Utility of the FRAIL Questionnaire in Detecting Heart Failure with Preserved Ejection Fraction

Area of Science:

• Gerontology
• Cardiology
• Primary Care

Background:

• Heart failure with preserved ejection fraction (HFpEF) is increasingly recognized, particularly in older populations.
• Frailty is a common condition in older adults and is associated with adverse health outcomes.
• The utility of frailty screening tools for detecting specific conditions like HFpEF requires further investigation.

Purpose of the Study:

• To evaluate the effectiveness of the FRAIL questionnaire as a screening tool for identifying heart failure in older Chinese adults.
• To explore the association between frailty status and indicators of cardiac dysfunction, including diastolic dysfunction and N-terminal prohormone of B-type natriuretic peptide (NT-proBNP) levels.

Main Methods:

• A cross-sectional study involving Chinese older adults (aged 60+) in Hong Kong.
• Participants completed the five-item FRAIL questionnaire and underwent assessments including handgrip strength, walking speed, and cardiac evaluations (ECG, echocardiography, NT-proBNP).
• Data on sociodemographics, lifestyle, and medical history were collected.

Main Results:

• Prevalence of diastolic dysfunction increased with frailty status (52% robust, 65% pre-frail, 85% frail).
• NT-proBNP levels were significantly higher in pre-frail and frail individuals compared to the robust group.
• Specific FRAIL components (fatigue, resistance, ambulation) were associated with diastolic dysfunction in older subgroups.

Conclusions:

• Frailty is significantly associated with heart failure with preserved ejection fraction (HFpEF).
• The FRAIL questionnaire shows potential as a screening tool for detecting undiagnosed HFpEF in older adults.
• These findings support considering HFpEF as a geriatric syndrome, emphasizing the role of frailty in its presentation.