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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Main Authors: 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
Format: Article
Language:English
Published: Wiley 2020-06-01
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.
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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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