{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T11:18:45Z","timestamp":1776338325089,"version":"3.51.2"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T00:00:00Z","timestamp":1773100800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"vor","delay-in-days":37,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"name":"Bayer Nederland, Boehringer Ingelheim, Daiichi Sankyo and Roche Diagnostics."}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Geriatr"],"DOI":"10.1186\/s12877-026-07189-0","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T05:18:17Z","timestamp":1773119897000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Polypharmacy and cardiovascular co-morbidity as key contributors to frailty in geriatric patients with AF \u2013 insights of the Dutch-GERAF cohort study"],"prefix":"10.1186","volume":"26","author":[{"given":"J.R.","family":"Spruit","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"LAR","family":"Zwart","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"RWMM","family":"Jansen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Muller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"JR de","family":"Groot","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"MEW","family":"Hemels","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,3,10]]},"reference":[{"issue":"8","key":"7189_CR1","first-page":"837","volume":"129","author":"SS Chugh","year":"2014","unstructured":"Chugh SS, Havmoeller R, Narayanan K, Singh D, Rienstra M, Benjamin EJ, et al. Worldw Epidemiol Atr Fibrillation Circulation. 2014;129(8):837\u201347.","journal-title":"Worldw Epidemiol Atr Fibrillation Circulation"},{"issue":"9","key":"7189_CR2","doi-asserted-by":"publisher","first-page":"105764","DOI":"10.1016\/j.jamda.2025.105764","volume":"26","author":"C Ceolin","year":"2025","unstructured":"Ceolin C, Mizzon E, Noale M, Ravelli A, Pigozzo S, Curreri C, et al. The impact of atrial fibrillation on physical performance in older adults: A longitudinal study in relation to cognitive function. J Am Med Dir Assoc. 2025;26(9):105764.","journal-title":"J Am Med Dir Assoc"},{"issue":"5","key":"7189_CR3","doi-asserted-by":"publisher","first-page":"432","DOI":"10.1093\/ageing\/afi146","volume":"34","author":"K Rockwood","year":"2005","unstructured":"Rockwood K. What would make a definition of frailty successful? Age Ageing. 2005;34(5):432\u20134.","journal-title":"Age Ageing"},{"key":"7189_CR4","first-page":"100106","volume":"13","author":"C de Terwangne","year":"2022","unstructured":"de Terwangne C, Sorgente A, Macovei S, Preumont T, Chierchia G, de Asmundis C, et al. Association between atrial fibrillation, frailty, and geriatric syndromes in the late elderly in a South Belgian outpatient and inpatient setting. Am Heart J Plus: Cardiol Res Pract. 2022;13:100106.","journal-title":"Am Heart J Plus: Cardiol Res Pract"},{"key":"7189_CR5","doi-asserted-by":"publisher","unstructured":"Salis F, Palimodde A, Demelas G, Scionis MI, Mandas A. Frailty and comorbidity burden in atrial fibrillation. Front Public Health. 2023;11:1134453. https:\/\/doi.org\/10.3389\/fpubh.2023.1134453. PMID: 36969648; PMCID: PMC10034171.","DOI":"10.3389\/fpubh.2023.1134453"},{"issue":"1","key":"7189_CR6","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1186\/s12916-020-01870-w","volume":"18","author":"C Wilkinson","year":"2020","unstructured":"Wilkinson C, Wu J, Searle SD, Todd O, Hall M, Kunadian V, et al. Clinical outcomes in patients with atrial fibrillation and frailty: insights from the ENGAGE AF-TIMI 48 trial. BMC Med. 2020;18(1):401.","journal-title":"BMC Med"},{"issue":"3","key":"7189_CR7","doi-asserted-by":"publisher","first-page":"M146","DOI":"10.1093\/gerona\/56.3.M146","volume":"56","author":"LP Fried","year":"2001","unstructured":"Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol Biol Sci Med Sci. 2001;56(3):M146\u201357.","journal-title":"J Gerontol Biol Sci Med Sci"},{"issue":"7","key":"7189_CR8","doi-asserted-by":"publisher","first-page":"722","DOI":"10.1093\/gerona\/62.7.722","volume":"62","author":"K Rockwood","year":"2007","unstructured":"Rockwood K, Mitnitski A. Frailty in relation to the accumulation of deficits. J Gerontol Biol Sci Med Sci. 2007;62(7):722\u20137.","journal-title":"J Gerontol Biol Sci Med Sci"},{"issue":"1","key":"7189_CR9","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1186\/1471-2318-8-24","volume":"8","author":"SD Searle","year":"2008","unstructured":"Searle SD, Mitnitski A, Gahbauer EA, Gill TM, Rockwood K. A standard procedure for creating a frailty index. BMC Geriatr. 