Frailty prevalence among older decompensated heart failure patients
Abstract Background Frailty is a clinical syndrome characterized by diminished strenght, endurance and reduced physiologic function that increases an individual’s vulnerability. This syndrome often coexists in elderly patients with heart failure and can have a negative impact on their health and wel...
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| Veröffentlicht in: | European heart journal 2023-11, Vol.44 (Supplement_2) |
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| creator | Fernandez-Berges, D Vazquez-Jaren, E Mayoral Teston, N Salgado Gil, N Zaro Bastanzuri, M J Fernandez Morillo, I Maese Calvo, J Munoz Salvador, L Arrighi Soria, I Gonzalez Fernandez, R |
| description | Abstract
Background
Frailty is a clinical syndrome characterized by diminished strenght, endurance and reduced physiologic function that increases an individual’s vulnerability.
This syndrome often coexists in elderly patients with heart failure and can have a negative impact on their health and well-being. In the last few years four domains of frailty had been described: clinical, functional, psyco-cognitive and social.
Purpose
To determine the prevalence of frailty in each domain in patients 65 years of age and older with decompensated heart failure (DHF).
Methods
Prospective and observational study carried out in consecutive patients admitted to hospital due to DHF. Different validated scales were used. Clinical Domain: Charlson Comorbidity Index (CCI), MiniNutritional Assessment (MNA), Clinical Frailty scale CFS), New York Heart Association classification (NYHA); Functional Domain: Timed Up and Go (Up&Go), Short Physical Performance Battery, Fried phenotype (SPPB), Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL); Psyco-cognitive Domain: Minimental State Examination (MMSE), Yesevage Geriatric Depression Scale (YGDS); Social Domain: Old American Resources and Services (OARS).
All patients signed the informed consent and were evaluated when they were clinically stable.
Results
200 consecutive patients were included, aged 81.1 (SD 7.7),108 (54%) were female.
Diabetes was present in 89 (44.7%) patients, arterial hypertension in 182 (91.5%), dyslipidemia in 138 (69.3%), active smoking in 8 (4.1 %), chronic obstructive pulmonary disease in 66 (33.5%), apnea 44 (22.4%), neoplasms in 36 (18.3%), chronic renal failure in 48 (24.4%), previous myocardial infarction in 42 (21.3%), stroke in 245 (12.2%), previous heart failure in 145 (73.6%), atrial fibrillation in 132 (66.7%). 10 (5%) lived in a nursing home. The in-hospital all-cause mortality rate was 7 (3.5%).
Clinical domain: 125 (65.1%) had high comorbidity (CCI). 60 (43.1%) were malnourished (MNA) and 129 (70.9 %) considered as frail (CFS). 151 (77%) were in NYHA Functional Class III-IV.
Functional domain: 165 (99.4 %) (Up&Go) and 170 (97.1 %) (SPPB) were considered at fall risk. 147 (83.5%), frail by the Fried Phenotype. 188 (97.4 %) (ADL) and 173 (89.6 %) (IADL) had some degree of dependence.
Psyco-cognitive: 82 (44.8%) had cognitive impairment (MMSE) and 70 (38%) some depression degree (YGDS).
Social: 28 (15.4%) considered not to have a good social support (OARS).
(See Tabl |
| doi_str_mv | 10.1093/eurheartj/ehad655.2658 |
| format | Article |
| fullrecord | <record><control><sourceid>oup_cross</sourceid><recordid>TN_cdi_crossref_primary_10_1093_eurheartj_ehad655_2658</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/eurheartj/ehad655.2658</oup_id><sourcerecordid>10.1093/eurheartj/ehad655.2658</sourcerecordid><originalsourceid>FETCH-LOGICAL-c1378-d8d7120c50e396e16a0a05a212c9c015c9be0a1a26c8f2abed1c024872c63a843</originalsourceid><addsrcrecordid>eNqN0MFKAzEQxvEgCtbqK0heYNuZ7CZNjlKsFgpeFLwt02TWtmx3l2RX6Nvb2uLZ05x-88FfiEeECYLLpzzEDVPsd1PeUDBaT5TR9kqMUCuVOVPoazECdDozxn7eiruUdgBgDZqRmC8ibev-ILvI31Rz41nSvm2-ZFsHjjKwb_cdN4l6DvJ3R1ZHMUSWHfVbbvp0L24qqhM_XO5YfCye3-ev2ertZTl_WmUe85nNgg0zVOA1cO4MoyEg0KRQeecBtXdrBkJSxttK0ZoDelCFnSlvcrJFPhbm_NfHNqXIVdnF7Z7ioUQoTynKvxTlJUV5SnGEeIbt0P3X_ABFlWge</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Frailty prevalence among older decompensated heart failure patients</title><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Oxford University Press Journals All Titles (1996-Current)</source><source>Alma/SFX Local Collection</source><creator>Fernandez-Berges, D ; Vazquez-Jaren, E ; Mayoral Teston, N ; Salgado Gil, N ; Zaro Bastanzuri, M J ; Fernandez Morillo, I ; Maese Calvo, J ; Munoz Salvador, L ; Arrighi Soria, I ; Gonzalez Fernandez, R</creator><creatorcontrib>Fernandez-Berges, D ; Vazquez-Jaren, E ; Mayoral Teston, N ; Salgado Gil, N ; Zaro Bastanzuri, M J ; Fernandez Morillo, I ; Maese Calvo, J ; Munoz Salvador, L ; Arrighi Soria, I ; Gonzalez Fernandez, R</creatorcontrib><description>Abstract
Background
Frailty is a clinical syndrome characterized by diminished strenght, endurance and reduced physiologic function that increases an individual’s vulnerability.
