Department of Medicine
Cardiology | Cardiovascular Diseases | Geriatrics
Background: Frailty is associated bidirectionally with cardiovascular disease. However, the relations between frailty and atrial fibrillation (AF) have not been fully elucidated.
Methods and Results: Using the FHS (Framingham Heart Study) Offspring cohort, we sought to examine both the association between frailty (2005-2008) and incident AF through 2016 and the association between prevalent AF and frailty status (2011-2014). Frailty was defined using the Fried phenotype. Models adjusted for age, sex, and smoking. Cox proportional hazards models, adjusted for competing risk of death, assessed the association between prevalent frailty and incident AF. Logistic regression models assessed the association between prevalent AF and new-onset frailty. For the incident AF analysis, we included 2053 participants (56% women; mean age, 69.7+/-6.9 years). By Fried criteria, 1018 (50%) were robust, 903 (44%) were prefrail, and 132 (6%) were frail. In total, 306 incident cases of AF occurred during an average 9.2 (SD, 3.1) follow-up years. After adjustment, there was no statistically significant association between prevalent frailty status and incident AF (prefrail versus robust: hazard ratio [HR], 1.22 [95% CI, 0.95-1.55]; frail versus robust: HR, 0.92 [95% CI, 0.57-1.47]). At follow-up, there were 111 new cases of frailty. After adjustment, there was no statistically significant association between prevalent AF and new-onset frailty (odds ratio, 0.48 [95% CI, 0.17-1.36]).
Conclusions: Although a bidirectional association between frailty and cardiovascular disease has been suggested, we did not find evidence of an association between frailty and AF. Our findings may be limited by sample size and should be further explored in other populations.
association study, atrial fibrillation, frailty
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© 2020 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
DOI of Published Version
Orkaby AR, Kornej J, Lubitz SA, McManus DD, Travison TG, Sherer JA, Trinquart L, Murabito JM, Benjamin EJ, Preis SR. Association Between Frailty and Atrial Fibrillation in Older Adults: The Framingham Heart Study Offspring Cohort. J Am Heart Assoc. 2021 Jan 5;10(1):e018557. doi: 10.1161/JAHA.120.018557. Epub 2020 Dec 29. PMID: 33372538. Link to article on publisher's site
Journal of the American Heart Association
Orkaby AR, Kornej J, Lubitz SA, McManus DD, Travison TG, Sherer JA, Trinquart L, Murabito JM, Benjamin EJ, Preis SR. (2021). Association Between Frailty and Atrial Fibrillation in Older Adults: The Framingham Heart Study Offspring Cohort. Open Access Publications by UMMS Authors. https://doi.org/10.1161/JAHA.120.018557. Retrieved from https://escholarship.umassmed.edu/oapubs/4507
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.