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

Authors Uchmanowicz I, Lomper K, Gros M, Kałużna-Oleksy M, Jankowska EA, Rosińczuk J, Cyrkot T, Szczepanowski R

Received 17 April 2020

Accepted for publication 13 June 2020

Published 15 July 2020 Volume 2020:15 Pages 1151—1161


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Richard Walker

Izabella Uchmanowicz,1 Katarzyna Lomper,1 Małgorzata Gros,2 Marta Kałużna-Oleksy,3 Ewa A Jankowska,4,5 Joanna Rosińczuk,6 Tomasz Cyrkot,7 Remigiusz Szczepanowski7

1Department of Clinical Nursing, Wroclaw Medical University, Wroclaw, Poland; 2Student Research Circle in Nursing, Wroclaw Medical University, Wroclaw, Poland; 3 1st Department of Cardiology, University of Medical Sciences in Poznan, Poznan, Poland; 4Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland; 5Centre for Heart Diseases, University Hospital, Wroclaw, Poland; 6Department of Nervous System Diseases, Wroclaw Medical University, Wroclaw, Poland; 7Department of Public Health, Wroclaw Medical University, Wroclaw, Poland

Correspondence: Katarzyna Lomper
Department of Clinical Nursing, Wroclaw Medical University, Faculty of Health Sciences, Wroclaw, Poland
Tel +48 71 784 18 05
Fax +48 71 345 93 24
Email [email protected]

Purpose: Atrial fibrillation (AF) is the most common cardiac arrhythmia, and its incidence increases with age. The elderly population is commonly affected by frailty syndrome (FS). FS syndrome along with anxiety and depressive symptoms are prevalent among elderly patients with AF. It is unclear whether depression contributes to AF or vice versa. The purpose of this study was to assess correlations between FS and the occurrence of anxiety and depression symptoms in a group of elderly patients with AF.
Patients and Methods: This cross-sectional study included 100 elderly patients (69 females, 31 males, mean age: 70.27 years) with AF. Standardized research instruments were used including the Tilburg Frailty Indicator (TFI) to assess FS, and two questionnaires to assess depression including the Geriatric Depression Scale (GDS), and the Hospital Anxiety Depression Scale (HADS).
Results: Mild FS was found in 38% and moderate FS in 29% of patients. Based on GDS scores, depression symptoms were found in 51% of patients’ sample. Based on HADS scores, 20% of patients were found to have anxiety symptoms, and 28% revealed depression symptoms. Single-factor analysis demonstrated a significant positive correlation between HADS anxiety symptoms (r=0.492), HADS depression symptoms (r=0.696), and GDS score (r=0.673) on the one hand, and overall TFI frailty score on the other. Multiple-factor analysis identified overall GDS score, education, and lack of bleeding as significant independent predictors of TFI scores (p< 0.05).
Conclusion: FS is common in the population of elderly patients with AF. We found evidence for the association between symptoms of anxiety and depression and the incidence of FS in this group of patients. Due to the risk of consequences which may in part be irreversible, screening for FS is recommended.

Keywords: atrial fibrillation, frailty syndrome, aging, anxiety, depression

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