This syndrome often coexists in elderly patients with heart failure and can have a negative impact on their health and well-being. In the last few years four domains of frailty had been described: clinical, functional, psyco-cognitive and social.
Purpose
To determine the prevalence of frailty in each domain in patients 65 years of age and older with decompensated heart failure (DHF).
Methods
Prospective and observational study carried out in consecutive patients admitted to hospital due to DHF. Different validated scales were used. Clinical Domain: Charlson Comorbidity Index (CCI), MiniNutritional Assessment (MNA), Clinical Frailty scale CFS), New York Heart Association classification (NYHA); Functional Domain: Timed Up and Go (Up&Go), Short Physical Performance Battery, Fried phenotype (SPPB), Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL); Psyco-cognitive Domain: Minimental State Examination (MMSE), Yesevage Geriatric Depression Scale (YGDS); Social Domain: Old American Resources and Services (OARS).
All patients signed the informed consent and were evaluated when they were clinically stable.
Results
200 consecutive patients were included, aged 81.1 (SD 7.7),108 (54%) were female.
Diabetes was present in 89 (44.7%) patients, arterial hypertension in 182 (91.5%), dyslipidemia in 138 (69.3%), active smoking in 8 (4.1 %), chronic obstructive pulmonary disease in 66 (33.5%), apnea 44 (22.4%), neoplasms in 36 (18.3%), chronic renal failure in 48 (24.4%), previous myocardial infarction in 42 (21.3%), stroke in 245 (12.2%), previous heart failure in 145 (73.6%), atrial fibrillation in 132 (66.7%). 10 (5%) lived in a nursing home. The in-hospital all-cause mortality rate was 7 (3.5%).
Clinical domain: 125 (65.1%) had high comorbidity (CCI). 60 (43.1%) were malnourished (MNA) and 129 (70.9 %) considered as frail (CFS). 151 (77%) were in NYHA Functional Class III-IV.
Functional domain: 165 (99.4 %) (Up&Go) and 170 (97.1 %) (SPPB) were considered at fall risk. 147 (83.5%), frail by the Fried Phenotype. 188 (97.4 %) (ADL) and 173 (89.6 %) (IADL) had some degree of dependence.
Psyco-cognitive: 82 (44.8%) had cognitive impairment (MMSE) and 70 (38%) some depression degree (YGDS).
Social: 28 (15.4%) considered not to have a good social support (OARS).
(See Table for details)
Conclusions
Patients with DHF are a complex and frail population that needs a holistic approach. The prevalence of frailty is high. In order to know how reversible frailty could be in older patients suffering DHF, clinical, functional, psyco-cognitive and social interventional trials are needed.</description><identifier>ISSN: 0195-668X</identifier><identifier>EISSN: 1522-9645</identifier><identifier>DOI: 10.1093/eurheartj/ehad655.2658</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><ispartof>European heart journal, 2023-11, Vol.44 (Supplement_2)</ispartof><rights>The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids></links><search><creatorcontrib>Fernandez-Berges, D</creatorcontrib><creatorcontrib>Vazquez-Jaren, E</creatorcontrib><creatorcontrib>Mayoral Teston, N</creatorcontrib><creatorcontrib>Salgado Gil, N</creatorcontrib><creatorcontrib>Zaro Bastanzuri, M J</creatorcontrib><creatorcontrib>Fernandez Morillo, I</creatorcontrib><creatorcontrib>Maese Calvo, J</creatorcontrib><creatorcontrib>Munoz Salvador, L</creatorcontrib><creatorcontrib>Arrighi Soria, I</creatorcontrib><creatorcontrib>Gonzalez Fernandez, R</creatorcontrib><title>Frailty prevalence among older decompensated heart failure patients</title><title>European heart journal</title><description>Abstract
Background
Frailty is a clinical syndrome characterized by diminished strenght, endurance and reduced physiologic function that increases an individual’s vulnerability.
