Abstract P242: Measuring Frailty in Heart Failure: A Community Perspective
Objective: To compare two measures of frailty in a community cohort of heart failure (HF) patients.
Background: Frailty is increasingly recognized as an important prognostic indicator in HF. Several methods have been proposed to measure frailty. Some conceptualize frailty as a biological phenotype, while others define it as an accumulation of deficits (impairments, disabilities, comorbid diseases), termed the Cumulative Deficit Index (CDI). Each approach has conceptual strengths and limitations; a distinct feature of the CDI is the ability to extract data from medical records. These two methods have never been compared in a community HF cohort.
Methods: Olmsted, Dodge and Fillmore County, MN residents with HF between 10/2007 and 12/2010 were prospectively recruited to assess the frailty phenotype. The biological frailty phenotype was defined as ≥3 of the following: unintentional weight loss >10 lbs. in 1 year, physical exhaustion, weak grip strength, and slowness and low activity measured by the SF-12 physical component score. Intermediate frailty was defined as having 1–2 components. The CDI was based on 33 deficits and defined as the proportion of deficits present for each patient.
Results: Among 131 patients (mean age 70.5±14, 62% male), according to the biological frailty phenotype definition 18% were frail, 50% intermediate frail and 31% not frail. The CDI ranged from 0.03–0.70, with a mean (SD) of 0.22 (0.12). The CDI was significantly correlated with the frailty phenotype (r=0.59, p<0.001). The mean (SD) of the CDI was 0.35 (0.14), 0.21 (0.10) and 0.15 (0.07) among the frail, intermediate frail and not frail phenotypes (Figure).
Conclusion: The CDI is significantly associated with the biological frailty phenotype and can thus be used as an alternative approach to measure frailty in HF. As the components of the biological frailty phenotype are not routinely assessed clinically, the CDI, which can be ascertained from medical records, is a feasible approach to ascertain frailty in large cohorts.
- © 2012 by American Heart Association, Inc.