Frailty highly prevalent among older hypertensive adults

The prevalence of frailty among older outpatients with hypertension is high, but the agreement between various frailty tools is moderate to weak, according to a study.

Hypertensive patients aged at least 75 years from two geriatric outpatient clinics of Careggi Hospital in Florence, Italy, were enrolled in this study. The authors applied four frailty scales, namely Fried Frailty Phenotype, Frailty Index, Clinical Frailty Scale (CFS), and Frailty Postal score, as well as two physical performance tests, namely Short Physical Performance Battery (SPPB) and usual gait speed.

Agreement between these measures was assessed by calculating the Cohen’s kappa coefficient. Finally, clinical features independently associated with frailty were identified via multiple logistic regression.

A total of 121 participants (mean age 81 years, 60 percent women) were included in the analysis. Frailty prevalence ranged from 33 percent to 50 percent depending on the tool used.

There was moderate agreement between Fried Frailty Phenotype, Frailty Index, and SPPB, as well as between Frailty Index and CFS. However, agreement was either weak or minimal between the other measures (K<0.60).

Regardless of the definition applied, use of walking aids and depression symptoms independently correlated with frailty. Other predictors of frailty included dementia, disability, and comorbidity burden, but not office and 24-h blood pressure values.

“Longitudinal studies are needed to assess the prognostic role of different frailty tools and their clinical utility in the choice of antihypertensive treatment,” the authors said.