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Utility of the FRAIL Questionnaire in Detecting Heart Failure with Preserved Ejection Fraction

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The journal of nutrition, health & aging

Abstract

Objective

To test the utility of the FRAIL questionnaire as a screening tool for heart failure.

Design

Cross sectional study.

Setting

Chinese older people in Hong Kong.

Participants

Participants aged 60 years and over were recruited from a territory-wide primary care needs assessment for older people based in community centers as well as two nonacute hospitals.

Measurements

Questionnaire administered included the five-item FRAIL scale, and information regarding sociodemographic data, smoking and alcohol use, history of cardiovascular disease and diabetes, and heart failure symptoms. Handgrip strength, walking speed and 6 minute walk distance were recorded. Cardiac assessment included electrocardiogram, echocardiography, and blood assay for N-terminal prohormone of B-type natriuretic peptide (NT-proBNP).

Results

The prevalence of diastolic dysfunction was high, being 52% in the robust group, increasing to 65% in the pre-frail and 85% in the frail group. This finding is accompanied by a corresponding increase in NT-proBNP from 64.18 pg/ml in the robust group, to 118.57 pg/ml in the pre-frail and 167.98 pg/ml in the frail group. Three of the five components of the FRAIL scale, fatigue, resistance and ambulation, were associated with increased odds ratios of diastolic dysfunction among those aged 75 years and older, while resistance alone was associated with increased odds ratio among those less than 75 years old.

Conclusion

Frailty is associated with heart failure with preserved ejection fraction (HFpEF), and frailty screening may be used to detect undiagnosed HFpEF. The findings support the proposal that HFpEF be considered a geriatric syndrome.

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Authors and Affiliations

  1. Department of Medicine & Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, Hong Kong

    Jean Woo, X. Yang, L. Tin Lui, Q. Li, K. Fai Cheng, Y. Fan, F. Yau, A. P. W. Lee, J. S. W. Lee & E. Fung

  2. Laboratory for Heart Failure and Circulation Research, Li Ka Shing Institute of Health Sciences, Prince of Wales Hospital, Shatin, Hong Kong SAR, Hong Kong

    X. Yang, L. Tin Lui, Q. Li, K. Fai Cheng & E. Fung

  3. Department of Medicine, Alice Ho Miu Ling Nethersole Hospital and Tai Po Hospital, Tai Po, Hong Kong SAR, Hong Kong

    J. S. W. Lee

  4. Department of Medicine & Therapeutics, Prince of Wales Hospital, Shatin, N.T., Hong Kong

    Jean Woo

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  1. Jean Woo
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  2. X. Yang
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Corresponding author

Correspondence to Jean Woo.

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Woo, J., Yang, X., Lui, L.T. et al. Utility of the FRAIL Questionnaire in Detecting Heart Failure with Preserved Ejection Fraction. J Nutr Health Aging 23, 373–377 (2019). https://doi.org/10.1007/s12603-019-1158-1

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  • DOI: https://doi.org/10.1007/s12603-019-1158-1

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