older who were hospitalized with CHD at a tertiary hospital in China. Frailty was assessed using the Tilburg Frailty Indicator (TFI). Variables with statistical significance in univariate analysis were entered into a Selection Operator (LASSO) regression for selection. Least Absolute Shrinkage and LASSO regression and multivariate logistic regression analyses were performed to identify significant predictors.
A total of 508 elderly patients with coronary heart disease who were hospitalized were included in the study, of whom 270 patients developed multidimensional frailty, resulting in an incidence rate of 53.15%. Variables with statistical significance in univariate analysis were entered into a LASSO regression for selection. Those retained by LASSO were then included in a multivariate logistic regression model. Multivariate analysis identified the following independent risk factors for multidimensional frailty: Age ≥ 75 years (OR = 2.821; 95% CI: 1.671-4.761); female (OR = 2.279; 95% CI: 1.426-3.643); insomnia (OR = 2.147; 95% CI: 1.374-3.354); depressive symptoms (OR = 4.233; 95% CI: 2.629-6.816). Conversely, higher scores on activities of daily living (ADL) (OR = 0.952; 95% CI: 0.921-0.984) and greater social support (OR = 0.935; 95% CI: 0.901-0.971) were protective against multidimensional frailty.
Multidimensional frailty is highly prevalent in hospitalized CHD patients and independently associated with psychosocial and functional factors. Early screening and integrated interventions targeting these determinants are essential to improve clinical outcomes.
衰弱日益被认为是一种多维综合征，在患有心血管疾病的老年人中尤为普遍。本研究旨在评估多维衰弱的患病率，并确定其在住院冠心病（CHD）老年患者中的关键决定因素，以便为早期评估和干预的针对性策略提供依据。
在中国一家三级医院对508例60岁及以上因冠心病住院的患者进行了一项横断面研究。使用蒂尔堡衰弱指标（TFI）评估衰弱情况。将单因素分析中有统计学意义的变量纳入选择算子（LASSO）回归进行筛选。进行最小绝对收缩和LASSO回归以及多因素逻辑回归分析以确定显著的预测因素。
本研究共纳入508例住院冠心病老年患者，其中270例发生多维衰弱，发生率为53.15%。将单因素分析中有统计学意义的变量纳入LASSO回归进行筛选。LASSO保留的变量随后纳入多因素逻辑回归模型。多因素分析确定了以下多维衰弱的独立危险因素：年龄≥75岁（OR = 2.821；95%CI：1.671 - 4.761）；女性（OR = 2.279；95%CI：1.426 - 3.643）；失眠（OR = 2.147；95%CI：1.374 - 3.354）；抑郁症状（OR = 4.233；95%CI：2.629 - 6.816）。相反，日常生活活动（ADL）得分较高（OR = 0.952；95%CI：0.921 - 0.984）和社会支持较多（OR = 0.935；95%CI：0.901 - 0.971）对多维衰弱有保护作用。
多维衰弱在住院冠心病患者中高度普遍，且与心理社会和功能因素独立相关。针对这些决定因素进行早期筛查和综合干预对于改善临床结局至关重要。
