Abstract 15740: Effects of an Integrated Self-Care Intervention on Frailty Risk in Persons With Heart Failure and Type 2 Diabetes Mellitus
Introduction: Frailty is a common condition in the elderly and a powerful predictor of mortality in CVD. In heart failure (HF), frailty has been shown to predict falls, disability, hospitalization and to substantially lower health related quality of life. Persons with HF are 6-7 times more likely to be frail than their age matched counterparts; the risk of frailty increases with multiple chronic conditions. Although 30-47% of persons with HF have concomitant type 2 diabetes mellitus (DM), frailty in persons with HF and DM has not been reported. The purpose of this study is to examine the effects of an integrated intervention on risk of frailty in persons with HF and DM.
Methods: A secondary analysis of a randomized, controlled, repeated measures 6-month intervention trial was performed. Persons with HF and DM (n=102), mean age 58.14 ± 10.3 years, 69% male, 66% African American, and mean LVEF 34.72 ± 17.5 were randomized into usual care (UC) or an integrated HF-DM self-care education/counseling (HF-DM-SC) group which provided HF-DM self-care education and skills, psychosocial counseling to increase HF and DM self-efficacy, enhanced physical activity through walking, and facilitated decision making. Baseline and 6-month data were examined. Frailty was defined as total distance <300 meters on the six-minute walk test (6MWT). Descriptive, t-test, and repeated-measures ANOVA statistical analyses were used.
Results: At baseline, 60% of participants were classified as frail. Mean age (59.82) was higher (t=-2.001, p=.05) in the frail group compared with those considered not frail (55.58). No group differences in frailty were found at baseline (p=.55); frailty was not associated with BMI, LVEF, NYHA class, or comorbidities. After the 6-month HF-DM-SC intervention, the percent considered frail in the intervention group decreased from 56% to 29% while frailty in the UC group increased from 63.5% to 65% (p=0.021). No differences in age between frail and non-frail remained at 6 months.
Discussion: Frailty increases the risk of adverse outcome in persons with HF and is not limited to the elderly in persons with HF and HF-DM. An integrated self-care intervention which emphasizes increased walking and physical activity can improve frailty risk and outcomes in persons with HF-DM.
Author Disclosures: B. Butts: None. R. Gary: None. C.M. Reilly: None. M.K. Higgins: None. J. Butler: None. S. Dunbar: Research Grant; Modest; NIH. Research Grant; Significant; significant.
- © 2014 by American Heart Association, Inc.