Frailty phenotype and associated nutritional factors in a sample of Portuguese outpatients with heart failure

https://doi.org/10.1016/j.numecd.2021.03.028Get rights and content
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Highlights

  • Frailty phenotype and heart failure are closely related.

  • Of Portuguese heart failure patients, 57.4% are pre-frail and 15.4% are frail.

  • Frailty is associated with low muscle mass, older age and obesity.

  • Although age >70 years is associated with frailty, more than half the frail patients are <65 years of age.

Abstract

Background and aim

Frailty phenotype (FP) is very common in heart failure (HF) and both syndromes worsen one another. The aim of this study is to first describe FP in a sample of Portuguese patients with HF, and to analyse its association with nutritional and clinical statuses, namely, muscle mass, obesity and functional class.

Methods and results

In this cross-sectional study, a sample of 136 outpatients with HF (24–81 years, 33.8% women) were randomly selected from the appointments' listings of a HF and Transplant clinic in a Portuguese University Hospital. FP was assessed according to Fried et al. muscle mass was estimated from the mid-upper arm muscle circumference; weight status was assessed using the body mass index; HF functional classes were registered. The association between participants' characteristics and FP categories was analysed using logistic ordinal regression. The frequency of pre-frailty and frailty is 57.4% and 15.4%, respectively. Within frail individuals, 52.4% were under the age of 65. In multivariable analysis, frailty was positively associated with age 70 or older (OR = 3.44) and obesity (OR = 2.66), and negatively associated with muscle mass (OR = 0.77) and HF functional classes I (OR = 0.14) or II (OR = 0.29).

Conclusion

Muscle mass seems to be an important predictor of frailty in patients with HF and should be taken into account when designing intervention plans that allow for reverting or modifying frailty and pre-frailty. Younger patients should be monitored for the presence and evolution of FP.

Keywords

Frailty phenotype
Heart failure
Nutritional status
Muscle mass
Obesity

Abbreviations

HF
Heart Failure
FP
Frailty Phenotype
NYHA
New York Heart Association
LVEF
Left-Ventricular Ejection Fraction
HGS
Hand Grip Strength
BMI
Body Mass Index
GS
Gait Speed
IPAQ-SF
International Physical Activity Questionnaire – Short Form
MET-min
Metabolic Equivalents of Tasks per minute
MAMC
Mid-upper Arm Muscle Circumference
MUAC
Mid-upper Arm Circumference
TST
Triceps Skinfold Thickness
LVAD
Left Ventricular Assist Device

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