Sex and age differences in fragility in a heart failure population

Background: Heart failure (HF) patients have a high degree of fragility and dependence from physical, cognitive and psychological points of view, and are a mainly geriatric population. Aim: To detect the existence of fragility in all patients treated in a Heart Failure Unit and to evaluate age and sex differences. Methods: All patients underwent a basic geriatric evaluation to detect possible loss of autonomy for doing basic and instrumental activities, cognitive deterioration, emotional disturbance or social risk. Results: Three hundred sixty patients (mean age 65.2 years, 41.7% ≥70 years, 27.5% women) were evaluated. Fragility was detected in 41.7% of patients, being more prevalent in patients ≥70 years (p<0.001) and in women (p<0.001). A Barthel Index <90 was found in 22.5% of patients and an anomalous OARS Scale was found in 18.3%. Pfeiffer test's score was abnormal in 7.8% of patients. A positive depression response in abbreviate GDS was observed in 29.7%. All items analysed were more prevalent in patients ≥70 years and in women, with the unexpected exception of depression symptoms that were as prevalent in younger as in older patients. Conclusion: Fragility is common in patients with heart failure, even in younger patients, and can be detected easily using standardised geriatric scales. Prevalence of fragility was significantly higher in older patients and in women, although the presence of depression symptoms was as prevalent in younger as in older patients.