Objectives: Heart failure is the end stage of hypertensive, coronary and valvular cardiovascular disease. It is a major and growing problem because of the increasing size of the aging population and the prolonged lives of cardiac patients with modern therapy. The goal of our study was to investigate the relationship between different parameters with survival, in a cohort of heart failure elderly patients. Methods: We studied a cohort of 244 patients hospitalized with heart failure (diagnosed according to Framingham criteria) at the Internal Medicine unit of a country hospital of Cantabria (Tres Mares Hospital at Reinosa); 115 were men and 129 were women with an age range of 55 to 100 years (median age and quartiles of 85 and 79–89 years). Fourteen (5.7%) patients died during hospitalization. All patients were followed up by telephone with a median survival of 984 days. The variables included in our study were age, sex, cognitive status Mini Mental Status Examination (MMSE), Barthel index, coronary disease, stroke, peripheral arteriopathy, atrial fibrillation, diabetes mellitus, COPD, smoking, heart rate, ejection fraction, NYHA class, systolic blood pressure, body mass index, midarm circumference, midarm muscle area (MAMA), triceps skinfold, handgrip strength, hemoglobin, serum albumin, serum prealbumin, lymphocyte count, total cholesterol, serum creatinine, serum urea nitrogen and natremia. To know which variables yield long term independent predictive value, we included in survival analysis with covariates (Cox regression) those variables with long term significant value when assessed by Kaplan–Meier and long rank test analysis. Results: The data with an independent predictive value were NYHA III/IV versus I/II, RR 3.73 (2.07–6.71) (p b 0.001); hemoglobin b 11 g/dl, RR 3.15 (1.83–5.40) (p b 0.001); serum creatinine N 1.5 mg/dl, RR 2.71 (1.59–4.61) (p b 0.001); MMSE b 21, RR 3.95 (1.70–9.17) (p 0.001); ejection fraction, RR 2.11 (1.17–3.79) (p 0.013): heart rate b 90 beats/min, RR 1.77 (1.04–3.00) (p 0.034); and midarm muscle area (MAMA) b 95th percentile, RR 0.22 (0.05–0.93) (p 0.039). Conclusion:ANYHA class III or IV class, a hemoglobin lower than 11 g/dl, a serum creatinine over 1.5 mg/dl, cognitive impairment with a MMSE lower than 21 points, an Ejection Fraction below 40% and a heart rate greater than 90/m were associated with a higher mortality rate. As a protective factor we found a MAMA over the 95th percentile of the normal population.