Results of Comprehensive Geriatric Assessment in Elderly and Senile Patients with Atrial Fibrillation

BACKGROUND: Atrial fibrillation (AF) remains one of the most prevalent cardiac arrhythmias, particularly among elderly and senile individuals. Concurrently, the prevalence of frailty reaches 40%. AIM: To perform a comprehensive geriatric assessment (CGA) and evaluate its outcomes among elderly and senile patients presenting with AF. METHODS: The study involved elderly and senile patients (n=216) with AF. CGA was conducted to evaluate the following domains: physical status (height, weight, body mass index, pain assessment, nutritional status); functional activity (basic activities of daily living and instrumental activities of daily living, the Short Physical Performance Battery (SPPB), self-assessment of fall risk); and the psychoemotional sphere (cognitive functions, emotional state, and anxiety levels). Results were analyzed based on age groups — elderly patients (65–74 years; n=109, 50.5%); senile patients (75–89 years; n=107, 49.5%), and on AF type comparing permanent AF (n=42, 19.4%), persistent or paroxysmal AF (n=174, 80.6%). The median patient age was 74 (IQR: 69–81) years; the cohort included 143 females (66.2%) and 73 males (33.8%). Statistical data processing was performed utilizing the Statistica software, version 13.0 (Dell Inc., USA). RESULTS: The SPPB scores were statistically significantly lower within the permanent AF group (5 [IQR]: 5–7) than in the paroxysmal or persistent AF group (6 [IQR]: 5–8) (p=0.021). Similarly, Barthel Index metrics were statistically significantly lower in these groups — 90 (IQR: 80–100) and 95 (IQR: 90–100) respectively (p=0.001) as were Lawton Instrumental Activities of Daily Living (IADL) Scale parameters — 6 (IQR: 4–7) and 7 (IQR: 6–8) respectively (p=0.001). When comparing the CGA outcomes across different age groups, the SPPB scores, Barthel Index, and Lawton IADL Scale metrics were statistically significantly lower within the senile cohort (p=0.001). CONCLUSION: The CGA outcomes demonstrated that permanent AF exerts a negative impact on CGA scores, particularly within the domains of functional activity and the psychoemotional sphere, leading to deterioration in these parameters. Furthermore, senile patients exhibited more pronounced impairments in identical CGA domains compared to the elderly cohort, indicating an independent association between age and these parameters.