Abstract 11721: Frailty Assessed by a Composite Assessment of Cognitive and Physical Frailty Predicts Long-Term Outcomes in Elderly Pre-Clinical Heart Failure Patients

Abstract

Introduction: We combined the Fried phenotype and the mini-mental state examination (MMSE) +clock drawing test (CDT) to assess frailty in elderly pre-clinical heart failure (HF) patients, and aimed to evaluated the prevalence and prognostic value of frailty assessed by this simple composite scoring system in this population. Methods: we conducted a single-center prospective observational cohort study in which enrolled inpatients≥ 65 years and followed up for 2 years. The primary outcomes were 2-year all-cause mortality or readmission. Multivariate Cox proportional hazard model was used to test the predictive validity. Results: Overall, 531 elderly pre-clinical HF inpatients were included in our study (mean age: 75.4±6.47 years, male: 230 [43.3%]). Among them, 11.7% (62/531) were assessed as cognitive impairment without physical frailty, 15.1% (80/531) were assessed as physical frailty without cognitive dysfunction and 13.0% (69/531) were assessed as cognitive frailty with physical frailty and cognitive impairment. The cognitive frailty individuals were older (P<0.05), had shorter time of education (P<0.001), higher level of N-terminal pro-B-type natriuretic peptide (P<0.05), and were more likely to have comorbidities of peripheral arterial disease and the history of stroke (P<0.05) and take ≥5 medications (P<0.05). Physical frailty patients (P=0.019) and cognitive frailty patients (P=0.003) both had a higher incidence of mortality or readmission during 2-year follow-up and had a 1.50-fold (95%CI 1.04-2.18, P=0.03) and 1.84-fold (95%CI 1.19-2.83, P=0.01) higher risk of 2-year adverse events, respectively, after adjusting age, sex, marital status,education years,diabetes and the history of stroke. Conclusions: In conclusion, cognitive frailty is common in elderly pre-clinical HF patients. Adding cognitive impairment to physical frailty could predict all-cause mortality or readmission better in this population in the long term.