Physical vs. multidimensional frailty in older adults with and without heart failure
Abstract Aims The assessment of frailty in older adults with heart failure (HF) is still debated. Here, we compare the predictive role and the diagnostic accuracy of physical vs. multidimensional frailty assessment on mortality, disability, and hospitalization in older adults with and without HF. Me...
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Language: | English |
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Wiley
2020-06-01
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Series: | ESC Heart Failure |
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Online Access: | https://doi.org/10.1002/ehf2.12688 |
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author | Gianluca Testa Francesco Curcio Ilaria Liguori Claudia Basile Martina Papillo Carlo Gabriele Tocchetti Gianlugi Galizia David Della‐Morte Gaetano Gargiulo Francesco Cacciatore Domenico Bonaduce Pasquale Abete |
author_facet | Gianluca Testa Francesco Curcio Ilaria Liguori Claudia Basile Martina Papillo Carlo Gabriele Tocchetti Gianlugi Galizia David Della‐Morte Gaetano Gargiulo Francesco Cacciatore Domenico Bonaduce Pasquale Abete |
author_sort | Gianluca Testa |
collection | DOAJ |
description | Abstract Aims The assessment of frailty in older adults with heart failure (HF) is still debated. Here, we compare the predictive role and the diagnostic accuracy of physical vs. multidimensional frailty assessment on mortality, disability, and hospitalization in older adults with and without HF. Methods and results A total of 1077 elderly (≥65 years) outpatients were evaluated with the physical (phy‐Fi) and multidimensional (m‐Fi) frailty scores and according to the presence or the absence of HF. Mortality, disability, and hospitalizations were assessed at baseline and after a 24 month follow‐up. Cox regression analysis demonstrated that, compared with phy‐Fi score, m‐Fi score was more predictive of mortality [hazard ratio (HR) = 1.05 vs. 0.66], disability (HR = 1.02 vs. 0.89), and hospitalization (HR = 1.03 vs. 0.96) in the absence and even more in the presence of HF (HR = 1.11 vs. 0.63, 1.06 vs. 0.98, and 1.14 vs. 1.03, respectively). The area under the curve indicated a better diagnostic accuracy with m‐Fi score than with phy‐Fi score for mortality, disability, and hospitalizations, both in absence (0.782 vs. 0.649, 0.763 vs. 0.695, and 0.732 vs. 0.666, respectively) and in presence of HF (0.824 vs. 0.625, 0.886 vs. 0.793, and 0.812 vs. 0.688, respectively). Conclusions The m‐Fi score is able to predict mortality, disability, and hospitalizations better than the phy‐Fi score, not only in absence but also in presence of HF. Our data also demonstrate that the m‐Fi score has better diagnostic accuracy than the phy‐Fi score. Thus, the use of the m‐FI score should be considered for the assessment of frailty in older HF adults. |
format | Article |
id | doaj-art-8c1b95a98fa94aca808f5271d2406c0b |
institution | Kabale University |
issn | 2055-5822 |
language | English |
publishDate | 2020-06-01 |
publisher | Wiley |
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series | ESC Heart Failure |
spelling | doaj-art-8c1b95a98fa94aca808f5271d2406c0b2025-02-03T10:25:47ZengWileyESC Heart Failure2055-58222020-06-01731371138010.1002/ehf2.12688Physical vs. multidimensional frailty in older adults with and without heart failureGianluca Testa0Francesco Curcio1Ilaria Liguori2Claudia Basile3Martina Papillo4Carlo Gabriele Tocchetti5Gianlugi Galizia6David Della‐Morte7Gaetano Gargiulo8Francesco Cacciatore9Domenico Bonaduce10Pasquale Abete11Department of Translational Medical Sciences University of Naples “Federico II” Via S. Pansini 80131 Naples ItalyDepartment of Translational Medical Sciences University of Naples “Federico II” Via S. Pansini 80131 Naples ItalyDepartment of Translational Medical