Clinical InvestigationHeart FailureFrailty and risk for heart failure in older adults: The health, aging, and body composition study
Section snippets
Study population
The Health ABC Study enrolled 3075 well-functioning, community dwelling individuals aged 70 to 79 years from 1997 to 1998. Participants were identified from a random sample of white Medicare beneficiaries and all age eligible black community residents from Pittsburgh and Memphis. Participants with manifest or missing data on HF at baseline (n = 140) were excluded. Of the 2935 such participants, 2825 (96%) had data for the Gill criteria and HABC Battery and were included in this analysis.
Study definitions
Baseline participant characteristics
The mean age of participants was 74 ± 3 years; 48% were men and 59% were white. Median HABC Battery score was 2.3 (IQR 1.9-2.6). Table I presents the baseline characteristics. Frailty was present in 17.5% (moderate 16.2% and severe 1.3%) of participants by Gill criteria. Frail participants were older (74 ± 3 vs 73 ± 3 years, P < .001), more frequently women (60.1% vs 50.4%, P < .001), and black (53% vs 38%, P < .001). Frailty status by the 2 indexes was concordant in 1882 (66.7%) participants.
Discussion
In this cohort of community-based elderly, frailty was a significant predictor of incident HF. A unit decrease in HABC Battery score, signifying worsening frailty, was associated with 30% (10%-55%) increase in HF risk. These findings were consistent in both sexes, and in blacks and whites, and were independent of clinical risk factors, inflammatory markers, ankle arm index, incident CHD, and death as a competing event. These results highlight that frailty raises HF risk independent of other
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For the Health ABC Study.