Cargando…

Association of Chronic Heart Failure with Frailty, Malnutrition, and Sarcopenia Parameters in Older Patients—A Cross-Sectional Study in a Geriatric Ward

The need to assess sarcopenia and frailty in patients with chronic heart failure (HF) has recently been raised. This cross-sectional study of 416 geriatric ward patients (median age (Me)—82 (IQR, 77–86) years, 77.4% female, 96.9% community dwelling) aimed to assess the prevalence of dynapenia, frail...

Descripción completa

Detalles Bibliográficos
Autores principales: Charkiewicz, Miroslaw, Wojszel, Zyta Beata, Kasiukiewicz, Agnieszka, Magnuszewski, Lukasz, Wojszel, Aleksandra
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10052656/
https://www.ncbi.nlm.nih.gov/pubmed/36983305
http://dx.doi.org/10.3390/jcm12062305
_version_ 1785015210476568576
author Charkiewicz, Miroslaw
Wojszel, Zyta Beata
Kasiukiewicz, Agnieszka
Magnuszewski, Lukasz
Wojszel, Aleksandra
author_facet Charkiewicz, Miroslaw
Wojszel, Zyta Beata
Kasiukiewicz, Agnieszka
Magnuszewski, Lukasz
Wojszel, Aleksandra
author_sort Charkiewicz, Miroslaw
collection PubMed
description The need to assess sarcopenia and frailty in patients with chronic heart failure (HF) has recently been raised. This cross-sectional study of 416 geriatric ward patients (median age (Me)—82 (IQR, 77–86) years, 77.4% female, 96.9% community dwelling) aimed to assess the prevalence of dynapenia, frailty syndrome, functional and nutritional health, and co-morbidity regarding their HF status. We collected data from comprehensive geriatric assessment. We observed HF in 162 (38.9%) patients, with 80 (49.4%) classified as New York Heart Association (NYHA) class III or IV. HF patients were significantly older, more frequently male, obese, hospitalized in the previous year, burdened with multimorbidity and polypharmacy, classified as frail, dependent on daily living activities, and physically non-active. Ischemic heart disease, atrial fibrillation, diabetes, peripheral arterial disease, anemia, chronic kidney disease, history of myocardial infarction, and stroke were found significantly more often in the HF group. A considerably higher percentage of HF patients had dynapenia (54.9% versus 41.9%, p = 0.02), but the difference was significant only in women. We found no significant difference between HF and no-HF groups regarding muscle performance, except for lower median gait speed in the HF group—0.53 m/s (0.35–0.89 m/s) versus 0.68 m/s (0.44–0.99 m/s), p = 0.02). HF patients significantly more often had low grip strength accompanied by slow gait, suggesting probable severe sarcopenia (40.4% vs. 29% in patients without HF, p = 0.046). In the regression analysis, significantly higher odds for HF were observed for lower mid-arm circumference (MAC) and dynapenia when controlling for age, sex, body mass index (BMI), calf circumference (CC), peripheral arterial disease, history of stroke, ischemic heart disease, atrial fibrillation, and diabetes mellitus. Conclusions: HF geriatric patients are often burdened with frailty, obesity, multimorbidity, and polypharmacy. As a result, they are more likely to present low muscle strength (potential sarcopenia), which is frequently accompanied by functional limitations (suggestive of more advanced stages of sarcopenia). This tendency is evident mainly in older women. Nevertheless, sarcopenia can be independently associated with HF in older patients with multimorbidity and disability who are hospitalized in a geriatric department, as a multivariable logistic regression analysis demonstrated.
format Online
Article
Text
id pubmed-10052656
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-100526562023-03-30 Association of Chronic Heart Failure with Frailty, Malnutrition, and Sarcopenia Parameters in Older Patients—A Cross-Sectional Study in a Geriatric Ward Charkiewicz, Miroslaw Wojszel, Zyta Beata Kasiukiewicz, Agnieszka Magnuszewski, Lukasz Wojszel, Aleksandra J Clin Med Article The need to assess sarcopenia and frailty in patients with chronic heart failure (HF) has recently been raised. This cross-sectional study of 416 geriatric ward patients (median age (Me)—82 (IQR, 77–86) years, 77.4% female, 96.9% community dwelling) aimed to assess the prevalence of dynapenia, frailty syndrome, functional and nutritional health, and co-morbidity regarding their HF status. We collected