Prevalence and prognostic impact of cognitive frailty in elderly patients with heart failure: sub‐analysis of FRAGILE‐HF

ESC Heart Failure

Kentaro Jujo¹  Hirofumi Nagamatsu²  Yuya Matsue³  Hiroshi Saito³  Nobuyuki Kagiyama³  Takatoshi Kasai³  Emi Maekawa⁴  Takeshi Kitai⁵  Saeko Yamasaki⁶  Satoko Higuchi⁷  Naoki Aizawa⁸  Hiroshi Wada⁹  Yuki Ogasahara^1,10  Katsuya Izawa^1,11  Kentaro Iwata^1,12  Tetsuya Ozawa^1,13  Kazuhiro Oka^1,14  Shuhei Yamamoto^1,15  Kazuya Saito^1,16  Kentaro Kamiya^1,17  Masaaki Konishi^1,18  Akihiro Makino^1,19  Shin‐ichi Momomura^2,20 

[1] Department of Cardiology Nishiarai Heart Center Hospital Tokyo Japan;Department of Cardiology Tokai University School of Medicine Isehara Japan;Department of Cardiovascular Biology and Medicine Juntendo University Graduate School of Medicine 2‐1‐1 Hongo, Bunkyo‐ku Tokyo 113‐8421 Japan;Department of Cardiovascular Medicine Kitasato University School of Medicine Sagamihara Japan;Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Osaka Japan;Department of Cardiovascular Medicine National Hospital Organization Matsumoto Medical Center Matsumoto Japan;Department of Cardiovascular Medicine Shinshu University School of Medicine Matsumoto Matsumoto Japan;Department of Cardiovascular Medicine, Nephrology and Neurology University of the Ryukyus Okinawa Japan;Department of Cardiovascular Medicine, Saitama Medical Center Jichi Medical University Saitama Japan;Department of Nursing The Sakakibara Heart Institute of Okayama Okayama Japan;Department of Rehabilitation Kasukabe Chuo General Hospital Kasukabe Japan;Department of Rehabilitation Kobe City Medical Center General Hospital Kobe Japan;Department of Rehabilitation Odawara Municipal Hospital Odawara Japan;Department of Rehabilitation Saitama Citizens Medical Center Saitama Japan;Department of Rehabilitation Shinshu University Hospital Matsumoto Japan;Department of Rehabilitation The Sakakibara Heart Institute of Okayama Okayama Japan;Department of Rehabilitation, School of Allied Health Sciences Kitasato University Sagamihara Japan;Division of Cardiology Yokohama City University Medical Center Yokohama Japan;Rehabilitation Center Kitasato University Medical Center Kitamoto Japan;Saitama Citizens Medical Center Saitama Japan;

关键词: Frailty;    Cognitive impairment;    Heart failure;    Elderly;    Prognosis;   

DOI  :  10.1002/ehf2.13844

来源: DOAJ

【 摘 要 】

Abstract Aims Although evidence suggests that cognitive decline and physical frailty in elderly patients with heart failure (HF) are associated with prognosis, the impact of concurrent physical frailty and cognitive impairment, that is, cognitive frailty, on prognosis has yet to be fully investigated. The current study sought to investigate the prevalence and prognostic impact of cognitive frailty in elderly patients with HF. Methods and results This study is a sub‐analysis of FRAGILE‐HF, a prospective multicentre observational study involving patients aged ≥65 years hospitalized for HF. The Fried criteria and Mini‐Cog were used to diagnose physical frailty and cognitive impairment, respectively. The association between cognitive frailty and the combined endpoint of mortality and HF rehospitalization within 1 year was then evaluated. Among the 1332 patients identified, 1215 who could be assessed using Mini‐Cog and the Fried criteria were included in this study. Among those included, 279 patients (23.0%) had cognitive frailty. During the follow‐up 1 year after discharge, 398 combined events were observed. Moreover, cognitive frailty was determined to be associated with a higher incidence of combined events (log‐rank: P = 0.0146). This association was retained even after adjusting for other prognostic factors (hazard ratio: 1.55, 95% confidence interval: 1.13–2.13). Furthermore, a sensitivity analysis using grip strength, short physical performance battery, and gait speed to determine physical frailty instead of the Fried criteria showed similar results. Conclusions This cohort study found that 23% of elderly patients with HF had cognitive frailty, which was associated with a 1.55‐fold greater risk for combined events within 1 year compared with patients without cognitive frailty.

【 授权许可】

Unknown