Physical Frailty Prominent in Women, Retired or Unemployed Patients with Heart Failure

In a poster presented at the Heart Failure Society of America 2024 Annual Meeting, researchers found that social detriments of health (SDOH), alone or in combination with others, were significant predictors of physical frailty in patients with heart failure (HF). The key SDOH identified in HF patients was retirement or unemployment, while female patients with HF were also significantly associated with predictors of physical frailty.

“Physical frailty affects a significant number of adults with [HF], conferring worse clinical and patient-reported outcomes. While the biological (including sex) and physiological factors contributing to physical frailty in HF are beginning to be understood, the contributing role of [SDOH] have not been studied,” wrote authors of the poster.¹

When it comes to physical frailty and its impact on HF patients, especially those who are elderly, it’s important to understand the true definition of physical frailty; one that has been debated upon until the last few decades. According to an article published in Age and Ageing, physical frailty is “a medical syndrome with multiple causes and contributors that is characterized by diminished strength, endurance, and reduced physiologic function that increases an individual's vulnerability for developing increased dependency and/or death.”²

Physical frailty is a medical syndrome with multiple causes and contributors that is characterized by diminished strength, endurance, and reduced physiologic function. | image credit: Paul Maguire / stock.adobe.com

To understand the association between SDOH and physical frailty, researchers conducted a secondary analysis from 2 separate studies on adults with HF. They then identified the SDOH factors that would be included in the study: race/ethnicity, level of education, financial status, employment status, marital status, and whether or not patients have someone to confide in. Finally, to measure the extent of patients’ physical frailty, they used various attributes, including unintentional weight loss, weakness, slowness, physical exhaustion, and low physical activity.¹

The study included a total of 160 participants (mean age, 61.7 years; 44% women) in the New York Heart Association (NYAH) functional class I-IV of HF (62% were NYAH class III or IV). Among the sample of participants, 44% were identified as having physical frailty, with the female sex and retirement or unemployment being the most significant predictors.¹

“A nested logistic regression model demonstrated that the block of SDOH factors significantly predicted physical frailty above and beyond age, sex, NYHA class, and comorbidity index,” they continued.

While more prominent in women and retired or unemployed participants, throughout study interventions, researchers found SDOH to be a significantly successful determinant of physical frailty in patients with HF, especially in older adults more susceptible to HF and physical frailty.

“SDOH, individually and in combination, are potential significant contributors to physical frailty in HF. Retirement or unemployment was a notable predictor of frailty, indicating that it warrants further research and clinical evaluation as a potential sentinel event for adults with HF. Additionally, female sex continues to be strongly associated with and influences predictors of physical frailty in HF,” concluded the authors.¹

Click here for more coverage of the Heart Failure Society of America 2024 Annual Meeting.

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References

1. Denfeld Q. Are social determinants of health related to physical frailty in heart failure? Presented at: Heart Failure Society of America Annual Scientific Meeting; September 27-30; Atlanta, Georgia. Poster 1385-026.

2. Gordon A, Masud T, Gladman J. Now that we have a definition for physical frailty, what shape should frailty medicine take? Age and Ageing. 2013;43(1):8-9. https://doi.org/10.1093/ageing/aft161