Atrial Fibrillation in Geriatric Patients: A Cross-Sectional Analysis of Risk Factors and Disease Patterns

Background Atrial fibrillation (AF) is the most common type of heart rhythm disorder worldwide, and it disproportionately affects elderly populations, contributing to elevated risks of stroke, heart failure, and cardiovascular mortality. Despite its clinical significance, there remains an underrepresentation of age-specific prevalence trends and modifiable risk factors among elderly cohorts in tertiary care settings. This observational study aimed to quantify AF prevalence, identify age-stratified patterns, and evaluate associations with comorbidities in elderly patients. Methods A cross-sectional study was carried out in a tertiary care hospital, involving 500 patients aged 60 years and older, who were enrolled consecutively upon admission. AF diagnosis was confirmed via a 60-lead electrocardiogram (ECG) or documented medical history. Demographic variables (age and gender) and comorbidities - hypertension, diabetes mellitus (DM), coronary artery disease (CAD), chronic kidney disease (CKD), obesity (body mass index, or BMI ≥30 kg/m²), and prior stroke - were systematically recorded. Risk factor prevalence was compared between AF and non-AF groups using descriptive statistics, without adjustment for potential confounders. Results The cohort had a mean age of 72.5 years (range: 60-89), with a male predominance (n = 300, or 60%). AF was identified in 60 participants, yielding a prevalence of 12%. Age stratification revealed a peak in AF prevalence among those aged 70-79 years: 15 (25%) cases were observed in the 60-69 age group, 30 (50%) in the 70-79 group, and 15 (25%) in the 80-89 group. A Chi-square test for trend confirmed that this variation across age strata was statistically significant (p = 0.03), supporting a true mid-elderly peak in AF occurrence. Hypertension was the most prevalent comorbidity in the overall cohort (n = 360, or 72%), and it was present in 45 (75%) of AF patients. DM was seen in 35 of the 60 AF patients (58.3%), compared to 200 out of 500 overall (40%). Obesity was also disproportionately higher among AF patients (n = 30, or 50%) than in the total cohort (n = 140, or 28%). Similarly, CAD was more frequent in AF patients (n = 25, or 41.7%) compared to the overall population (n = 125, or 25%). CKD was present in 20 (33.3%) AF patients versus 90 (18%) in the full cohort, and a prior history of stroke was noted in 15 (25%) AF patients, compared to 75 (15%) in the overall group. Although the gender distribution in AF cases (n = 36 males, or 60%) mirrored the overall cohort, a Chi-square test showed no statistically significant difference in AF prevalence between males and females (p = 0.99), indicating that gender was not a significant determinant in this study. Conclusion This study reports a 12% prevalence of AF among elderly inpatients, with a statistically significant peak in the 70-79 age group. Key modifiable risk factors - hypertension, diabetes, obesity, and CAD - were more common in patients with AF, highlighting the interplay of metabolic and cardiovascular contributors in its pathogenesis. While routine ECG screening in high-risk subgroups appears feasible in tertiary care settings, the cross-sectional design and potential selection bias limit broader applicability. These findings underscore the need for longitudinal, community-based studies to confirm age-specific trends and develop scalable AF screening strategies for elderly populations.