Frailty Assessment in Aortic Stenosis based on Dynamic Interconnection between Cardiac and Motor Systems

Background: Aortic stenosis (AS) is the most common acquired valvar disease and is associated with increased risk for frailty. Frailty as a geriatric syndrome is associated with muscle weakness and a compromised autonomic nervous system (ANS) performance in older adults. The purpose of the current work was to assess differences in both motor and ANS performance, and interaction between them, as symptoms of frailty in community dwelling older adults with and without AS. Results: Eighty-six participants were recruited, including 30 with (age=72$\pm$11, 10 non-frail and 20 pre-frail/frail) and 56 without AS (age=80$\pm$8, 12 non-frail and 44 pre-frail/frail). There was a significant difference in UEF motor score between older adults with and without AS (p<0.01, mean values of 0.57$\pm$0.25 and 0.48$\pm$0.23, respectively). Differences in UEF motor score was also observed between the frailty groups (p=0.02, mean values of 0.55$\pm$0.24 and 0.40$\pm$0.20 for pre-frail/frail and non-frail, respectively). CCM parameters showed significant differences between the frailty groups (p=0.02, mean CCM of 0.69$\pm$0.05 for non-frail and 0.54$\pm$0.03 for pre-frail/frail), but not between the AS groups (p>0.70). No significant interaction was observed between frailty and AS condition (p>0.08). Conclusion: Current findings suggest that ANS measures may be highly associated with frailty regardless of AS condition. Combining motor and HR dynamics parameters in a multimodal model may provide a promising tool for frailty assessment