Nursing Care for Frailty and Atrial Fibrillation in the Elderly: A Case Study
Keywords:
Aging, Atrial fibrillation, Frailty, Nursing careAbstract
Frailty in the elderly is a condition in which the body deteriorates and the ability to adapt decreases, resulting in a risk of health complications. Co-morbidities and frailty in the elderly are associated with physiological changes in the heart, leading to an increased risk of arrhythmias, particularly atrial fibrillation. Frail elderly individuals may exhibit subtle signs and symptoms of atrial fibrillation. Therefore, frailty assessment and screening for atrial fibrillation in the elderly are crucial for proper nursing care. This includes critical care, which emphasizes nursing care and the prevention of severe complications. Meanwhile, continuous care encompasses discharge planning, health promotion, the prevention and reduction of long-term complications, and rehabilitation supported by a multidisciplinary team. This approach takes into account individual patient needs to promote a sustainable quality of life for the elderly and their families.
References
Bencivenga, L., Komici, K., Nocella, P., Grieco, F. V., Spezzano, A., Puzone, B., Cannavo, A., Cittadini, A., Corbi, G., Ferrara, N., & Rengo, G. (2020). Atrial fibrillation in the elderly: A risk factor beyond stroke. Ageing Research Reviews, 61, 101092. https://doi.org/10.1016/j.arr.2020.101092
Cai, L., Sun, Y., Zhu, J., Wang, B., Tan, X., Shi, W., Xu, D., Wang, Y., Lu, Y., & Wang, N. (2025). Long-term changes in frailty and incident atrial fibrillation, heart failure, coronary heart disease, and stroke: A prospective follow-up study. Heart Rhythm, 22(12), 3090-3098. https://doi.org/10.1016/j.hrthm.2025.01.004
Chen, Q., Yi, Z., & Cheng, J. (2018). Atrial fibrillation in aging population. Aging Medicine, 1(1), 67–74. https://doi.org/10.1002/agm2.12015
Dent, E., Morley, J. E., Cruz-Jentoft, A. J., Woodhouse, L., Rodríguez-Mañas, L., Fried, L. P., Woo, J., Aprahamian, I., Sanford, A., Lundy, J., Landi, F., Beilby, J., Martin, F. C., Bauer, J. M., Ferrucci, L., Merchant, R. A., Dong, B., Arai, H., Hoogendijk, E. O., … Vellas, B. (2019). Physical frailty: ICFSR international clinical practice guidelines for identification and management. Journal of Nutrition, Health & Aging, 23(9), 771–787. https://doi.org/10.1007/s12603-019-1273-z
Diaz, A. N. R, Troy, A. L., Kaplinskiy, V., Pritchard, A., Vani, R., Ko, D., & Orkaby, A. R. (2024). Assessment and management of atrial fibrillation in older adults with frailty. Geriatrics (Basel, Switzerland), 9(2), 50. https://doi.org/10.3390/geriatrics9020050
Gao, P., Gao, X., Xie, B., Tse, G., & Liu, T. (2024). Aging and atrial fibrillation: A vicious circle. International Journal of Cardiology, 395, 131445. https://doi.org/10.1016/j.ijcard.2023.131445
Gelder, I. C. V., Rienstra, M., Bunting, K. V., Casado-Arroyo, R., Caso, V., Crijns, H. J. G. M., Potter, T. J. R. D., Dwight, J., Guasti, L., Hanke, T., Jaarsma, T., Lettino, M., Løchen, M., Lumbers, R. T., Maesen, B., Mølgaard, I., Rosano, G. M. C., Sanders, P., Schnabel, R. B., … ESC Scientific Document Group. (2024). 2024 ESC guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). European Heart Journal, 45(36), 3314–3414. https://doi.org/10.1093/eurheartj/ehae176
Hang, F., Chen, J., Wang, Z., Yan, J., & Wu, Y. (2022). Association between the frailty and new-onset atrial fibrillation/flutter among elderly hypertensive patients. Frontiers in Cardiovascular Medicine, 9, 881946. https://doi.org/10.3389/fcvm.2022.881946
Harrison, S. L., Johnsen S. P., & Lip, G. Y. H. (2023). The impact of frailty on the management of atrial fibrillation. Aging, 15(14), 6622-6624. https://doi.org/10.18632/aging.204918
Khurshid, S., Ashburner, J. M., Ellinor, P. T., McManus, D. D., Atlas, S. J., Singer, D. E., & Lubitz, S. A. (2023). Prevalence and incidence of atrial fibrillation among older primary care patients. JAMA Network Open, 6(2), e2255838. https://doi.org/10.1001/jamanetworkopen.2022.55838
Kim, J. Y., Kim, J., Park, S. J., Park, K. M., Han, S. J., Kim, D. K., Park, Y. M., Lee, S. H., Park, J. S., On, Y. K., & LEDIOS Registry Investigators. (2024). Optimal dose of edoxaban for very elderly atrial fibrillation patients at high risk of bleeding: The LEDIOS registry. Korean Circulation Journal, 54(7), 398–406. https://doi.org/10.4070/kcj.2024.0084
