The frailty syndrome is associated with adverse health outcomes in very old patients with stable heart failure: A prospective study in six Spanish hospitals

Rodríguez-Pascual, Carlos; Paredes-Galán, Emilio; Ferrero-Martínez, Ana-Isabel; Gonzalez-Guerrero, J.L.; Hornillos‐Calvo, Mercedes; Colino, Rocío Menéndez; Torres-Torres, Ivett; Vilches‐Moraga, Arturo; Galán, M.M. Díez; Suárez-García, Francisco Manuel; Olcoz-Chiva, Maria-Teresa; Rodríguez‐Artalejo, Fernando

doi:10.1016/j.ijcard.2017.02.016

Cited by 78 publications

(65 citation statements)

References 41 publications

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“…Four articles evaluating the association between gait speed (low vs. high) with IADL demonstrated worsening in IADL (OR = 1.93, 95% CI: 1.69–2.21, I 2 = 0.0) ( Figure B). Five articles were pooled comparing the lowest quintile for gait speed with the upper four quintiles with ADL demonstrated an association in worsening ADL (OR = 3.08, 95% CI: 2.13–4.46, I 2 = 75.7) ( Figure C).…”

Section: Resultsmentioning

confidence: 99%

Muscle mass, strength, and physical performance predicting activities of daily living: a meta‐analysis

Wang

Yao

Zirek

et al. 2019

J cachexia sarcopenia muscle

360

258

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Background Activities of daily living (ADLs) and instrumental activities of daily living (IADLs) are essential for independent living and are predictors of morbidity and mortality in older populations. Older adults who are dependent in ADLs and IADLs are also more likely to have poor muscle measures defined as low muscle mass, muscle strength, and physical performance, which further limit their ability to perform activities. The aim of this systematic review and meta‐analysis was to determine if muscle measures are predictive of ADL and IADL in older populations. Methods A systematic search was conducted using four databases (MEDLINE, EMBASE, Cochrane, and CINAHL) from date of inception to 7 June 2018. Longitudinal cohorts were included that reported baseline muscle measures defined by muscle mass, muscle strength, and physical performance in conjunction with prospective ADL or IADL in participants aged 65 years and older at follow‐up. Meta‐analyses were conducted using a random effect model. Results Of the 7760 articles screened, 83 articles were included for the systematic review and involved a total of 108 428 (54.8% female) participants with a follow‐up duration ranging from 11 days to 25 years. Low muscle mass was positively associated with ADL dependency in 5/9 articles and 5/5 for IADL dependency. Low muscle strength was associated with ADL dependency in 22/34 articles and IADL dependency in 8/9 articles. Low physical performance was associated with ADL dependency in 37/49 articles and with IADL dependency in 9/11 articles. Forty‐five articles were pooled into the meta‐analyses, 36 reported ADL, 11 reported IADL, and 2 reported ADL and IADL as a composite outcome. Low muscle mass was associated with worsening ADL (pooled odds ratio (95% confidence interval) 3.19 (1.29–7.92)) and worsening IADL (1.28 (1.02–1.61)). Low handgrip strength was associated with both worsening ADL and IADL (1.51 (1.34–1.70); 1.59 (1.04–2.31) respectively). Low scores on the short physical performance battery and gait speed were associated with worsening ADL (3.49 (2.47–4.92); 2.33 (1.58–3.44) respectively) and IADL (3.09 (1.06–8.98); 1.93 (1.69–2.21) respectively). Low one leg balance (2.74 (1.31–5.72)), timed up and go (3.41 (1.86–6.28)), and chair stand test time (1.90 (1.63–2.21)) were associated with worsening ADL. Conclusions Muscle measures at baseline are predictors of future ADL and IADL dependence in the older adult population.

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Section: Resultsmentioning

confidence: 99%

Muscle mass, strength, and physical performance predicting activities of daily living: a meta‐analysis

Wang

Yao

Zirek

et al. 2019

J cachexia sarcopenia muscle

360

258

View full text Add to dashboard Cite

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“…Worsening patient condition from myocardium overload causes worsening HF and reduces cardiac function 21, 22. Such overload of the myocardium may also lead to a higher risk of falling, decreased mobility, and decreased ability to perform basic activities of daily living, which, in turn, results in increased frailty 23, 24. In fact, in the refusal group, frailty status was relatively progressed compared with the non‐refusal group.…”

Section: Discussionmentioning

confidence: 99%

Patients Refusing Transcatheter Aortic Valve Replacement Even Once Have Poorer Clinical Outcomes