2008;8(1):24.","journal-title":"BMC Geriatr"},{"issue":"5","key":"7189_CR10","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1503\/cmaj.050051","volume":"173","author":"K Rockwood","year":"2005","unstructured":"Rockwood K. A global clinical measure of fitness and frailty in elderly people. Can Med Assoc J. 2005;173(5):489\u201395.","journal-title":"Can Med Assoc J"},{"issue":"2","key":"7189_CR11","doi-asserted-by":"publisher","first-page":"50","DOI":"10.3390\/geriatrics9020050","volume":"9","author":"AN Rosas Diaz","year":"2024","unstructured":"Rosas Diaz AN, Troy AL, Kaplinskiy V, Pritchard A, Vani R, Ko D, et al. Assessment and management of atrial fibrillation in older adults with frailty. Geriatrics. 2024;9(2):50.","journal-title":"Geriatrics"},{"issue":"1","key":"7189_CR12","doi-asserted-by":"publisher","first-page":"49","DOI":"10.15420\/ecr.2016:13:2","volume":"11","author":"A Alonso","year":"2016","unstructured":"Alonso A, Arenas de Larriva AP. Atrial Fibrillation, cognitive decline and dementia. Eur Cardiol Rev. 2016;11(1):49.","journal-title":"Eur Cardiol Rev"},{"issue":"5","key":"7189_CR13","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1007\/s12471-024-01868-6","volume":"32","author":"LAR Zwart","year":"2024","unstructured":"Zwart LAR, Spruit JR, Hemels MEW, de Groot JR, Pisters R, Riezebos RK, et al. Design of the Dutch multicentre study on opportunistic screening of geriatric patients for atrial fibrillation using a smartphone PPG app: the Dutch-GERAF study. Neth Heart J. 2024;32(5):200\u20135.","journal-title":"Neth Heart J"},{"key":"7189_CR14","doi-asserted-by":"publisher","unstructured":"Zwart LAR, Spruit JR, Jansen RWMM, Riezebos RK, Pisters R, Louter L, et al. Opportunistic screening for atrial fibrillation among frail older patients, little effort for a high diagnostic yield. Outcomes of the Dutch-GERAF study. Age Ageing. 2025;54(4):afaf105. https:\/\/doi.org\/10.1093\/ageing\/afaf105. PMID: 40253687; PMCID: PMC12009541.","DOI":"10.1093\/ageing\/afaf105"},{"key":"7189_CR15","doi-asserted-by":"crossref","unstructured":"Kok R, VF. Folstein, &. Dutch translation of the Mini Mental State Examination 1975;2002.","DOI":"10.1037\/t07757-000"},{"issue":"3","key":"7189_CR16","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1016\/0022-3956(75)90026-6","volume":"12","author":"MF Folstein","year":"1975","unstructured":"Folstein MF, Folstein SE, McHugh PR. Mini-mental state: A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189\u201398.","journal-title":"J Psychiatr Res"},{"issue":"9","key":"7189_CR17","doi-asserted-by":"crossref","first-page":"1991","DOI":"10.1111\/jgs.15925","volume":"67","author":"ZSPNBVCSWVCICJCH Nasreddine","year":"2019","unstructured":"Nasreddine ZSPNBVCSWVCICJCH. The Montreal cognitive Assessment, moca: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2019;67(9):1991\u20131991.","journal-title":"J Am Geriatr Soc"},{"key":"7189_CR18","doi-asserted-by":"publisher","unstructured":"O\u2019Bryant SE, Humphreys JD, Smith GE, Ivnik RJ, Graff-Radford NR, Petersen RC, et al. Detecting dementia with the Mini-Mental state examination in highly educated individuals. Arch Neurol. 2008;65(7):963\u20137. https:\/\/doi.org\/10.1001\/archneur.65.7.963. PMID: 18625866; PMCID: PMC2587038.","DOI":"10.1001\/archneur.65.7.963"},{"issue":"7","key":"7189_CR19","doi-asserted-by":"publisher","first-page":"738","DOI":"10.1093\/gerona\/62.7.738","volume":"62","author":"K Rockwood","year":"2007","unstructured":"Rockwood K, Andrew M, Mitnitski A. A comparison of two approaches to measuring frailty in elderly people. J Gerontol Biol Sci Med Sci. 2007;62(7):738\u201343.","journal-title":"J Gerontol Biol Sci Med Sci"},{"issue":"3","key":"7189_CR20","doi-asserted-by":"publisher","first-page":"1037","DOI":"10.1007\/s41999-025-01182-3","volume":"16","author":"PH Drop","year":"2025","unstructured":"Drop PH, van Ham C, Mulder ACM, Veeken \u2013 Dijkstra PA, Daal JO, Zwart LAR. Validation of the nurse directed frailty assessment tool, to identify patients at risk of emergency department visits, hospitalisation, and 1-year all-cause mortality. Eur Geriatr Med. 2025;16(3):1037\u201344.","journal-title":"Eur Geriatr Med"},{"key":"7189_CR21","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1016\/j.ejim.2024.12.034","volume":"134","author":"M Camafort","year":"2025","unstructured":"Camafort M, Kasiakogias A, Agabiti-Rosei E, Masi S, Iliakis P, Benetos A, et al. Hypertensive heart disease in older patients: considerations for clinical practice. Eur J Intern Med. 2025;134:75\u201388.","journal-title":"Eur J Intern