In 278 frail heart failure patients, multicomponent geriatric interventions including occupational therapy and polypharmacy review were commonly recommended to support functionality.
Frail older patients with heart failure have a high burden of geriatric syndromes and social risk, highlighting the need for multidisciplinary geriatric assessment and multicomponent interventions.
Abstract Introduction Frailty is common in patients with heart failure. Detecting it would allow the selection of those who could benefit from a multicomponent geriatric intervention. Methods A total of 278 patients (≥ 65 years old) attended in an ambulatory heart failure clinic (March 2021 to January 2025) were studied. They had previously been classified as frail using the VES-13 questionnaire (≥ 3 points). All patients were assessed by a geriatrics team, and the following variables were recorded: age, Lawton and Barthel index (LI and BI), Pfeiffer test (PT), Short Physical Performance Battery (SPPB), Timed Up & Go, VIG frailty index (FI-VIG), comorbidity (Charlson), and social risk scale (TIRS). The number of falls in the previous year, number of geriatric syndromes, number of drugs, NYHA functional class and various multicomponent interventions were also recorded. Results Mean age: 80.5±5.4 years, BI: 77.1±20.4, LI: 3.9±2.6, PT: 1.6±1.9 errors, previous falls: 1.0±1.6, FI-VIG: 0.4±0.3, Charlson index: 3.3±1.5, number of geriatric syndromes: 4.2±1.8, medications: 12.2±3.8, SPPB: 4.9±2.6, Timed Up & Go: 19.8±9.0 seconds, TIRS: 1.4±1.1. The most prevalent geriatric syndromes were: polypharmacy 98.9% (275), incontinence 60.8% (169) (mainly urinary), and hearing loss 42.1% (117). Social risk was identified in 79.1% (220) of patients. According to FI-VIG, 46.4% (129) had moderate frailty, and 36.3% (101) had mild frailty. NYHA II was found in 57.6% (160), and NYHA III in 35.6% (99). The most common multicomponent recommendations included: occupational therapy counselling 52.9% (147), home-based physical therapy 41% (114), recommendation of assistive devices 26.6% (74) (cane, walker, wheelchair), referral to a specialized dementia clinic in 13.3% (37), cognitive stimulation 21.2% (59), recommendation for social assessment in 75.2% (209), and polypharmacy review in all patients using STOPP-START criteria. Conclusions Detecting frailty in HF patients, in collaboration with the cardiology team, and implementing multicomponent interventions could help maintain functionality, prevent disability, and maybe eventually improve survival in the future. Conducting a situational diagnosis, symptom control, and advanced planning in patients with advanced frailty could enhance their quality of life.
Roig et al. (2025) studied this question. In 278 frail heart failure patients, multicomponent geriatric interventions including occupational therapy and polypharmacy review were commonly recommended to support functionality.