Atrial fibrillation and acceleration of frailty: findings from the Irish Longitudinal Study on Ageing

• Published in: Age and ageing Vol. 51; no. 2
• Main Authors: Richard, Georgia, O’Halloran, Aisling M, Doody, Paul, Harbison, Joseph, Kenny, Rose Anne, Romero-Ortuno, Roman
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 02.02.2022; Oxford Publishing Limited (England)
• Subjects: Acceleration; Aged; Aging; Atrial fibrillation; Atrial Fibrillation - diagnosis; Atrial Fibrillation - epidemiology; Cardiac arrhythmia; Case-Control Studies; Cross-Sectional Studies; Disability; Fibrillation; Frail; Frail Elderly; Frailty; Frailty - diagnosis; Frailty - epidemiology; Geriatric Assessment; Humans; Longitudinal Studies; Older people; Phenotypes; Retrospective Studies; Variance analysis; phenotype; frailty; atrial fibrillation; older people
• ISSN: 0002-0729; 1468-2834; 1468-2834
• DOI: 10.1093/ageing/afab273

Abstract Introduction both atrial fibrillation (AF) and frailty are increasingly prevalent with age. Cross-sectional studies have suggested a relationship between AF and frailty, but longitudinal data are lacking. We explored if the presence of AF was associated with accelerated progression of frailty over 8 years in community-dwelling older adults. Methods a longitudinal retrospective case-control study was conducted using data from Waves 1 and 5 of the Irish Longitudinal Study on Ageing (TILDA). Participants with electrocardiographically detected AF at Wave 1 were matched to controls without AF (1:2) based on age and gender. Frailty was assessed using both the frailty phenotype (FP) and a 31-item frailty index (FI). Change in cases’ and controls’ FP and FI scores from Waves 1 to 5 were modelled using repeated measures analysis of variance (RM-ANOVA). Results one hundred eighteen TILDA participants with AF at Wave 1 were matched to 236 controls. By FP, participants with AF were not significantly more frail than controls at Wave 1 (P = 0.166) but were at Wave 5 (P = 0.011), and RM-ANOVA suggested that frailty progressed more in participants with AF between Waves 1 and 5 compared with controls (P = 0.033). By FI, participants with AF were significantly more frail at Wave 1 (P < 0.001) and 5 (P = 0.010), and RM-ANOVA did not show a difference in frailty progression between groups (P = 0.955). Conclusion AF may drive the development of the FP. The FP is a pre-disability syndrome and hence may be better than the FI as a focus for disability prevention in adults with AF.