This syndrome often coexists in elderly patients with heart failure and can have a negative impact on their health and well-being. In the last few years four domains of frailty had been described: clinical, functional, psyco-cognitive and social.
Purpose
To determine the prevalence of frailty in each domain in patients 65 years of age and older with decompensated heart failure (DHF).
Methods
Prospective and observational study carried out in consecutive patients admitted to hospital due to DHF. Different validated scales were used. Clinical Domain: Charlson Comorbidity Index (CCI), MiniNutritional Assessment (MNA), Clinical Frailty scale CFS), New York Heart Association classification (NYHA); Functional Domain: Timed Up and Go (Up&Go), Short Physical Performance Battery, Fried phenotype (SPPB), Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL); Psyco-cognitive Domain: Minimental State Examination (MMSE), Yesevage Geriatric Depression Scale (YGDS); Social Domain: Old American Resources and Services (OARS).
All patients signed the informed consent and were evaluated when they were clinically stable.
Results
200 consecutive patients were included, aged 81.1 (SD 7.7),108 (54%) were female.
Diabetes was present in 89 (44.7%) patients, arterial hypertension in 182 (91.5%), dyslipidemia in 138 (69.3%), active smoking in 8 (4.1 %), chronic obstructive pulmonary disease in 66 (33.5%), apnea 44 (22.4%), neoplasms in 36 (18.3%), chronic renal failure in 48 (24.4%), previous myocardial infarction in 42 (21.3%), stroke in 245 (12.2%), previous heart failure in 145 (73.6%), atrial fibrillation in 132 (66.7%). 10 (5%) lived in a nursing home. The in-hospital all-cause mortality rate was 7 (3.5%).
Clinical domain: 125 (65.1%) had high comorbidity (CCI). 60 (43.1%) were malnourished (MNA) and 129 (70.9 %) considered as frail (CFS). 151 (77%) were in NYHA Functional Class III-IV.
Functional domain: 165 (99.4 %) (Up&Go) and 170 (97.1 %) (SPPB) were considered at fall risk. 147 (83.5%), frail by the Fried Phenotype. 188 (97.4 %) (ADL) and 173 (89.6 %) (IADL) had some degree of dependence.
Psyco-cognitive: 82 (44.8%) had cognitive impairment (MMSE) and 70 (38%) some depression degree (YGDS).
Social: 28 (15.4%) considered not to have a good social support (OARS).
(See Table for details)
Conclusions
Patients with DHF are a complex and frail population that needs a holistic approach. The prevalence of frailty is high. In order to know how reversible frailty could be in older patients suffering DHF, clinical, functional, psyco-cognitive and social interventional trials are needed.</description><issn>0195-668X</issn><issn>1522-9645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNqN0MFKAzEQxvEgCtbqK0heYNuZ7CZNjlKsFgpeFLwt02TWtmx3l2RX6Nvb2uLZ05x-88FfiEeECYLLpzzEDVPsd1PeUDBaT5TR9kqMUCuVOVPoazECdDozxn7eiruUdgBgDZqRmC8ibev-ILvI31Rz41nSvm2-ZFsHjjKwb_cdN4l6DvJ3R1ZHMUSWHfVbbvp0L24qqhM_XO5YfCye3-ev2ertZTl_WmUe85nNgg0zVOA1cO4MoyEg0KRQeecBtXdrBkJSxttK0ZoDelCFnSlvcrJFPhbm_NfHNqXIVdnF7Z7ioUQoTynKvxTlJUV5SnGEeIbt0P3X_ABFlWge</recordid><startdate>20231109</startdate><enddate>20231109</enddate><creator>Fernandez-Berges, D</creator><creator>Vazquez-Jaren, E</creator><creator>Mayoral Teston, N</creator><creator>Salgado Gil, N</creator><creator>Zaro Bastanzuri, M J</creator><creator>Fernandez Morillo, I</creator><creator>Maese Calvo, J</creator><creator>Munoz Salvador, L</creator><creator>Arrighi Soria, I</creator><creator>Gonzalez Fernandez, R</creator><general>Oxford University Press</general><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20231109</creationdate><title>Frailty prevalence among older decompensated heart failure patients</title><author>Fernandez-Berges, D ; Vazquez-Jaren, E ; Mayoral Teston, N ; Salgado Gil, N ; Zaro Bastanzuri, M J ; Fernandez Morillo, I ; Maese Calvo, J ; Munoz Salvador, L ; Arrighi Soria, I ; Gonzalez Fernandez, R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1378-d8d7120c50e396e16a0a05a212c9c015c9be0a1a26c8f2abed1c024872c63a843</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fernandez-Berges, D</creatorcontrib><creatorcontrib>Vazquez-Jaren, E</creatorcontrib><creatorcontrib>Mayoral Teston, N</creatorcontrib><creatorcontrib>Salgado