Frailty (FS) in Patients with Acute Coronary Syndrome (ACS): Comparison between tools for Comprehensive Geriatric Assessment (MMSE, ADL, IADL, HADS) and Tilburg Frailty Indicator (TFI) (original) (raw)

Purpose: It is known fact that age is a strong predictor of adverse events in acute coronary syndrome (ACS). In this context the main risk factor in elderly patients, ie, frailty syndrome (FS), gains special importance. The availability of tools to identify frail persons is relevant for both research and clinical purposes. The purpose of the study was to investigate the correlation of the scale for assessing frailty - the Tilburg Frailty Indicator (TFI) and its domains (mental and physical) - with other research tools commonly used for comprehensive geriatric assessment (CGA) in patients with ACS. Patients and Methods: The study covered 135 people and was carried out in the cardiology ward at T. Marciniak Lower Silesian Specialist Hospital in Wroclaw, Poland. The patients were admitted with ACS. ST-segment elevation (STEMI) and non-ST-segment-elevation (NSTEMI) were defined by the presence of certain conditions in reference to the literature. The Polish adaptation of the TFI was used for the FS assessment, which was compared to other single measures used in geriatric assessment: Mini Mental State Examination (MMSE), Hospital Anxiety and Depression Scale (HADS), Activities of Daily Living (ADLs). Results: The mean TFI value in the studied group amounted to 7.13±2.81 (median=7,IQR=5-9,range={0,14}). Significant correlations were demonstrated between the values of the TFI and other scales: positive for HADS (r=0.602,p<0.001), reverse for MMSE (r=-0.603,p<0.001) and IADL (r=-0.462,p<0.001). Patients with a TFI≥5 revealed considerably higher values of the HADS scale (p<0.001), considerably lower values on the MMSE (p<0.001) and IADL scales (p=0.001). Conclusion: The results for the TFI comply with the results of other scales (MMSE, HADS, ADL, IADL), which confirm the credibility of the Polish adaptation of the tool. Stronger correlations were observed for mental components and the mental scales turned out to be independently related with the TFI in a multidimensional analysis. Keywords: Frailty Syndrome, Acute Coronary Syndrome, Comprehensive Geriatric Assessment Tools