Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2025 Nov;35(11):104159.
doi: 10.1016/j.numecd.2025.104159. Epub 2025 May 19.

Frailty increases the risk of hospitalization for atrial fibrillation in older adults: a population-based cohort study

Caterina Trevisan  1 , Chiara Ceolin  2 , Davide Liborio Vetrano  3 , Mirko Petrovic  4 , Gregory Y H Lip  5 , Iain Buchan  6 , Marina De Rui  7 , Giuseppe Sergi  8 , Stefania Maggi  9 , Marianna Noale  10 ; AFFIRMO Consortium; Søren Påske Johnsen  11 , Riccardo Proietti  11 , Pia Cordsen  11 , Gregory Lip  12 , Deirdre Lane  12 , Martin O'Flaherty  12 , Carrol Gamble  12 , Iain Buchan  12 , Christodoulos Kypridemos  12 , Brendan Collins  12 , Donato Leo  12 , Mirko Petrovic  13 , Delphine De Smedt  13 , Stefanie De Buyser  13 , Cheima Amrouch  13 , Davide Liborio Vetrano  14 , Amaia Calderón-Larrañaga  14 , Lu Dai  14 , Stefania Maggi  15 , Marianna Noale  15 , D A N Gheorghe-Andrei  16 , Anca Rodica Dan  16 , Nicola Ferri  17 , Alessandra Buja  17 , Giuseppe Sergi  17 , Vincenzo Stefano Rebba  17 , Caterina Trevisan  17 , Tatjana Potpara  18 , Laura Vivani  19 , Silvia Ananstasia  19 , Alessandro Ferri  20 , Gehad Shehata  20 , Nadia Rosso  20 , Marco Cicerone  20 , Jacek Marczyk  21 , Trudie Lobban  22 , Georg Ruppe  23 , Graziano Onder  24 , Federica Censi  24 , Robero Da Cas  24 , Cecilia Damiano  24 , Guendalina Graffigna  25 , Caterina Bosio  25 , Lorenzo Palamenghi  25 , Serena Barello  25 , Aldo Pietro Maggioni  26 , Andrea Lorimer  26 , Donata Lucci  26 , Dipak Kalra  27 , Nathan Lea  27 , John Ainsworth  28 , Charlotte Stockton-Powdrell  28 , Alam Sanaullah  28 , Francisco Marín  29 , Vanessa Roldán  29 , José Miguel Rivera-Caravaca  29 , Mariya Tokmakova  30
Affiliations
Free article
Observational Study

Frailty increases the risk of hospitalization for atrial fibrillation in older adults: a population-based cohort study

Caterina Trevisan et al. Nutr Metab Cardiovasc Dis. 2025 Nov.
Free article

Abstract

Background and aims: Atrial fibrillation (AF) is more common with increasing age and older adults have greater prevalence of frailty, multimorbidity and polypharmacy, which may impact clinical outcomes. The present study aims to investigate the relationship between frailty and the risk of hospitalization for AF in older adults, and second, the possible interaction of multimorbidity in this association.

Methods and results: Data from the Progetto Veneto Anziani (Pro.V.A.), an observational cohort study in north-eastern Italy, were utilised. The analyses included 2909 individuals aged ≥65 years without AF at baseline, assessed between 1995 and 1997, with follow-ups at 4.4 and 7 years. Frailty was defined according to Fried's criteria, and multimorbidity as the number of chronic diseases. AF-related hospitalizations and deaths were recorded up to December 31, 2018. Multi-adjusted mixed-effects Cox regressions were performed to test associations. Over the follow-up period, 318 (10.9 %) participants experienced AF-related hospitalizations. Compared to robust participants, the hazard ratio (HR) of hospitalizations due to AF was 1.42 (95 % Confidence Interval (95 %CI): 1.04-1.95) in pre-frail and 1.98 (95 %CI: 1.21-3.26) in frail individuals, even after adjusting for multimorbidity. The number of chronic diseases was only marginally and not significantly associated with AF-related hospitalizations (HR 1.07, 95 %CI: 0.99-1.15), but did not significantly interact with frailty in the association with AF-related hospitalizations.

Conclusion: Older adults with frailty present with higher hazards of AF-related hospitalizations, irrespective of the presence of multimorbidity. Further studies are needed to evaluate whether reducing frailty may prevent AF development and improve health outcomes in older adults.

Keywords: AFFIRMO project; Atrial fibrillation; Frailty; Hospitalization; Multimorbidity.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest None.

Publication types

MeSH terms

LinkOut - more resources