Relationship Between Comprehensive Geriatric Assessment and Heart Failure with Preserved Ejection Fraction in Elderly...

To explore the association between comprehensive geriatric assessment (CGA)-related projects and indicators of heart failure with preserved ejection fraction (HFpEF) in hospitalised older adults, and to evaluate their predictive value for HFpEF risk.

An observational study. Place and Duration of the Study: Department of Geriatrics, Mindong Hospital Affiliated to Fujian Medical University, Mindong, China, from July to December 2024.

A total of 134 patients aged ≥60 years who received standard CGA were included in the single-centre cross-sectional analysis. The CGA protocol was used to evaluate frailty using the FRAIL scale, sarcopenia risk using the SARC-CalF score, nutritional status, cognitive function, basic activities of daily living, and fall risk. Patients were divided into the HFpEF group (n = 50) and the heart failure without preserved ejection fraction (non-HFpEF) group (n = 84) according to clinical diagnosis. Statistical methods included initial univariate screening, variable selection using Least Absolute Shrinkage and Selection Operator (LASSO) regression, followed by multivariable logistic regression, and receiver operating characteristic (ROC) curve analysis to evaluate diagnostic performance.

Patients with HFpEF were older, had a higher burden of polypharmacy, and had higher FRAIL scores than those in the non-HFpEF group (all p <0.05). In the adjusted multivariate analysis, both FRAIL and SARC-CalF scores were independently associated with HFpEF. The odds ratio for the FRAIL score was 3.68 (95% CI, 1.83-8.39), while the odds ratio for the SARC-CalF score was 1.47 (95% CI, 1.21-1.86). ROC analysis shows that the prediction utility of the two tools is relatively strong. The AUC for the FRAIL scale is 0.88, whereas the AUC for the SARC-CalF scale is 0.89. The optimal diagnostic thresholds are 1.5 points (indicating pre-frailty) and 11 points.

The SARC-CalF and FRAIL scales are sensitive for identifying high-risk older adults with HFpEF. Their combined use improves predictive specificity and accuracy compared with either scale alone. This dual-scale approach may provide a practical and efficient preliminary screening tool for HFpEF in geriatric care.

HFpEF, Comprehensive geriatric assessment, Aged, Frailty, Pre-frailty, Sarcopenia.