Multidimensional Frailty and Resilience in Relation to Quality of Life in Senior Patients with Cardiovascular...

Background/Objectives: Cardiovascular diseases are the leading cause of morbidity and mortality in older adults and are frequently associated with multidimensional frailty and reduced quality of life. The present study aimed to investigate the associations among multiple domains of the Comprehensive Geriatric Assessment (CGA), including frailty, cognitive status, emotional status, nutritional status, functional status, fall risk, psychological resilience, and perceived quality of life, in older adults with cardiovascular disease. Methods: A cross-sectional observational study was conducted on 100 patients aged ≥60 years admitted to the Geriatrics Department of the "Dr. C.I. Parhon" Clinical Hospital, Iași. Cognitive, emotional, nutritional, and functional status, fall risk, frailty (Fried and Tilburg scales), resilience- Connor-Davidson Resilience Scale-25 (CD-RISC-25), and quality of life- World Health Organization Quality of Life-BREF (WHOQOL-BREF) were assessed. Statistical analysis included chi-square or Fisher's exact tests and exploratory discrimination analysis using ROC curves. Results: Overall, 61% of participants reported a very good quality of life, whereas the remaining 39% reported a moderately reduced quality of life. Better perceived quality of life was significantly associated with preserved cognitive status, fewer depressive symptoms, better nutritional status, lower frailty (as assessed by both the Fried Frailty Phenotype and the Tilburg Frailty Indicator), preserved functional independence, lower fall risk, and greater psychological resilience (all p < 0.05). In contrast, neither demographic characteristics nor cardiovascular diagnoses were significantly associated with quality of life. Exploratory receiver operating characteristic (ROC) analysis demonstrated modest discriminatory performance for cognitive status- Mini-Mental State Examination (MMSE) (AUC = 0.660; p = 0.007), nutritional status- Mini Nutritional Assessment (MNA) (AUC = 0.624; p = 0.038), and the Tilburg Frailty Indicator (AUC = 0.635; p = 0.024), whereas psychological resilience exhibited an inverse relationship with the predefined outcome (AUC = 0.293; p = 0.001). Conclusions: In hospitalized older adults with cardiovascular disease, perceived quality of life was primarily associated with multidimensional geriatric, functional, nutritional, cognitive, and psychosocial factors, rather than with demographic characteristics or cardiovascular diagnoses. Psychological resilience was identified as an important psychosocial correlate of better perceived quality of life, supporting its inclusion in individualized comprehensive geriatric interventions. These findings highlight the importance of comprehensive geriatric assessment in identifying factors associated with quality of life. Given the cross-sectional design, the observed relationships should be interpreted as associations rather than causal effects and require confirmation in prospective longitudinal studies.