# Segmental Bioimpedance Phase Angles for Frailty Detection in Hospitalized Older Adults with Cardiovascular Disease: A Cross-Sectional Observational Study

## TL;DR

Segmental bioimpedance phase angles can help detect frailty in older men with cardiovascular disease, but are less effective in women.

## Contribution

This study introduces segmental phase angles as a potential non-invasive tool for frailty detection in hospitalized older adults with cardiovascular disease.

## Key findings

- Segmental phase angles in men showed moderate accuracy for frailty detection.
- Frailty was associated with lower phase angles and biomarkers like low hemoglobin and high CRP.
- Predictive capacity of segmental phase angles was limited in women.

## Abstract

What are the main findings?

Segmental bioimpedance phase angles are significantly lower in frail older adults hospitalized with cardiovascular disease.

In men, left body and left leg phase angles showed moderate discriminatory capacity for frailty detection, while women showed lower predictive performance.

What are the implications of the main findings?

Segmental phase angle measurement is a simple, rapid, and non-invasive bedside tool that can support early frailty identification in cardiology wards.

Integrating phase angles with routine biomarkers such as hemoglobin and CRP could improve patient risk stratification, optimize resource allocation, and guide individualized care strategies in hospital settings.

Background/Objectives: Whole-body phase angle is associated with in-hospital morbidity and mortality, although cut-off points vary. Studies on the relationship between segmental phase angles and frailty in patients with cardiovascular disease are limited. Therefore, we aimed to assess the prognostic value of segmental phase angles in detecting frailty in older adults hospitalized with cardiovascular disease. Methods: A cross-sectional observational study was conducted on hospitalized patients aged ≥60 years with cardiovascular disease (sample size: 117–158 subjects). Frailty was identified using Fried’s five criteria. Biomarkers, body composition, and segmental phase angles were assessed using multifrequency bioimpedance. Associations with frailty were analyzed using logistic regression and Receiver Operating Characteristic (ROC) curves. Sensitivity, specificity, and positive likelihood ratio (LR+) were calculated (95% CI; p < 0.05). Results: A total of 157 patients (men: 64.24%; women: 33.76%) were included, with a mean age of 73.23 years (SD = 7.91). The prevalence of frailty was 28.66%. In men, the phase angles of the left hemisphere (5.15°) and left leg (4.25°) demonstrated moderate-accuracy capacity (AUC: 0.66–0.71; LR+: >2). In women, the segments with significance did not exceed an LR+ of 2. Frailty was associated with lower phase angle values in all segments and biomarkers such as hemoglobin < 12 g/dL (p = 0.011) and CRP > 5 mg/L (p = 0.030). Conclusions: Segmental phase angles demonstrated moderate discriminatory capacity for identifying frailty among hospitalized older men with cardiovascular disease, though predictive capacity in women was limited. This approach may support bedside frailty screening and inform individualized management.