Assessment of Frailty and Occurrence of Anxiety and Depression in Elderly Patients with Atrial Fibrillation

Figures & data

Figure 1 STROBE flow diagram of study participants.

Table 1 Sociodemographic Characteristics of the Patients Studied (n=100)

Characteristics	Values (n=100)
Age [years]
Mean ± SD	70.27 ± 3.48
Me	70
Q1-Q3	67-74
Sex
Female	61%
Male	39%
Education
Primary	29%
Vocational	34%
High school	25%
College/University	12%
Residence
Rural	44%
Urban	55%
No answer	1%
Professionally active?
Yes	15%
No	85%
Marital status
In a relationship	59%
Single	9%
Divorced	10%
Widowed	22%

Abbreviations: Me, median; Q1, first quartile; Q3, third quartile.

Table 2 Clinical Data of the Patients Studied (n=100)

Characteristics	Values
Duration of illness [years]
Mean ± SD	3.96 ± 3.52
Me	3
Q1-Q3	2-5
Times the patient had undergone cardioversion
Mean ± SD	3.32 ± 2.2
Me	3
Q1-Q3	2-3
AF symptoms*
Palpitations	83%
Chest pain	25%
Fatigability	33%
Sweating	14%
Shortness of breath	13%
Dizziness	18%
Fainting	11%
Comorbidities*
Arterial hypertension	82%
Ischemic heart disease	16%
Diabetes mellitus	31%
Heart failure	20%
Hyperthyroidism	11%
Respiratory disorders	15%
History of TIA	17%
Atherosclerosis	16%
Ischemic stroke	13%
Rheumatic disorders	1%
Number of hospitalizations due to AF
1–2	43%
3–5	48%
6-10	7%
More than 10 hospitalizations	2%

Note: *The total exceeds 100%, as the item allowed for multiple choices.

Abbreviations: Me, median; Q1, first quartile; Q3, third quartile; AF, atrial fibrillation; TIA, transient ischemic attack.

Table 3 TFI, HADS, and GDS Scores in the Patients Studied (n=100)

Characteristics	Values
TFI
Physical components
Mean ± SD	3.22 ± 2.27
Me	3
Q1-Q3	1-5
Psychological components
Mean ± SD	2.23 ± 0.75
Me	2
Q1-Q3	2-3
Social components
Mean ± SD	1.34 ± 0.95
Me	1
Q1-Q3	1-2
0-4 No frailty	33%
5-8 Mild frailty	38%
9-12 Moderate frailty	29%
13-15 Severe frailty	0%
HADS Anxiety
0-7 No disorder	58%
8-10 Borderline result	22%
11-21 Marked disorder	20%
HADS Depression
0-7 No disorder	46%
8-10 Borderline result	26%
11-21 Marked disorder	28%
GDS
0-5 No depression	49%
6-15 Depression	51%

Abbreviations: Me, median; Q1, first quartile; Q3, third quartile; TFI, Tilburg Frailty Indicator; HADS, hospital anxiety depression scale; GDS, Geriatric Depression Scale.

Table 4 Single-Factor Analysis for Selected Variables and FS (TFI)

TFI	HADS Anxiety		HADS Depression		GDS
	Coefficient Correlation	p*	Coefficient Correlation	p*	Coefficient Correlation	p*
Overall TFI score	0.492	p<0.001 NP	0.696	p<0.001 NP	0.673	p<0.001 NP
Physical components	0.455	p<0.001 NP	0.663	p<0.001 NP	0.656	p<0.001 NP
Psychological components	−0.073	p=0.47 NP	−0.137	p=0.175 NP	−0.159	p=0.114 NP
Social components	0.222	p=0.026 NP	0.313	p=0.001 NP	0.273	p=0.006 NP

Notes: *p = normal distribution of both correlated variables, Pearson’s correlation coefficient used; NP = distribution not normal for at least one of the correlated variables, Spearman correlation coefficient used.

Abbreviations: TFI, Tilburg Frailty Indicator; HADS, hospital anxiety depression scale; GDS, Geriatric Depression Scale.

Table 5 Multiple-Factor Analysis for the Overall TFI Score

	Parameter	95% CI	P
HADS: Anxiety	-0.115	-0.287, 0.057	0.188
HADS: Depression	0.091	-0.063, 0.245	0.243
GDS	0.206	0.022, 0.39	0.029
Age [years]	0.143	-0.006, 0.293	0.06
Education
Primary	Reference item
Vocational	0.311	-0.667, 1.289	0.529
High school	-0.092	-1.28, 1.097	0.879
College/University	-1.546	-3.056, -0.035	0.045
Bleeding
Yes	Reference item
No	-0.933	-1.76, -0.107	0.027

Abbreviations: TFI, Tilburg Frailty Indicator; HADS, hospital anxiety depression scale; GDS, Geriatric Depression Scale.

Table 6 Multiple-Factor Analysis for the Physical TFI Score

	Parameter	95% CI	P
HADS: Anxiety	-0.113	-0.257, 0.03	0.12
HADS: Depression	0.09	-0.038, 0.217	0.166
GDS	0.212	0.059, 0.364	0.007
Age [years]	0.183	0.061, 0.306	0.004
How is medication taken
My medication is prepared and given to me by another person	Reference item
My medication is placed in a labeled box	-0.991	-1.953, -0.028	0.044
I take my medication on my own	-0.758	-1.668, 0.152	0.101
Can the patient tell how many tablets they take daily
Yes	Reference item
No	-0.265	-1.106, 0.576	0.533
Does the patient read information leaflets
Yes	Reference item
No	0.264	-0.467, 0.996	0.474

Abbreviations: TFI, Tilburg Frailty Indicator; HADS, hospital anxiety depression scale; GDS, Geriatric Depression Scale.

Table 7 Multiple-Factor Analysis for the Psychological TFI Score

	Parameter	95% CI	P
HADS: Anxiety	0.049	-0.018, 0.116	0.147
HADS: Depression	0.015	-0.046, 0.075	0.63
GDS	-0.031	-0.103, 0.041	0.395
Age [years]	-0.013	-0.07, 0.045	0.666
How is medication taken
My medication is prepared and given to me by another person	Reference item
My medication is placed in a labeled box	-0.295	-0.72, 0.131	0.172
I take my medication on my own	0.3	-0.08, 0.68	0.12
Heart failure
No	Reference item
Yes	-0.421	-0.812, -0.03	0.035
Dizziness
No	Reference item
Yes	-0.408	-0.79, -0.027	0.036

Abbreviations: TFI, Tilburg Frailty Indicator; HADS, hospital anxiety depression scale; GDS, Geriatric Depression Scale.

Table 8 Multiple-Factor Analysis for the Social TFI Score

	Parameter	95% CI	P
HADS: Anxiety	-0.038	-0.107, 0.03	0.271
HADS: Depression	0.093	0.032, 0.155	0.003
GDS	0	-0.07, 0.07	0.995
Marital status
Married	Reference item
Single	1.1	0.576, 1.623	<0.001
Divorced	0.238	-0.269, 0.745	0.354
Widowed	0.605	0.219, 0.991	0.002
Sex
Female	Reference item
Male	-0.685	-0.992, -0.378	<0.001
How is medication taken
My medication is prepared and given to me by another person	Reference item
My medication is placed in a labeled box	0.613	0.18, 1.046	0.006
I take my medication on my own	0.243	-0.127, 0.614	0.195
Nosebleeds
No	Reference item
Yes	0.177	-0.178, 0.532	0.324

Abbreviations: TFI, Tilburg Frailty Indicator; HADS, hospital anxiety depression scale; GDS, Geriatric Depression Scale.