Frailty linked to dementia, disability in older CHD patients

Physical frailty appears to accelerate the development of geriatric outcomes in patients with coronary heart disease (CHD), reveals a study.

In the general population, frailty, which is a clinical state of vulnerability, correlates with subsequent adverse geriatric syndromes. This study then assessed the long-term impact of the condition on geriatric outcomes among older CHD patients.

The authors used the National Health and Aging Trends Study, a prospective cohort study linked to a Medicare sample, and identified CHD by self-report or International Classification of Diseases (ICD) coded 1 year prior to the baseline visit.

The Fried physical frailty phenotype was applied to measure frailty among participants. Geriatric outcomes were evaluated annually during a 6-year follow-up.

A total of 4,656 participants were included, of whom 1,213 (26 percent) had a history of CHD 1 year prior to their baseline visit. Participants with frailty were older (ages ≥75: 80.9 percent vs 68.9 percent; p<0.001), more likely to be female, and belong to an ethnic minority compared to those without frailty.

Frail individuals had a higher prevalence of hypertension, stroke, falls, disability, anxiety/depression, and multimorbidity than nonfrail participants.

In a discrete time survival model, older CHD patients with frailty also had a significantly greater incidence of geriatric syndromes during 6-year follow-up, including dementia, loss of independence, activities of daily living disability, instrumental activities of daily living disability, and mobility disability.

“Efforts to identify frailty in the context of CHD are needed, as well as interventions to limit or reverse frailty status for older patients with CHD,” the authors said.