International Journal of Heart Failure

The Korean Society of Heart Failure (대한심부전학회)
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The Dual Burden of Frailty and Heart Failure

  • Cristiana Vitale (Clinical Academic Group, St. George's University Hospital) ;
  • Ilaria Spoletini (IRCCS San Raffaele) ;
  • Giuseppe M.C. Rosano (Department of Human Sciences and Promotion of Quality of Life, Chair of Pharmacology, San Raffaele University of Rome)
  • Received : 2023.10.14
  • Accepted : 2024.04.08
  • Published : 2024.07.30
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Abstract

Frailty is highly prevalent among patients with heart failure (HF) and independently predicts adverse outcomes. However, optimal frailty definitions, assessments, and management in HF remain unclear. Frailty is common in HF, affecting up to 80% of patients depending on population characteristics. Even pre-frailty doubles mortality risk versus robust patients. Frailty worsens HF prognosis through systemic inflammation, neurohormonal changes, sarcopenia, and micronutrient deficiency. Simple screening tools like gait speed and grip strength predict outcomes but lack HF-specificity. Comprehensive geriatric assessment is ideal but not always feasible. Exercise, nutrition, poly-pharmacy management, and multidisciplinary care models can help stablize frailty components and improve patient-centred outcomes. Frailty frequently coexists with and exacerbates HF. Routine frailty screening should guide supportive interventions to optimize physical, cognitive, and psychosocial health. Further research on HF-specific frailty assessment tools and interventions is warranted to reduce this dual burden.

Keywords

Acknowledgement

This study was supported by the Italian Ministry of Health (Ricerca Corrente 20/1819).

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