Sciences University of Naples “Federico II” Via S. Pansini 80131 Naples ItalyDepartment of Translational Medical Sciences University of Naples “Federico II” Via S. Pansini 80131 Naples ItalyDepartment of Translational Medical Sciences University of Naples “Federico II” Via S. Pansini 80131 Naples ItalyDepartment of Translational Medical Sciences University of Naples “Federico II” Via S. Pansini 80131 Naples ItalyDepartment of Translational Medical Sciences University of Naples “Federico II” Via S. Pansini 80131 Naples ItalyDepartment of Systems Medicine University of Rome Tor Vergata Rome ItalyDivision of Internal Medicine AOU San Giovanni di Dio e Ruggi di Aragona Salerno ItalyDepartment of Translational Medical Sciences University of Naples “Federico II” Via S. Pansini 80131 Naples ItalyDepartment of Translational Medical Sciences University of Naples “Federico II” Via S. Pansini 80131 Naples ItalyDepartment of Translational Medical Sciences University of Naples “Federico II” Via S. Pansini 80131 Naples ItalyAbstract Aims The assessment of frailty in older adults with heart failure (HF) is still debated. Here, we compare the predictive role and the diagnostic accuracy of physical vs. multidimensional frailty assessment on mortality, disability, and hospitalization in older adults with and without HF. Methods and results A total of 1077 elderly (≥65 years) outpatients were evaluated with the physical (phy‐Fi) and multidimensional (m‐Fi) frailty scores and according to the presence or the absence of HF. Mortality, disability, and hospitalizations were assessed at baseline and after a 24 month follow‐up. Cox regression analysis demonstrated that, compared with phy‐Fi score, m‐Fi score was more predictive of mortality [hazard ratio (HR) = 1.05 vs. 0.66], disability (HR = 1.02 vs. 0.89), and hospitalization (HR = 1.03 vs. 0.96) in the absence and even more in the presence of HF (HR = 1.11 vs. 0.63, 1.06 vs. 0.98, and 1.14 vs. 1.03, respectively). The area under the curve indicated a better diagnostic accuracy with m‐Fi score than with phy‐Fi score for mortality, disability, and hospitalizations, both in absence (0.782 vs. 0.649, 0.763 vs. 0.695, and 0.732 vs. 0.666, respectively) and in presence of HF (0.824 vs. 0.625, 0.886 vs. 0.793, and 0.812 vs. 0.688, respectively). Conclusions The m‐Fi score is able to predict mortality, disability, and hospitalizations better than the phy‐Fi score, not only in absence but also in presence of HF. Our data also demonstrate that the m‐Fi score has better diagnostic accuracy than the phy‐Fi score. Thus, the use of the m‐FI score should be considered for the assessment of frailty in older HF adults.https://doi.org/10.1002/ehf2.12688Multidimensional frailtyOlder adultsHeart failure |
spellingShingle | Gianluca Testa Francesco Curcio Ilaria Liguori Claudia Basile Martina Papillo Carlo Gabriele Tocchetti Gianlugi Galizia David Della‐Morte Gaetano Gargiulo Francesco Cacciatore Domenico Bonaduce Pasquale Abete Physical vs. multidimensional frailty in older adults with and without heart failure ESC Heart Failure Multidimensional frailty Older adults Heart failure |
title | Physical vs. multidimensional frailty in older adults with and without heart failure |
title_full | Physical vs. multidimensional frailty in older adults with and without heart failure |
title_fullStr | Physical vs. multidimensional frailty in older adults with and without heart failure |
title_full_unstemmed | Physical vs. multidimensional frailty in older adults with and without heart failure |
title_short | Physical vs. multidimensional frailty in older adults with and without heart failure |
title_sort | physical vs multidimensional frailty in older adults with and without heart failure |
topic | Multidimensional frailty Older adults Heart failure |
url | https://doi.org/10.1002/ehf2.12688 |
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