Cardiol Res

Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access

Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc

Journal website https://www.cardiologyres.org

Original Article

Volume 11, Number 6, December 2020, pages 405-411

Relationship Between Kihon Checklist Score and Anxiety Levels in Elderly Patients Undergoing Early Phase II Cardiac Rehabilitation

Figure 1. Correlation between KCL scores and anxiety levels. KCL score correlated with state anxiety (r = 0.32, P < 0.05) (a) and trait anxiety (r = 0.41, P < 0.05) (b) in elderly patients undergoing early phase II CR (n = 255). KCL score, excluding depression mood, correlated with state anxiety (r = 0.23, P < 0.05) (c) and trait anxiety (r = 0.33, P < 0.05) (d) in elderly patients undergoing early phase II CR (n = 255). KCL: Kihon Checklist.

**Table 1.** Clinical Characteristics of the Study Participants
	Non-frailty (n = 75)	Pre-frailty (n = 81)	Frailty (n = 99)	P value
Data are presented as the mean value ± SD. ^aP < 0.05 vs. non-frailty by Tukey’s honest significant difference test. BMI: body mass index; CVD: cardiovascular disease; CR: cardiac rehabilitation; eGFR: estimated glomerular filtration rate; TG: triglyceride; HDL-C: high-density lipoprotein cholesterol; LDL-C: low-density lipoprotein cholesterol; HbA1c: hemoglobin A1c; BNP: brain natriuretic peptide; GNRI, geriatric nutritional risk index; LV: left ventricular.
Age (years)	73.8 ± 5.7	75.0 ± 5.8	75.5 ± 5.8	0.14
Male (%)	60 (80)	48 (60)^a	62 (62)^a	0.01
BMI (kg/m²)	23.5 ± 2.7	22.5 ± 3.9	21.5 ± 4.6^a	< 0.01
Hypertension (%)	55 (73)	53 (66)	70 (70)	0.35
Dyslipidemia (%)	37 (49)	37 (46)	46 (46)	0.89
Diabetes mellitus (%)	20 (27)	24 (30)	36 (36)	0.26
Current smoker (%)	14 (19)	9 (10)	13 (13)	0.24
CVD at the beginning of CR
Ischemic heart disease (%)	40 (53)	43 (53)	52 (52)	0.99
Open heart surgery (%)	41 (55)	49 (61)	64 (64)	0.41
Chronic heart failure (%)	13 (17)	19 (24)	24 (24)	0.51
Anthropometric parameters and physical function
Body fat percentage (%)	22.8 ± 8.0	24.2 ± 11.2	21.7 ± 9.8	0.28
Lean body weight (kg)	47.5 ± 7.6	42.7 ± 8.6^a	41.9 ± 9.2^a	< 0.01
Grip strength (kg)	28.1 ± 6.8	27.1 ± 7.4	25.4 ± 7.9	0.27
6-min walking test (m)	387 ± 72	339 ± 92^a	310 ± 95^a	< 0.01
Laboratory data
Hemoglobin (g/dL)	13.2 ± 1.9	12.5 ± 1.8^a	12.2 ± 1.7^a	< 0.01
Albumin (g/dL)	3.9 ± 0.4	3.8 ± 0.6	3.7 ± 0.5	0.08
Creatinine (mg/dL)	1.03 ± 1.13	1.19 ± 1.28	1.31 ± 1.60	0.39
eGFR (mL/min/1.73m²)	67.0 ± 21.3	63.2 ± 26.6	57.5 ± 24.6^a	0.03
TG (mg/dL)	112 ± 59	114 ± 96	104 ± 48	0.58
HDL-C (mg/dL)	49 ± 15	50 ± 15	49 ± 15	0.93
LDL-C (mg/dL)	101 ± 27	103 ± 30	94 ± 28	0.08
HbA1c (%)	6.0 ± 0.7	6.1 ± 0.9	6.2 ± 0.9	0.31
BNP (pg/mL)	205 ± 407	265 ± 374	303 ± 709	0.49
GNRI	102.3 ± 8.5	98.1 ± 14.3	96.0 ± 12.1^a	< 0.01
LV ejection fraction (%)	59.7 ± 15.3	56.3 ± 14.6	57.1 ± 16.4	0.34

Table 1. Clinical Characteristics of the Study Participants

Non-frailty (n = 75)

Pre-frailty (n = 81)

Frailty (n = 99)

P value

Data are presented as the mean value ± SD. ^aP < 0.05 vs. non-frailty by Tukey’s honest significant difference test. BMI: body mass index; CVD: cardiovascular disease; CR: cardiac rehabilitation; eGFR: estimated glomerular filtration rate; TG: triglyceride; HDL-C: high-density lipoprotein cholesterol; LDL-C: low-density lipoprotein cholesterol; HbA1c: hemoglobin A1c; BNP: brain natriuretic peptide; GNRI, geriatric nutritional risk index; LV: left ventricular.