National Institute for Health and Care Excellence. (2021). Atrial fibrillation: Diagnosis and management. https://www.nice.org.uk/guidance/ng196/resources/atrial-fibrillation-diagnosis-and-management-pdf-66142085507269
Parks, A. L., Frankel, D. S., Kim, D. H., Ko, D., Kramer, D. B., Lydston, M., Fang, M. C., & Shah, S. J. (2024). Management of atrial fibrillation in older adults. BMJ, 386, e076246. https://doi.org/10.1136/bmj-2023-076246
Soliman, E. Z., Rahman, A. F., Zhang, Z., Rodriguez, C. J., Chang, T. I., Bates, J. T., Ghazi, L., Blackshear, J. L., Chonchol, M., Fine, L. J., Ambrosius, W. T., & Lewis, C. E. (2020). Effect of intensive blood pressure lowering on the risk of atrial fibrillation. Hypertension, 75(6), 1491–1496. https://doi.org/10.1161/HYPERTENSIONAHA.120.14766
Talasaz, A. H., McGonagle, B., HajiQasemi, M., Ghelichkhan, Z. A., Sadeghipour, P., Rashedi, S., Cuker, A., Lech, T., Goldhaber, S. Z., Jennings, D. L., Piazza, G., & Bikdeli, B. (2025). Pharmacokinetic and pharmacodynamic interactions between food or herbal products and oral anticoagulants: Evidence review, practical recommendations, and knowledge gaps. Seminars in Thrombosis and Hemostasis, 51(5), 560–571. https://doi.org/10.1055/s-0044-1790258
Testa, C., Salvi, M., Zucchini, I., Cattabiani, C., Giallauria, F., Petraglia, L., Leosco, D., Lauretani, F., & Maggio, M. (2025). Atrial fibrillation as a geriatric syndrome: Why are frailty and disability often confused? A geriatric perspective from the new guidelines. International Journal of Environmental Research and Public Health, 22(2), 179. https://doi.org/10.3390/ijerph22020179
Thanakijtummakul, N. (2021). Nursing care for reducing bruising in patients receiving enoxaparin sodium. Journal of Nurses Association of Thailand Northern Office, 27(1), 38-49.
Trevisan, C., Ceolin, C., Vetrano, D. L., Petrovic, M., Lip, G. Y. H., Buchan, I., Rui, M. D., Sergi, G., Maggi, S., Noale, M., Consortium A., Johnsen, S. P., Proietti, R., Cordsen, P., Lip, G., Lane, D., O'Flaherty, M., Gamble, C., Buchan, I., … Tokmakova, M. (2025). Frailty increases the risk of hospitalization for atrial fibrillation in older adults: A population-based cohort study. Nutrition, Metabolism, and Cardiovascular Diseases, 35, 104159. https://doi.org/10.1016/j.numecd.2025.104159
van Deutekom, C., Hendriks, J. M. L., Myrstad, M., Van Gelder, I. C., & Rienstra, M. (2024). Managing elderly patients with atrial fibrillation and multimorbidity: Call for a systematic approach. Expert Review of Cardiovascular Therapy, 22(10), 523–536. https://doi.org/10.1080/14779072.2024.2416666
Volgman, A. S., Nair, G., Lyubarova, R., Merchant, F. M., Mason, P., Curtis, A. B., Wenger, N. K., Aggarwal, N. T., Kirkpatrick, J. N., & Benjamin, E. J. (2022). Management of atrial fibrillation in patients 75 years and older: JACC state-of-the-art review. Journal of the American College of Cardiology, 79(2), 166–179. https://doi.org/10.1016/j.jacc.2021.10.037
Williams, E. G., Alissa, M., Alsugoor, M. H., Albakri, G. S., Altamimi, A. A., Alabdullateef, A. A., Almansour, N. M., Aldakheel, F. M., Alessa, S., & Marber, M. (2025). Integrative approaches to atrial fibrillation prevention and management: Leveraging gut health for improved cardiovascular outcomes in the aging population. Current Problems in Cardiology, 50(3), 102952. https://doi.org/10.1016/j.cpcardiol.2024.102952
Yao, J., Chen, K., He, Z., & Chen, D. (2025). Impact of frailty on outcomes of elderly patients with atrial fibrillation: A systematic review and meta-analysis. Pakistan Journal of Medical Sciences, 41(3), 891–901. https://doi.org/10.12669/pjms.41.3.11357
Zheng, Y., Zhang, N., Tse, G., Li, G., Lip, G. Y. H., & Liu, T. (2023). Co-administered oral anticoagulants with nonsteroidal anti-inflammatory drugs and the risk of bleeding: A systematic review and meta-analysis. Thrombosis Research, 232, 15–26. https://doi.org/10.1016/j.thromres.2023.10.011
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Nursing Journal CMU

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
บทความที่ได้รับการตีพิมพ์เป็นลิขสิทธิ์ของวารสารพยาบาลสาร
ข้อความที่ปรากฏในบทความแต่ละเรื่องในวารสารวิชาการเล่มนี้เป็นความคิดเห็นส่วนตัวของผู้เขียนแต่ละท่านไม่เกี่ยวข้องกับมหาวิทยาลัยเชียงใหม่ และคณาจารย์ท่านอื่นๆในมหาวิทยาลัยฯ แต่อย่างใด ความรับผิดชอบองค์ประกอบทั้งหมดของบทความแต่ละเรื่องเป็นของผู้เขียนแต่ละท่าน หากมีความผิดพลาดใด ๆ ผู้เขียนแต่ละท่านจะรับผิดชอบบทความของตนเองแต่ผู้เดียว