Frailty in TOPCAT: a deep dive into the deficit index approach for defining frailty

Flint, Kelsey

doi:10.1002/ejhf.1316

Cited by 4 publications

(5 citation statements)

References 11 publications

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“…Problems in self-care and difficulties in leaving home may reduce also patient’s access to healthcare, which also contributes to insufficient treatment surveillance, delayed responses, and untimely treatment modifications, thus increasing the risk of negative outcomes 37 …”

Section: Introductionmentioning

confidence: 99%

Frailty in patients with heart failure

Vitale

Uchmanowicz

2019

European Heart Journal Supplements

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The importance of frailty in heart failure (HF) patients has been increasingly recognized because of its high prevalence and its significantly adverse impact on prognosis and quality of life. Due to the impact of frailty on both prognosis and treatment of HF patients, all patients with HF, regardless of their chronological age, should be evaluated for the presence of, or the risk for developing frailty. However, although several instruments are available, there is still no consensus as to which is the best method to assess frailty in patients with HF. Therefore, a validated and easy to apply instrument to assess frailty in HF patients in daily practice is warranted.

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Section: Introductionmentioning

confidence: 99%

Frailty in patients with heart failure

Vitale

Uchmanowicz

2019

European Heart Journal Supplements

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“…Regular exercise is a Class 1, level A recommendation for all HF patients, 24 , 49 which for the older patient may relate to engagement in some level of physical activity where possible 50 , 51 . Frailty, 52 , 53 as well as comorbidities such as arthritis may make this more challenging, therefore appropriate physical support (i.e. walking aid, well-fitted shoes) may be appropriate, particularly if the patient is prone to falls.…”

Section: Treatment Approachesmentioning

confidence: 99%

Care plans for the older heart failure patient

Hill

Carson

Vitale

2019

European Heart Journal Supplements

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Heart failure (HF) professionals are managing an older population with multiple, often interconnected comorbidities. The average age of the HF patient has increased substantially and many have a number of comorbidities. For the older HF patient, diligent planning of care has the potential to reduce hospitalization, improve quality of life and mortality; nevertheless, this vital component is often overlooked. Frailty, cachexia, sarcopenia, and cognitive impairment are all common in the older HF patient and require special care considerations. Many older HF patients live for many years with troublesome symptoms that could be better addressed through the incorporation of a palliative approach to care. Effective care plans can help patients maximize their health potential through both lifestyle and pharmacological interventions. However, current evidence remains scarce on what constitutes an optimal plan, therefore further studies are urgently needed. We review the care that could be implemented for the complex older HF patient with comorbidities.

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“…Frailty is a physiological decline in function that occurs with age, such as physical and cognitive decline, reduced physical activity, and more. Its hallmark is the increased vulnerability of physiological processes to various risk and stress factors, particularly pronounced in the elderly 1 . Recent research suggested that frailty is not confined to old age and occurs continuously, with young adults accumulating frailty risks that may manifest as a more pronounced frailty trajectory than their peers when they enter middle and old age 2 .…”

Section: Introductionmentioning

confidence: 99%

“…Its hallmark is the increased vulnerability of physiological processes to various risk and stress factors, particularly pronounced in the elderly. 1 Recent research suggested that frailty is not confined to old age and occurs continuously, with young adults accumulating frailty risks that may manifest as a more pronounced frailty trajectory than their peers when they enter middle and old age. 2 Early identification and intervention of weakness in young adults may yield greater benefits compared with strategies solely targeting frail elderly individuals.…”

Section: Introductionmentioning

confidence: 99%

Long‐term insulin resistance is associated with frailty, frailty progression, and cardiovascular disease

Ke,

Wen,

Huang

et al. 2024

J cachexia sarcopenia muscle

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BackgroundInsulin resistance and diabetes are associated with an increased risk of frailty, and frailty is associated with cardiovascular disease and premature mortality. We aim to investigate the impact of long‐term insulin resistance trajectories on future frailty and cardiovascular risk among young adults.MethodsIn total, 3168 participants with a 30‐year follow‐up period. The baseline period covered the first 15 years as the exposure period. Insulin resistance was determined using the homeostasis model assessment for insulin resistance (HOMA‐IR), and three trajectories (low, moderate, and high) were constructed. The subsequent 15 years constituted the event accrual period. Frailty was assessed using a deficit accumulation mode, and cardiovascular outcomes were obtained from the 15‐year event accrual period.ResultsThe mean age of all 3168 participants was 41.0 (37.0–43.0) years, with 1750 (55.2%) being women. Participants in the high level of insulin resistance trajectory had an increased prevalence of frailty (OR: 1.55, 95% CI: 1.05–2.30, P = 0.028). Although no statistically significant associations were observed after full adjustment, single‐factor analysis indicated association between the moderate and high trajectories and frailty progression. Additionally, participants with high level of insulin resistance trajectory were associated with an increased risk of cardiovascular disease, coronary heart disease, and stroke. A notable correlation between HOMA‐IR trajectory and cardiovascular diseases was still discernible within the subgroup where the frailty index ≥0.12 (HR: 2.12, 95% CI: 1.17–3.83, P = 0.013) (P for interaction >0.05).ConclusionsLong‐term high level of insulin resistance is associated with high prevalence of frailty, and an increased risk of cardiovascular events. Emphasizing the importance of early prevention and intervention for abnormal glucose metabolism in young adults to prevent frailty and cardiovascular disease.

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Frailty in TOPCAT: a deep dive into the deficit index approach for defining frailty

Cited by 4 publications

References 11 publications

Frailty in patients with heart failure

Frailty in patients with heart failure

Care plans for the older heart failure patient

Long‐term insulin resistance is associated with frailty, frailty progression, and cardiovascular disease

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