Objective: Older adults, especially those aged 80 years and over, compromise a heterogeneous group due to different levels of frailty, multimorbidity and mental health conditions. These parameters are understudied in very old hypertensive community-dwelling adults. The aim of this study was to investigate the relationship between frailty level and symptoms of anxiety and depression in those patients. Design and method: We conducted a cross-sectional study of consecutive community-dwelling hypertensive patients aged 80 years and over evaluated at a reference Hypertension Unit. Office blood pressure (BP) measurements, frailty status using the Clinical Frailty Score (CFS) scale and symptoms of anxiety and depression using the Hospital Anxiety and Depression Scale (HADS) questionnaire were recorded. Results: A total of 105 patients were included (mean age 83.9±3.8 years, 49.5% women, body mass index 29.3±6.51, mean office systolic/diastolic BP 133.8±19.5/70.8±10.4mmHg, mean number of prescribed medications 5.9±3.0). Regarding frailty, 74 patients (70%) had preserved functional status (groups 1-3 of CFS), 25 patients (24%) had loss of function but preserved autonomy for the activities of daily living (groups 4-5 of CFS), and 6 patients (6%) had severe loss of severe loss of functionality and autonomy for the activities of daily living (groups 6-7 of CFS). Anxiety and depression symptoms were found in 30% and 25% of patients, respectively. The frailty score was significantly associated with the HADS depression subscale score (HADS-D) (r=0.462, p<0.001), while there was a trend toward a positive association between the frailty score and the HADS anxiety subscale score (HADS-A) (r=0.177, p=0.071). The number of prescribed medications was also correlated with the HADS-D score (r=0.283, p=0.003). Moreover, women had significantly higher HADS-A (p=0.013) and HADS-D scores (p=0.027) than men. Conclusions: The prevalence of anxiety and depression symptoms is high in very old hypertensive community-dwelling patients. The frailty level is associated with symptoms of depression, whereas the female sex is associated with both anxiety and depression symptoms. These findings highlight the importance of integrating mental health screening into the routine assessment of very old hypertensive patients, especially of women and those characterized by frailty.
Vakka et al. (Fri,) studied this question.