A high Rockwood frailty index (aHR 1.05) and decreased handgrip strength (aHR 3.42) were independently associated with increased long-term all-cause mortality in older adults.
Cohort (n=811)
No
Does physical frailty and decreased physical function predict all-cause mortality in older adults with and without chronic heart failure?
In older adults, frailty and decreased physical function (especially low handgrip strength) are highly prevalent in heart failure and independently predict long-term all-cause mortality.
Effect estimate: aHR 1.05 (95% CI 1.0004 to 1.10)
p-value: p=<0.05
Abstract Background Frailty, a syndrome characterized by a decline in function reserve, is common in older patients with heart failure (HF) and is associated with prognosis. This study aimed to evaluate the impact of frailty on outcomes in older patients with preserved and reduced cardiac function. Methods In total, 811 adults aged ≥65 years were consecutively enrolled from 2009 to 2018. HF was diagnosed according to the ICD9 code and a 2D echocardiogram was categorized by reduced ejection fraction (HFrEF) and preserved ejection fraction (HFpEF). The index date was registered at the time of HF. All patients received a comprehensive geriatric assessment, and clinical outcomes were examined with adjustment of the other prognostic variables. Results Mean age was 80.5 ± 7.1 years. The prevalence of HF, HFpEF, HFrEF, Fried, and Rockwood frailty indicators was 28.5, 10.4, 9.7, 52.5, and 74.9%, respectively. At baseline, scores in the Timed Up and Go test was closely associated with the severity of HF, either with HFpEF or HFrEF. After a mean follow-up of 3.2 ± 2.0 years, we found that HF patients with low handgrip strength (HGS) had the poorest survival, followed by non-HF patients with decreased HGS, and HF with fair HGS in comparison with non-HF with fair HGS ( p = 0.008) if participants were arbitrarily divided into two HGS groups. In all patients, a high Rockwood frailty index was independently associated with increased mortality (adjusted hazard ratio aHR = 1.05; 95% confidence interval CI: 1.0004 to 1.10). In addition, the adjusted mortality HR was 3.42 with decreased HGS (95% CI: 1.03 to 11.40), 7.65 with use of mineralocorticoid receptor antagonist (95% CI: 2.22 to 26.32), and 1.26 with associated multi-comorbidities assessed by Charlson comorbidity index (95% CI: 1.05 to 1.51). Conclusions Our study results indicate that frailty and decreased physical functions were associated with HF. Besides, frailty and HGS predicted prognosis in the patients, and there was a combined effect of HF and low HGS on survival.
Weng et al. (Mon,) conducted a cohort in Chronic heart failure (HFpEF and HFrEF) and physical frailty (n=811). High Rockwood frailty index vs. Low Rockwood frailty index was evaluated on All-cause mortality (aHR 1.05, 95% CI 1.0004 to 1.10, p=<0.05). A high Rockwood frailty index (aHR 1.05) and decreased handgrip strength (aHR 3.42) were independently associated with increased long-term all-cause mortality in older adults.