Background: Heart failure (HF) is a cardiovascular disease that is increasing by epidemic proportions, largely due to an aging society and therapeutic advances in disease management. Because heart failure is largely a cardiogeriatric syndrome, age-related syndromes such as frailty and cognitive impairment are common in heart failure patients. Purpose: To assess the prevalence and determinants of frailty and cognitive impairment in a HF population ≥60 years of age. Methods: Data from n=236 patients with HF (77±9 years; 43% female) visiting the heart-brain clinic in Amsterdam in 2018-2019. HF severity was evaluated by NT-proBNP and NYHA-classification. Frailty was assessed using Fried's frailty criteria, cognition using the Montreal cognitive assessment (MoCa). Logistic regression analyses were performed to evaluate which variables were associated with frailty and cognitive impairment. Results: Median (IQR) NT-proBNP was 2000 (876-3469) pmol/L, 38% of patients had NYHA III-IV. 51% of patients were pre-frail and 28% frail. 77% of the patients were (mildly) cognitive impaired. Age, NYHA-classification III-IV, NT-proBNP>2000 pmol/L and use of ≥10 drugs were associated with frailty; HR (95% CI): 2.0 (1.4-3.0) per 10 years, 3.4 (1.9-6.2), 1.8 (1.0-3.2) and 1.8 (1.4-3.3) respectively. Age was associated with cognitive impairment; HR (95% CI) 2.2 (1.4-3.6) per 10 years. Conclusion(s): Frailty affects almost a third of the patients with HF and is more prevalent in older patients and those with more severe HF. Screening for frailty and cognitive impairment should be part of the standard workup in older HF patients as frail and/or cognitively impaired HF patients are less likely to adhere to their HF treatment and more likely to be (re)admitted to hospital for HF. (Figure Presented) .
Kleipool, E. E. F., Handoko, M. L., Van Rossum, A. C., Hornstra, J. M., Peters, M. J. L., Liem, S. S., & Muller, M. (2019). P4515The aging heart failure patient: frailty and cognitive impairment more common than you would expect - baseline data of the heart-brain clinic. European Heart Journal, 40(Supplement_1). https://doi.org/10.1093/eurheartj/ehz745.0908