Abstract 1550: Frailty Decreases Health Related Quality of Life in Older Adults With Heart Failure
Background: While frailty has been discussed extensively in the geriatric literature it is limited in the cardiovascular literature. Frailty refers to a state of vulnerability secondary to co-occurring, multiple system deterioration. Health related quality of life (HRQOL) is known to be impaired in older adults with HF. But a possible relationship between frailty and HRQOL has not been explored.
Objective: To determine if frailty explains unique variance in HRQOL in HF after adjusting for factors known to determine HRQOL- gender, income, ethnicity, health perception, and functional status.
Methods: A frailty index score was developed by weighting age, number of co-morbid conditions, and the symptom severity of fatigue, dyspnea on exertion, and chest pain using data from a benchmark sample of 130, primarily older (M 70±13.1 years), end stage HF (98% NYHA class III/IV) patients. The index was then tested in one sample (M 74±10.9 years, 87% NYHA class III/IV) and verified in a second sample (M 71±11.7 years, 92% NYHA class III/IV). A 2-step block regression analysis was used in which known predictors of HRQOL were entered first and the frailty index was entered in a second step. HRQOL was assessed using the Minnesota Living with Heart Failure Questionnaire (MLHFQ) summary score.
Results: In the first sample, known predictors of HRQOL explained 11% (p 0.14) of the variance in HRQOL. When the frailty index score was added an additional 24% (p 0.001) of the variance in HRQOL was explained. In the second sample, known predictors explained 15% (p 0.04) of the variance in HRQOL and the frailty index score added an additional 40% (p ≤0.001) of the variance.
Conclusion: Frailty explains a significant amount of unique variance in HRQOL in older adults with HF. Assessing and treating indicators of frailty may be one way of improving HRQOL for these people.