data from comprehensive geriatric assessment. We observed HF in 162 (38.9%) patients, with 80 (49.4%) classified as New York Heart Association (NYHA) class III or IV. HF patients were significantly older, more frequently male, obese, hospitalized in the previous year, burdened with multimorbidity and polypharmacy, classified as frail, dependent on daily living activities, and physically non-active. Ischemic heart disease, atrial fibrillation, diabetes, peripheral arterial disease, anemia, chronic kidney disease, history of myocardial infarction, and stroke were found significantly more often in the HF group. A considerably higher percentage of HF patients had dynapenia (54.9% versus 41.9%, p = 0.02), but the difference was significant only in women. We found no significant difference between HF and no-HF groups regarding muscle performance, except for lower median gait speed in the HF group—0.53 m/s (0.35–0.89 m/s) versus 0.68 m/s (0.44–0.99 m/s), p = 0.02). HF patients significantly more often had low grip strength accompanied by slow gait, suggesting probable severe sarcopenia (40.4% vs. 29% in patients without HF, p = 0.046). In the regression analysis, significantly higher odds for HF were observed for lower mid-arm circumference (MAC) and dynapenia when controlling for age, sex, body mass index (BMI), calf circumference (CC), peripheral arterial disease, history of stroke, ischemic heart disease, atrial fibrillation, and diabetes mellitus. Conclusions: HF geriatric patients are often burdened with frailty, obesity, multimorbidity, and polypharmacy. As a result, they are more likely to present low muscle strength (potential sarcopenia), which is frequently accompanied by functional limitations (suggestive of more advanced stages of sarcopenia). This tendency is evident mainly in older women. Nevertheless, sarcopenia can be independently associated with HF in older patients with multimorbidity and disability who are hospitalized in a geriatric department, as a multivariable logistic regression analysis demonstrated. MDPI 2023-03-16 /pmc/articles/PMC10052656/ /pubmed/36983305 http://dx.doi.org/10.3390/jcm12062305 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Charkiewicz, Miroslaw
Wojszel, Zyta Beata
Kasiukiewicz, Agnieszka
Magnuszewski, Lukasz
Wojszel, Aleksandra
Association of Chronic Heart Failure with Frailty, Malnutrition, and Sarcopenia Parameters in Older Patients—A Cross-Sectional Study in a Geriatric Ward
title Association of Chronic Heart Failure with Frailty, Malnutrition, and Sarcopenia Parameters in Older Patients—A Cross-Sectional Study in a Geriatric Ward
title_full Association of Chronic Heart Failure with Frailty, Malnutrition, and Sarcopenia Parameters in Older Patients—A Cross-Sectional Study in a Geriatric Ward
title_fullStr Association of Chronic Heart Failure with Frailty, Malnutrition, and Sarcopenia Parameters in Older Patients—A Cross-Sectional Study in a Geriatric Ward
title_full_unstemmed Association of Chronic Heart Failure with Frailty, Malnutrition, and Sarcopenia Parameters in Older Patients—A Cross-Sectional Study in a Geriatric Ward
title_short Association of Chronic Heart Failure with Frailty, Malnutrition, and Sarcopenia Parameters in Older Patients—A Cross-Sectional Study in a Geriatric Ward
title_sort association of chronic heart failure with frailty, malnutrition, and sarcopenia parameters in older patients—a cross-sectional study in a geriatric ward
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10052656/
https://www.ncbi.nlm.nih.gov/pubmed/36983305
http://dx.doi.org/10.3390/jcm12062305
work_keys_str_mv AT charkiewiczmiroslaw associationofchronicheartfailurewithfrailtymalnutritionandsarcopeniaparametersinolderpatientsacrosssectionalstudyinageriatricward
AT wojszelzytabeata associationofchronicheartfailurewithfrailtymalnutritionandsarcopeniaparametersinolderpatientsacrosssectionalstudyinageriatricward
AT kasiukiewiczagnieszka associationofchronicheartfailurewithfrailtymalnutritionandsarcopeniaparametersinolderpatientsacrosssectionalstudyinageriatricward
AT magnuszewskilukasz associationofchronicheartfailurewithfrailtymalnutritionandsarcopeniaparametersinolderpatientsacrosssectionalstudyinageriatricward
AT wojszelaleksandra associationofchronicheartfailurewithfrailtymalnutritionandsarcopeniaparametersinolderpatientsacrosssectionalstudyinageriatricward