Gil, N</creatorcontrib><creatorcontrib>Zaro Bastanzuri, M J</creatorcontrib><creatorcontrib>Fernandez Morillo, I</creatorcontrib><creatorcontrib>Maese Calvo, J</creatorcontrib><creatorcontrib>Munoz Salvador, L</creatorcontrib><creatorcontrib>Arrighi Soria, I</creatorcontrib><creatorcontrib>Gonzalez Fernandez, R</creatorcontrib><collection>CrossRef</collection><jtitle>European heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fernandez-Berges, D</au><au>Vazquez-Jaren, E</au><au>Mayoral Teston, N</au><au>Salgado Gil, N</au><au>Zaro Bastanzuri, M J</au><au>Fernandez Morillo, I</au><au>Maese Calvo, J</au><au>Munoz Salvador, L</au><au>Arrighi Soria, I</au><au>Gonzalez Fernandez, R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Frailty prevalence among older decompensated heart failure patients</atitle><jtitle>European heart journal</jtitle><date>2023-11-09</date><risdate>2023</risdate><volume>44</volume><issue>Supplement_2</issue><issn>0195-668X</issn><eissn>1522-9645</eissn><abstract>Abstract
Background
Frailty is a clinical syndrome characterized by diminished strenght, endurance and reduced physiologic function that increases an individual’s vulnerability.
This syndrome often coexists in elderly patients with heart failure and can have a negative impact on their health and well-being. In the last few years four domains of frailty had been described: clinical, functional, psyco-cognitive and social.
Purpose
To determine the prevalence of frailty in each domain in patients 65 years of age and older with decompensated heart failure (DHF).
Methods
Prospective and observational study carried out in consecutive patients admitted to hospital due to DHF. Different validated scales were used. Clinical Domain: Charlson Comorbidity Index (CCI), MiniNutritional Assessment (MNA), Clinical Frailty scale CFS), New York Heart Association classification (NYHA); Functional Domain: Timed Up and Go (Up&Go), Short Physical Performance Battery, Fried phenotype (SPPB), Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL); Psyco-cognitive Domain: Minimental State Examination (MMSE), Yesevage Geriatric Depression Scale (YGDS); Social Domain: Old American Resources and Services (OARS).
All patients signed the informed consent and were evaluated when they were clinically stable.
Results
200 consecutive patients were included, aged 81.1 (SD 7.7),108 (54%) were female.
Diabetes was present in 89 (44.7%) patients, arterial hypertension in 182 (91.5%), dyslipidemia in 138 (69.3%), active smoking in 8 (4.1 %), chronic obstructive pulmonary disease in 66 (33.5%), apnea 44 (22.4%), neoplasms in 36 (18.3%), chronic renal failure in 48 (24.4%), previous myocardial infarction in 42 (21.3%), stroke in 245 (12.2%), previous heart failure in 145 (73.6%), atrial fibrillation in 132 (66.7%). 10 (5%) lived in a nursing home. The in-hospital all-cause mortality rate was 7 (3.5%).
Clinical domain: 125 (65.1%) had high comorbidity (CCI). 60 (43.1%) were malnourished (MNA) and 129 (70.9 %) considered as frail (CFS). 151 (77%) were in NYHA Functional Class III-IV.
Functional domain: 165 (99.4 %) (Up&Go) and 170 (97.1 %) (SPPB) were considered at fall risk. 147 (83.5%), frail by the Fried Phenotype. 188 (97.4 %) (ADL) and 173 (89.6 %) (IADL) had some degree of dependence.
Psyco-cognitive: 82 (44.8%) had cognitive impairment (MMSE) and 70 (38%) some depression degree (YGDS).
Social: 28 (15.4%) considered not to have a good social support (OARS).
(See Table for details)
Conclusions
Patients with DHF are a complex and frail population that needs a holistic approach. The prevalence of frailty is high. In order to know how reversible frailty could be in older patients suffering DHF, clinical, functional, psyco-cognitive and social interventional trials are needed.</abstract><cop>US</cop><pub>Oxford University Press</pub><doi>10.1093/eurheartj/ehad655.2658</doi><oa>free_for_read</oa></addata></record> |
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| source | Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection |
| title | Frailty prevalence among older decompensated heart failure patients |
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