TY - JOUR
T1 - The prevalence of frailty in heart failure
T2 - A systematic review and meta-analysis
AU - Denfeld, Quin E.
AU - Winters-Stone, Kerri
AU - Mudd, James
AU - Gelow, Jill
AU - Kurdi, Sawsan
AU - Lee, Christopher
N1 - Funding Information:
Funding acknowledgements: This work was supported by the National Institutes of Health/National Institute of Nursing Research (NIH/NINR) Ruth L. Kirschstein National Research Service Award (1F31NR015936-01; Denfeld), the National Hartford Centers of Gerontological Nursing Excellence (NHCGNE) Patricia G. Archbold Scholar Program (Denfeld) and an ARCS Scholar Award (Denfeld). Current post-doctoral funding for Quin Denfeld was provided by NIH/National Heart, Lung, and Blood Institute (NIH/NHLBI) at Oregon Health & Science University Knight Cardiovascular Institute (2T32HL094294; Thornburg). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH/NINR, NIH/NHLBI, or the NHCGNE.
Publisher Copyright:
© 2017 Elsevier B.V.
PY - 2017/6/1
Y1 - 2017/6/1
N2 - Background There is a growing interest in the intersection of heart failure (HF) and frailty; however, estimates of the prevalence of frailty in HF vary widely. The purpose of this paper was to quantitatively synthesize published literature on the prevalence of frailty in HF and to examine the relationship between study characteristics (i.e. age and functional class) and the prevalence of frailty in HF. Methods The prevalence of frailty in HF, divided into Physical Frailty and Multidimensional Frailty measures, was synthesized across published studies using a random-effects meta-analysis of proportions approach. Meta-regression was performed to examine the influence of age and functional class (at the level of the study) on the prevalence of frailty. Results A total of 26 studies involving 6896 patients with HF were included in this meta-analysis. Despite considerable differences across studies, the overall estimated prevalence of frailty in HF was 44.5% (95% confidence interval, 36.2%–52.8%; z = 10.54; p < 0.001). The prevalence was slightly lower among studies using Physical Frailty measures (42.9%, z = 9.05; p < 0.001) and slightly higher among studies using Multidimensional Frailty measures (47.4%, z = 5.66; p < 0.001). There were no significant relationships between study age or functional class and prevalence of frailty. Conclusions Frailty affects almost half of patients with HF and is not necessarily a function of age or functional classification. Future work should focus on standardizing the measurement of frailty and on broadening the view of frailty beyond a strictly geriatric syndrome in HF.
AB - Background There is a growing interest in the intersection of heart failure (HF) and frailty; however, estimates of the prevalence of frailty in HF vary widely. The purpose of this paper was to quantitatively synthesize published literature on the prevalence of frailty in HF and to examine the relationship between study characteristics (i.e. age and functional class) and the prevalence of frailty in HF. Methods The prevalence of frailty in HF, divided into Physical Frailty and Multidimensional Frailty measures, was synthesized across published studies using a random-effects meta-analysis of proportions approach. Meta-regression was performed to examine the influence of age and functional class (at the level of the study) on the prevalence of frailty. Results A total of 26 studies involving 6896 patients with HF were included in this meta-analysis. Despite considerable differences across studies, the overall estimated prevalence of frailty in HF was 44.5% (95% confidence interval, 36.2%–52.8%; z = 10.54; p < 0.001). The prevalence was slightly lower among studies using Physical Frailty measures (42.9%, z = 9.05; p < 0.001) and slightly higher among studies using Multidimensional Frailty measures (47.4%, z = 5.66; p < 0.001). There were no significant relationships between study age or functional class and prevalence of frailty. Conclusions Frailty affects almost half of patients with HF and is not necessarily a function of age or functional classification. Future work should focus on standardizing the measurement of frailty and on broadening the view of frailty beyond a strictly geriatric syndrome in HF.
KW - Aging
KW - Frailty
KW - Heart failure
KW - Meta-analysis
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U2 - 10.1016/j.ijcard.2017.01.153
DO - 10.1016/j.ijcard.2017.01.153
M3 - Article
C2 - 28215466
AN - SCOPUS:85013066288
VL - 236
SP - 283
EP - 289
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
ER -