The Role of Sleep Disturbance, Depression and Anxiety in Frail Patients with AF-Gender Differences

The aim of the study was to assess the link between anxiety and depression and frailty syndrome (FS) in patients with atrial fibrillation (AF) with regard to gender differences. Material and methods. The study was conducted on 158 patients with AF (mean age 70.4 +/- 7.6). The study used the hospital anxiety and depression scale (HADS-M), the Athens insomnia scale (AIS) and the Edmonton frailty scale to assess and compare anxiety, depression, and sleep disturbance between frail and non-frail patients with AF. Results. FS was diagnosed in 53.2% of patients. A comparative analysis showed a statistically significantly higher severity level of anxiety (12.0 +/- 2.6 vs. 8.4 +/- 2.5, p < 0.001) and depression (12.5 +/- 2.5 vs. 7.2 +/- 3.3, p < 0.001) in frail patients compared to non-frail patients. The analysis of the level of anxiety, depression and FS did not show any significant differences between the studied women and men. However, statistically, significant differences were observed when FS occurred, regardless of gender. Anxiety disorders were observed in 75.5% of patients with FS and in 16.7% without frailty, whereas depressive disorders were observed in 73.6% of frail patients and in 4.2% without frailty. In an analysis of the impact of cumulative variables on the level of frailty, the risk of FS in patients with anxiety/depression and sleep disturbance is almost 500 times higher compared to patients without anxiety/depression and sleep disturbance. The risk of frailty in patients with sleep disturbance only is thirteen times higher than in the reference group, i.e., in patients without depression/anxiety and sleep disturbances. Conclusions: Patients with AF and FS show deeper anxiety, depression and sleep disturbances. Gender does not influence the risk of frailty in AF patients. Frailty in patients with AF is associated with a higher risk of depression, sleep disturbances and anxiety.

Automated summary

The study found that a significant percentage of patients with atrial fibrillation (AF) have frailty syndrome (FS), with frail patients showing higher levels of anxiety and depression compared to non-frail patients, regardless of gender. There is a strong association between anxiety, depression, and sleep disturbances with FS in patients with AF.