The prevalence of frailty in heart failure: A systematic review and meta-analysis

Quin Denfeld, Kerri Winters-Stone, James Mudd, Jill Gelow, Sawsan Kurdi, Christopher Lee

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
JournalInternational Journal of Cardiology
DOIs
StateAccepted/In press - Oct 12 2016

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Meta-Analysis
Heart Failure
Geriatrics
Cross-Sectional Studies
Confidence Intervals

Keywords

  • Aging
  • Frailty
  • Heart failure
  • Meta-analysis

ASJC Scopus subject areas

  • Medicine(all)
  • Cardiology and Cardiovascular Medicine

Cite this

@article{7387102c50a94cc5b4c748826d95c3ae,
title = "The prevalence of frailty in heart failure: A systematic review and meta-analysis",
abstract = "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.",
keywords = "Aging, Frailty, Heart failure, Meta-analysis",
author = "Quin Denfeld and Kerri Winters-Stone and James Mudd and Jill Gelow and Sawsan Kurdi and Christopher Lee",
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T2 - A systematic review and meta-analysis

AU - Denfeld, Quin

AU - Winters-Stone, Kerri

AU - Mudd, James

AU - Gelow, Jill

AU - Kurdi, Sawsan

AU - Lee, Christopher

PY - 2016/10/12

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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.

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