Age (years)

73.8 ± 5.7

75.0 ± 5.8

75.5 ± 5.8

0.14

Male (%)

60 (80)

48 (60)^a

62 (62)^a

0.01

BMI (kg/m²)

23.5 ± 2.7

22.5 ± 3.9

21.5 ± 4.6^a

< 0.01

Hypertension (%)

55 (73)

53 (66)

70 (70)

0.35

Dyslipidemia (%)

37 (49)

37 (46)

46 (46)

0.89

Diabetes mellitus (%)

20 (27)

24 (30)

36 (36)

0.26

Current smoker (%)

14 (19)

9 (10)

13 (13)

0.24

CVD at the beginning of CR

Ischemic heart disease (%)

40 (53)

43 (53)

52 (52)

0.99

Open heart surgery (%)

41 (55)

49 (61)

64 (64)

0.41

Chronic heart failure (%)

13 (17)

19 (24)

24 (24)

0.51

Anthropometric parameters and physical function

Body fat percentage (%)

22.8 ± 8.0

24.2 ± 11.2

21.7 ± 9.8

0.28

Lean body weight (kg)

47.5 ± 7.6

42.7 ± 8.6^a

41.9 ± 9.2^a

< 0.01

Grip strength (kg)

28.1 ± 6.8

27.1 ± 7.4

25.4 ± 7.9

0.27

6-min walking test (m)

387 ± 72

339 ± 92^a

310 ± 95^a

< 0.01

Laboratory data

Hemoglobin (g/dL)

13.2 ± 1.9

12.5 ± 1.8^a

12.2 ± 1.7^a

< 0.01

Albumin (g/dL)

3.9 ± 0.4

3.8 ± 0.6

3.7 ± 0.5

0.08

Creatinine (mg/dL)

1.03 ± 1.13

1.19 ± 1.28

1.31 ± 1.60

0.39

eGFR (mL/min/1.73m²)

67.0 ± 21.3

63.2 ± 26.6

57.5 ± 24.6^a

0.03

TG (mg/dL)

112 ± 59

114 ± 96

104 ± 48

0.58

HDL-C (mg/dL)

49 ± 15

50 ± 15

49 ± 15

0.93

LDL-C (mg/dL)

101 ± 27

103 ± 30

94 ± 28

0.08

HbA1c (%)

6.0 ± 0.7

6.1 ± 0.9

6.2 ± 0.9

0.31

BNP (pg/mL)

205 ± 407

265 ± 374

303 ± 709

0.49

GNRI

102.3 ± 8.5

98.1 ± 14.3

96.0 ± 12.1^a

< 0.01

LV ejection fraction (%)

59.7 ± 15.3

56.3 ± 14.6

57.1 ± 16.4

0.34

**Table 2.** Comparison of Kihon Checklist Score and Anxiety Levels Among Three Groups
	Non-frailty (n = 75)	Pre-frailty (n = 81)	Frailty (n = 99)	P value
Data are presented as the mean value ± SD. ^aP < 0.05 vs. non-frailty. ^bP < 0.05 vs. pre-frailty by Tukey’s honest significant difference test. STAI: state-trait anxiety inventory.
Kihon Checklist
Instrumental activities of daily living	0.2 ± 0.4	0.4 ± 0.8	1.5 ± 1.7^{a, b}	< 0.01
Physical function	0.4 ± 0.7	1.3 ± 1.1^a	2.4 ± 1.4^{a, b}	< 0.01
Nutritional status	0.3 ± 0.5	0.6 ± 0.6^a	0.8 ± 0.7^{a, b}	< 0.01
Oral function	0.2 ± 0.5	1.0 ± 0.8^a	1.5 ± 0.9^{a, b}	< 0.01
Social activities	0.1 ± 0.4	0.3 ± 0.5^a	0.8 ± 0.7^{a, b}	< 0.01
Cognitive function	0.1 ± 0.3	0.5 ± 0.6^a	0.8 ± 0.9^{a, b}	< 0.01
Depressive mood	0.4 ± 0.6	1.4 ± 1.2^a	3.0 ± 1.5^{a, b}	< 0.01
STAI
State anxiety	34.9 ± 1.0	37.7 ± 0.9	41.6 ± 0.9^a	< 0.01
Trait anxiety	35.1 ± 1.1	39.2 ± 1.0^a	45.5 ± 0.9^{a, b}	< 0.01

Table 2. Comparison of Kihon Checklist Score and Anxiety Levels Among Three Groups

Non-frailty (n = 75)

Pre-frailty (n = 81)

Frailty (n = 99)

P value

Data are presented as the mean value ± SD. ^aP < 0.05 vs. non-frailty. ^bP < 0.05 vs. pre-frailty by Tukey’s honest significant difference test. STAI: state-trait anxiety inventory.

Kihon Checklist

Instrumental activities of daily living

0.2 ± 0.4

0.4 ± 0.8

1.5 ± 1.7^{a, b}

< 0.01

Physical function

0.4 ± 0.7

1.3 ± 1.1^a

2.4 ± 1.4^{a, b}

< 0.01

Nutritional status

0.3 ± 0.5

0.6 ± 0.6^a

0.8 ± 0.7^{a, b}

< 0.01

Oral function

0.2 ± 0.5

1.0 ± 0.8^a

1.5 ± 0.9^{a, b}

< 0.01

Social activities

0.1 ± 0.4

0.3 ± 0.5^a

0.8 ± 0.7^{a, b}

< 0.01

Cognitive function

0.1 ± 0.3

0.5 ± 0.6^a

0.8 ± 0.9^{a, b}

< 0.01

Depressive mood

0.4 ± 0.6

1.4 ± 1.2^a

3.0 ± 1.5^{a, b}

< 0.01

STAI

State anxiety

34.9 ± 1.0

37.7 ± 0.9

41.6 ± 0.9^a

< 0.01

Trait anxiety

35.1 ± 1.1

39.2 ± 1.0^a

45.5 ± 0.9^{a, b}

< 0.01