Background: Current research indicates that cognitive frailty has a high prevalence among older adult patients with heart failure, but there is still a lack of longitudinal evidence on its impact on prognosis.
Objectives: This study aims to describe the prevalence of cognitive frailty and its prognostic significance.
Methods: This study was conducted from September 2023 to December 2024 at a comprehensive hospital affiliated with a university. Cognitive frailty was defined as the coexistence of physical frailty and cognitive impairment. Physical frailty was assessed using the FRAIL frailty scale, while cognitive impairment was evaluated using the Montreal Cognitive Assessment and the Clinical Dementia Rating scale. The Cox proportional hazards regression model was used to analyze the impact of cognitive frailty on all-cause mortality within one year and the combined endpoint of readmission and all-cause mortality.
Results: This study enrolled a total of 350 patients, with 334 completing one-year follow-up after discharge, resulting in a loss to follow-up rate of 4.5%. The prevalence of cognitive frailty was very common, reaching 31.7%. After adjusting for confounding factors, cognitive frailty still had a significant effect on one-year all-cause mortality (HR = 2.256; 95%CI: 1.209-4.208; P = 0.011) and combined endpoints (HR = 1.563; 95%CI: 1.158-2.111; P = 0.004).
Conclusion: The high prevalence of cognitive frailty in older adult patients with heart failure and its significant increase in the risk of adverse outcomes such as all-cause mortality and readmission after discharge should alert healthcare providers to pay more attention to cognitive frailty and provide evidence for follow-up studies.
Keywords: Cognitive frailty; Heart failure; Older adults; Prognosis.
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