Correlation of ankle-brachial index with frailty status in old hospitalized patients

Introduction: Frailty is a state of vulnerability due to poor recovery of homeostasis after stressor event and is a consequence of cumulative decline in many physiological systems, including the cardiovascular one. Atherosclerosis causes a chronic reduction of vascularization of tissues, contributing in this way to the functional and cognitive decline of the elderly. The Ankle-Brachial Index (ABI), obtained by the ankle/brachial blood pressure ratio, as an indicator of atherosclerosis, could be used as a marker of frailty. Methods: Our cross-sectional monocentric study selected 100 patients of ≥ 65 years old (average age 80 ± 6.9 years) hospitalized in the Internal Medicine department of our institution. Subjects were evaluated with ABI and frailty indexes (death, hospitalization length, delirium, falls, cognitive impairment, ADL and I-ADL). Results: At the correlation analysis of the various indexes of frailty considered, the only significant correlations with the ABI were represented by the cognitive impairment (r = − 0.298; p = 0.003) and the ADL index (r = 0.198; p = 0.048). At the subsequent multivariate regression, the ABI index remained a statistically significant determinant of cognitive impairment (β = − 5.818; p = 0.01) but not of ADL (β = 0.328; p = 0.729). Conclusions: Lower ABI is associated with worse cognitive performance in old age, possibly because of long-term exposure to atherosclerotic disease. This would accentuate the functional disability of the elder, even in the simplest daily actions, and support the hypothesis that the ABI can be used as a marker of frailty in elderly people.