Abstract 801: Frailty and Health Status in Patients With Coronary Disease
Background: Previous studies on age-associated impairments (frailty, comorbidity) lacked focus on patients’ self-reported health status. We studied the relationship between age-associated impairments and health status in elderly undergoing percutaneous coronary interventions (PCI).
Methods and Results: Standardized tests were administered to patients ≥65 years who underwent PCI in the community from 2005–2008 to ascertain frailty (Fried criteria), comorbidity (Charlson and Sachdev indices), and health status, including symptoms, function and quality of life (QOL) [SF-36 and Seattle Angina Questionnaires (SAQ)]. Among 629 patients enrolled, 19% were frail, 47% had intermediate frailty, and only 21% were not frail. Frail patients were older and had higher comorbidity, including diabetes mellitus, hypertension, and chronic kidney disease. Frailty had the strongest correlations with the SF-36 Physical Component Score (r=−0.44) and the CES Depression score (r=0.36). It exhibited weaker associations (r values between 0.20 and 0.27) with comorbidity, the SAQ Physical Limitation scale, and the SF-36 Mental Component Score. Overall, quality of life index (SF-36 for physical and mental components) was significantly lower (29.5 vs. 43.9 and 49.2 vs. 57.4, respectively) in patients with and without frailty. Following adjustments by linear regression, compared to those without frailty, intermediately frail and frail patients had lower adjusted health status scores. The magnitude of difference was 1.8 to 8.8 times greater in frail patients than the estimated difference for a 10-year increase in age. The median SAQ score for physical limitations was lower in patients with intermediate frailty (71.8) and frailty (58.9) compared to those not frail (82.2).
Conclusion: In elderly patients undergoing PCI health status is related to age-associated impairments adding a new dimension to the complex process of risk prediction in the elderly.