Assessing the impact of frailty on statin prescriptions among older stroke survivors with and without diabetes

PURPOSE: This study aimed to examine the relationship of frailty and statin prescription in older stroke survivors, and to compare the relationship between participants with and without type 2 diabetes. METHODS: A cross-sectional study was conducted in older patients with ischemic stroke in a tertiary hospital in Malaysia. Frailty assessments prior to discharge from hospital were determined using the Clinical Frailty Scale (CFS) version 2.0. Odds ratios (ORs) were estimated from logistic regression models to examine the relationship between frailty and the prescription of statins. RESULTS: There were 282 participants (mean age 80.8, SD 6.3), 132 with diabetes and 162 were female. The mean CFS score was 6.1 (SD 1.1) in all participants, 6.0 (SD 1.1) in participants without diabetes, and 6.2 (SD 1.0) in participants with diabetes (p = 0.099). Statin was the most commonly prescribed medication at discharge (69.0 %). There was no significant difference on statin prescription rates between participants with and without diabetes (71.0 % vs. 67.3 %, p = 0.508). Increased CFS score was significantly associated with reduced odds of receiving statins in all participants (adjusted OR 0.64, 95 % CI 0.46-0.88), and in participants without diabetes (adjusted OR 0.55, 95 % CI 0.33-0.90), but not in participants with diabetes (adjusted OR 0.73, 95 %CI 0.46-1.18). CONCLUSION: Frailty was associated with reduced odds of receiving statins in the study population. The differences in the relationship between frailty and statin prescriptions among participants with and without diabetes may suggest a personalized approach in secondary prevention for older patients after strokes.