PulseTrendingJournal ClubResearchersJournalsExplore
Instagram
HomeTrendingJournal ClubExplore
Synapse
⌘+K
Synapse
September 14, 2026JHLT OpenOpen Access

Cognitive Frailty and Mortality Among Patients on the Heart Transplant Waiting List: A Prospective Cohort Study

View Full Paper
Ask AI
Bookmark
Share

Population

150 patients listed for heart transplantation within the previous 30 days at a tertiary center in Brazil…

Design

Cohort

Follow-up

1-year

Key result

Physical and cognitive frailty were associated with early mortality risk (initial SHR 5.47, p=0.023 for physical frailty), but lost independent significance after multivariable adjustment.

Authors

FOFrancisco Wellington Sousa OliveiraÉIÉrika T. IkedaJNJuliana Araújo Nascimento

Discussion

Loading...

Member takes

Overview

May warrant adding cognitive screening to transplant frailty assessment; leaves open whether interventions modify mortality risk.

Key Points

  • To determine the prevalence of physical and cognitive frailty among heart transplant candidates and evaluate their association with mortality while on the waiting list.
  • Conducted a prospective cohort study of 150 patients listed for heart transplantation within the previous 30 days at a tertiary center in Brazil, with 1-year follow-up.
  • Assessed physical frailty using Fried criteria, cognition using the Montreal Cognitive Assessment (MoCA) and Wechsler Abbreviated Scale of Intelligence (WASI), and depressive symptoms with the Beck Depression Inventory (BDI).
  • Defined cognitive frailty as meeting at least 3 of 6 criteria in a modified Fried phenotype incorporating cognitive impairment as an added domain.
  • Physical frailty occurred in 78.7% of candidates, while cognitive frailty was present in 88.7% by MoCA and 86.7% by WASI; over 1 year, 41.3% of patients died and 67.3% underwent transplantation.
  • Physical frailty was associated with heightened early mortality risk (initial SHR=5.47, p=0.023; TVC SHR=0.99, p=0.008), with similar time-dependent patterns observed for cognitive frailty via MoCA (initial SHR=1.61, p=0.011; TVC SHR=1.00, p=0.011) and WASI (initial SHR=1.57, p=0.012; TVC SHR=1.00, p=0.007).
  • Following multivariable adjustment for underlying clinical severity markers, neither physical nor cognitive frailty remained independently associated with overall mortality.

Study Design

Type

Cohort (n=150)

Multicenter

No

Structured PICO

P
Population
150 patients listed for heart transplantation within the previous 30 days, predominantly male with a mean age of 49.8 years, followed for 1 year.
O
Outcome
Mortality during 1-year follow-uphard clinical

Main Result

Hazard Ratio: 5.47

p-value: p=0.023

Physical and cognitive frailty are highly prevalent among heart transplant candidates and associated with early mortality, but this association loses significance after adjusting for disease severity.

Limitations

  • Frailty may reflect the underlying clinical status at the time of listing rather than acting as an independent prognostic factor
  • Adequacy of the Fried phenotype as a frailty assessment tool in this specific population is questionable

Cite This Study

Oliveira et al. (2026) conducted a cohort in Heart transplant candidates (n=150). Physical and cognitive frailty vs. Non-frail patients was evaluated on Early mortality after listing (SHR 5.47, p=0.023). Physical and cognitive frailty were associated with early mortality risk (initial SHR 5.47, p=0.023 for physical frailty), but lost independent significance after multivariable adjustment.

synapsesocial.com/papers/6aa7afef79e9260bc85aacfbhttps://doi.org/10.1016/j.jhlto.2026.100680
View Full Paper
Ask AI
Bookmark
Share