# Prevalence and determinants of multidimensional frailty in hospitalized older adults with coronary heart disease: a LASSO regression analysis

## TL;DR

This study finds that over half of hospitalized older adults with heart disease are frail, with age, gender, and mental health being key factors.

## Contribution

The study uses LASSO regression to identify novel, multidimensional determinants of frailty in CHD patients.

## Key findings

- 53.15% of hospitalized elderly CHD patients were found to have multidimensional frailty.
- Depressive symptoms and insomnia were significant risk factors for frailty.
- Higher ADL scores and social support were protective against frailty.

## Abstract

Frailty has increasingly been recognized as a multidimensional syndrome and is particularly prevalent among older adults with cardiovascular disease. This study aimed to assess the prevalence of multidimensional frailty and identify its key determinants in hospitalized elderly patients with coronary heart disease (CHD), with the goal of informing targeted strategies for early assessment and intervention.

A cross-sectional study was conducted involving 508 patients aged 60 years or older who were hospitalized with CHD at a tertiary hospital in China. Frailty was assessed using the Tilburg Frailty Indicator (TFI). Variables with statistical significance in univariate analysis were entered into a Selection Operator (LASSO) regression for selection. Least Absolute Shrinkage and LASSO regression and multivariate logistic regression analyses were performed to identify significant predictors.

A total of 508 elderly patients with coronary heart disease who were hospitalized were included in the study, of whom 270 patients developed multidimensional frailty, resulting in an incidence rate of 53.15%. Variables with statistical significance in univariate analysis were entered into a LASSO regression for selection. Those retained by LASSO were then included in a multivariate logistic regression model. Multivariate analysis identified the following independent risk factors for multidimensional frailty: Age ≥ 75 years (OR = 2.821; 95% CI: 1.671–4.761); female (OR = 2.279; 95% CI: 1.426–3.643); insomnia (OR = 2.147; 95% CI: 1.374–3.354); depressive symptoms (OR = 4.233; 95% CI: 2.629–6.816). Conversely, higher scores on activities of daily living (ADL) (OR = 0.952; 95% CI: 0.921–0.984) and greater social support (OR = 0.935; 95% CI: 0.901–0.971) were protective against multidimensional frailty.

Multidimensional frailty is highly prevalent in hospitalized CHD patients and independently associated with psychosocial and functional factors. Early screening and integrated interventions targeting these determinants are essential to improve clinical outcomes.