Targeted Geriatric Assessment to Predict Outcomes in Older Adults With Heart Failure

Health care for older adults with heart failure (HF) has primarily focused on cardiovascular assessment, with limited attention to geriatric conditions that might affect meaningful clinical outcomes.

The purpose of this study was to evaluate whether the 10-minute Targeted Geriatric Assessment (10-TaGA) enhances the prediction of clinical outcomes in older adults with HF.

Prospective cohort study of HF patients consecutively admitted to a geriatric day hospital in Brazil. Cox proportional hazard models assessed 1-year all-cause mortality, hospitalization, HF hospitalization, and days of health lost among 10-TaGA score tertiles (low-, intermediate-, and high-risk groups), adjusted for clinical variables and the Cardiac and Comorbid Conditions Heart Failure risk score.

Among the 326 patients included (mean age 80.9 ± 7.7 years; 37.7% female; 59.8% identified as White), 76 died within 1 year. We observed a graded association between 10-TaGA risk categories and the primary outcome of all-cause mortality or hospitalization (low-risk, reference; intermediate-risk, adjusted HR: 1.41 [95% CI: 0.96-2.05]; high-risk, adjusted HR: 1.97 [95% CI: 1.30-2.99]). Similar trend was found for days of health lost (mean difference of +22 days [95% CI: -2 to +45] and +49 days [95% CI: +9 to +88] for the intermediate- and high-risk groups). Adding the 10-TaGA to clinical variables and the Cardiac and Comorbid Conditions Heart Failure improved discrimination for all-cause mortality/hospitalization (time-specific difference in area under the curve at 1 year: 0.04 [95% CI: 0.01-0.08]; P = 0.025).

In older adults with HF referred to the geriatric day hospital, the 10-TaGA provided clinically relevant information beyond standard cardiac assessments and may support effective patient-centered care.