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Frailty Assessment in Heart Failure: an Overview of the Multi-domain Approach

  • Nonpharmacologic Therapy: Surgery, Ventricular Assist Devices, Biventricular Pacing, and Exercise (A. Hasan, Section Editor)
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Abstract

Purpose of Review

The study aims (1) to provide a contemporary description of frailty assessment in heart failure and (2) to provide an overview of multi-domain frailty assessment in heart failure.

Recent Findings

Frailty assessment is an important predictive measure for mortality and hospitalisation in individuals with heart failure. To date, there are no frailty assessment instruments validated for use in heart failure. This has resulted in significant heterogeneity between studies regarding the assessment of frailty. The most common frailty assessment instrument used in heart failure is the Frailty Phenotype which focuses on five physical domains of frailty; the appropriateness a purely physical measure of frailty in individuals with heart failure who frequently experience decreased exercise tolerance and shortness of breath is yet to be determined. A limited number of studies have approached frailty assessment using a multi-domain view which may be more clinically relevant in heart failure.

Summary

There remains a lack of consensus regarding frailty assessment and an absence of a validated instrument in heart failure. Despite this, frailty continues to be assessed frequently, primarily for research purposes, using predominantly physical frailty measures. A more multidimensional view of frailty assessment using a multi-domain approach will likely be more sensitive to identifying at risk patients.

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Authors and Affiliations

  1. ImPACCT, Faculty of Health, University of Technology Sydney, PO Box 123, Ultimo, NSW, 2007, Australia

    Julee McDonagh

  2. Western Sydney Nursing & Midwifery Research Centre, Blacktown Clinical & Research School, Blacktown Hospital, Western Sydney University & Western Sydney Local Health District, Marcel Crescent, Blacktown, NSW, 2148, Australia

    Caleb Ferguson & Phillip J. Newton

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  1. Julee McDonagh
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Caleb Ferguson and Phillip J. Newton declare no conflicts of interest.

Julee McDonagh has received funding to support this research provided by the NSW Ministry of Health under the NSW Health PhD Scholarship Program, co-funded by the University of Technology Sydney.

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This article is part of the Topical Collection on Nonpharmacologic Therapy: Surgery, Ventricular Assist Devices, Biventricular Pacing, and Exercise

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McDonagh, J., Ferguson, C. & Newton, P.J. Frailty Assessment in Heart Failure: an Overview of the Multi-domain Approach. Curr Heart Fail Rep 15, 17–23 (2018). https://doi.org/10.1007/s11897-018-0373-0

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