Identifying a Relationship Between Physical Frailty and Heart Failure Symptoms.
Quin E Denfeld, Kerri Winters-Stone, James O Mudd and 2 others
PMID 28353543WHAT IT FOUND
Half of 49 adults with heart failure were physically frail.
After accounting for projected one-year survival, frailty was associated with more than two times as much breathlessness, 75% worse wake disturbance, and 76% more depression. Pain and anxiety did not differ.
Key findings
01After accounting for projected one-year survival, physically frail adults with heart failure were more than two times as breathless and had 75% worse wake disturbance symptoms than those not physically frail.
02Physically frail adults with heart failure had significantly higher rates of moderate or greater depression; after accounting for projected one-year survival they had 76% more depressive symptoms than those not physically frail.
03There was no significant difference in reported pain severity or interference, and no significant difference in reported anxiety.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for RNs
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What it does not show
This was a cross-sectional study, so it shows association between physical frailty and heart failure symptoms, not cause. The sample was small (49 adults), and the authors said it may have been underpowered to detect small effect sizes. Only one participant was non-frail, so non-frail and pre-frail were combined as not physically frail, and the full frailty spectrum was not captured. Participants were from one academic advanced heart failure clinic, were mostly younger, racially homogeneous, and mostly non-ischemic, so results may not generalise to all adults with heart failure.
Declared interests
The authors declare no conflict of interest. The study was funded by the U.S. National Institutes of Health.
The easy way to misread this
Do not conclude that reducing physical frailty will improve heart failure symptoms. This was a cross-sectional association in 49 adults, with only one non-frail participant, so it cannot show cause or treatment effect.