Shimura

Yamamoto

Kano

et al. 2018

JAHA

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BackgroundAlthough transcatheter aortic valve replacement (TAVR) is the least invasive treatment for patients with symptomatic aortic stenosis, some patients hesitate to undergo the procedure. We investigated the clinical impact of treatment delay after patient refusal of TAVR.Methods and ResultsWe used the Japanese OCEAN (Optimized Catheter valvular intervention) regsitry data of 1542 patients who underwent TAVR. Refusal was defined as at least 1 refusal of TAVR at the time of informed consent. Patients were separated into 2 groups: refusal (28/1542, 1.8%) and non‐refusal (1514/1542, 98.2%). We compared the baseline characteristics, procedural outcomes, and mortality rates between the groups. Additionally, data on reasons for refusal and those leading to eventually undergoing TAVR were collected. Age, surgical risk scores, and frailty were higher in the refusal group than in the non‐refusal group (P<0.05 for all). Periprocedural complications did not differ between groups, whereas 30‐day and cumulative 1‐year mortality were significantly higher in the refusal group than in the non‐refusal group (7.1% versus 1.3%, P=0.008 and 28.8% versus 10.3%, P=0.010, respectively). Multivariate Cox regression analysis revealed that TAVR refusal was an independent predictor of increased midterm mortality (hazard ratio: 3.37; 95% confidence interval: 1.52–7.48; P=0.003). The most common reason for refusal was fear (13/28, 46.4%), and the most common reason for changing their mind was worsening heart failure (21/28, 75.0%). All patients in the refusal group decided to undergo TAVR within 20 months (median: 5.5 months).ConclusionsRefusing TAVR even once led to poorer prognosis; therefore, this fact should be clearly discussed when obtaining informed consent.

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“…Physical frailty results in elevated rates of mortality, morbidity, functional decline, and major adverse cardiac and cerebrovascular events following cardiac surgery [5]. Some earlier studies indicated associations of physical frailty with poor prognosis in cardiac patients [6-8]. Physical frailty is emerging as a syndrome of pre-disability and can be minimized or reversed by a number of interventions.…”

Section: Introductionmentioning

confidence: 99%

Office-Based Physical Assessment in Patients Aged 75 Years and Older with Cardiovascular Disease

et al. 2019

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Background: The detection of impaired physical performance in older adults with cardiovascular disease is essential for clinical management and therapeutic decision-making. There is a requirement for an assessment tool that can be used conveniently, rapidly, and securely in clinical practice for screening decreased physical performance. Objective: The present study was performed to evaluate the association of office-based physical assessments with decreased physical performance and to compare the prognostic capability of these assessments in older adults with cardiovascular disease. Methods: A total of 1,040 patients aged 75 years and older with cardiovascular disease were included in this analysis. One-leg standing time (OLST) and handgrip strength were measured as office-based physical assessment tools, and short physical performance battery (SPPB), 6-min walk distance, and usual gait speed were also measured at hospital discharge as measurements of physical performance. All-cause mortality was assessed by death registry at the hospital. We examined the association of office-based measures with physical performance and all-cause mortality. Results: The areas under the curve of OLST for SPPB < 10, 6-min walk distance < 300 m, and usual gait speed < 1.0 m/s were 0.87 (95% CI 0.83–0.91), 0.83 (95% CI 0.80–0.86), and 0.81 (95% CI 0.78–0.85), respectively. The discrimination abilities of OLST for decreased physical performance were significantly higher than those of handgrip strength. After adjusting for the effects of patient characteristics, the hazard ratio for all-cause mortality in the < 3 s group for OLST was 1.68 (95% CI 1.06–2.67, p = 0.03). Handgrip strength, however, was not significantly associated with mortality risk in these participants. Conclusion: Short OLST, in particular < 3 s, is associated with decreased physical performance and elevated mortality risk in elderly patients with cardiovascular disease. OLST can be conveniently measured in the clinician’s office as a screening tool for impaired physical performance.

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The frailty syndrome is associated with adverse health outcomes in very old patients with stable heart failure: A prospective study in six Spanish hospitals

Cited by 78 publications

References 41 publications

Muscle mass, strength, and physical performance predicting activities of daily living: a meta‐analysis

Muscle mass, strength, and physical performance predicting activities of daily living: a meta‐analysis

Patients Refusing Transcatheter Aortic Valve Replacement Even Once Have Poorer Clinical Outcomes

Office-Based Physical Assessment in Patients Aged 75 Years and Older with Cardiovascular Disease

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