Med"},{"issue":"1","key":"7189_CR22","first-page":"6","volume":"12","author":"V Cicek","year":"2024","unstructured":"Cicek V, Babaoglu M, Saylik F, Yavuz S, Mazlum AF, Genc MS, et al. A new risk prediction model for the assessment of myocardial injury in elderly patients undergoing Non-Elective surgery. J Cardiovasc Dev Dis. 2024;12(1):6.","journal-title":"J Cardiovasc Dev Dis"},{"issue":"3","key":"7189_CR23","doi-asserted-by":"publisher","first-page":"653","DOI":"10.1007\/s40520-021-01960-6","volume":"34","author":"M\u0130 Hay\u0131ro\u011flu","year":"2022","unstructured":"Hay\u0131ro\u011flu M\u0130, \u00c7\u0131nar T, \u00c7inier G, Pay L, Yumurta\u015f A\u00c7, Tezen O, et al. Comparison of mortality prediction scores in elderly patients with ICD for heart failure with reduced ejection fraction. Aging Clin Exp Res. 2022;34(3):653\u201360.","journal-title":"Aging Clin Exp Res"},{"issue":"2","key":"7189_CR24","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1161\/01.STR.28.2.316","volume":"28","author":"A Ott","year":"1997","unstructured":"Ott A, Breteler MMB, de Bruyne MC, van Harskamp F, Grobbee DE, Hofman A. Atrial fibrillation and dementia in a Population-Based study. Stroke. 1997;28(2):316\u201321.","journal-title":"Stroke"},{"issue":"6","key":"7189_CR25","doi-asserted-by":"publisher","first-page":"770","DOI":"10.1111\/ggi.12349","volume":"15","author":"M Di Nisio","year":"2015","unstructured":"Di Nisio M, Prisciandaro M, Rutjes AW, Russi I, Maiorini L, Porreca E. Dementia in patients with atrial fibrillation and the value of the <\u2009scp>H Achinski ischemic score. Geriatr Gerontol Int. 2015;15(6):770\u20137.","journal-title":"Geriatr Gerontol Int"},{"issue":"8","key":"7189_CR26","doi-asserted-by":"publisher","first-page":"604","DOI":"10.1097\/NMD.0000000000000336","volume":"203","author":"ME Habeych","year":"2015","unstructured":"Habeych ME, Castilla-Puentes R. Comorbid medical conditions in vascular dementia. J Nerv Mental Disease. 2015;203(8):604\u20138.","journal-title":"J Nerv Mental Disease"},{"issue":"23","key":"7189_CR27","doi-asserted-by":"publisher","first-page":"7388","DOI":"10.3390\/jcm12237388","volume":"12","author":"LAR Zwart","year":"2023","unstructured":"Zwart LAR, Walgers JJ, Hemels MEW, Germans T, de Groot JR, Jansen RWMM. The use of oral anticoagulation is not independently associated with mortality in frail older patients with repeated falls. J Clin Med. 2023;12(23):7388.","journal-title":"J Clin Med"}],"container-title":["BMC Geriatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12877-026-07189-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12877-026-07189-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12877-026-07189-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T10:39:09Z","timestamp":1776335949000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12877-026-07189-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,10]]},"references-count":27,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["7189"],"URL":"https:\/\/doi.org\/10.1186\/s12877-026-07189-0","relation":{},"ISSN":["1471-2318"],"issn-type":[{"value":"1471-2318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,10]]},"assertion":[{"value":"30 September 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study complies with the declaration of Helsinki, and the protocol was approved by the medical Ethical Committee Oost Nederland (reference number 2019\u20135889), Prof. dr. P.N.R. Dekhuijzen, Chairman, Research Ethics Committee: On behalf of the research ethics committee of the Radboud University Nijmegen Medical Centre I hereby let you know that the abovementioned study doesn\u2019t fall within the remit of the Medical Research Involving Human Subjects Act (WMO). Therefore, the study can be carried out (in the Netherlands) without an approval by an accredited research ethics committee.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"JdG is Supported by the Dutch Heart Foundation and Dutch CardioVascular Alliance, 01-002-2022-0118 EmbRACE; ZonMW\/ERA4Health. Received research grants through institutions from Atricure, Bayer, Boston Scientific, Daiichi Sankyo, Johnson&Johnson, Medtronic and Philips. Received speaker fees from Atricure, Bayer, Berlin Chemie, Daiichi Sankyo, Johnson&Johnson, Menarini, Medtronic, Novartis and Servier. MH received speakers fees from Roche Diagnostics, Bayer, BMS\/Pfizer, Boehringer Ingelheim and Daiichi Sankyo.JS, LZ, MM, and RJ declare that they have no competing interests. All patients gave written informed consent to participate.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"539"}}