Current findings and challenges on frailty, sarcopenia, and cachexia in older patients with heart failure: insights from the FRAGILE-HF study.

Frailty has increasingly been recognized as an important factor influencing the prognosis of older patients with heart failure (HF). While previous studies have primarily focused on physical frailty, the need for comprehensive frailty assessments, including assessments of cognitive and social aspects, has been emphasized for effective HF management. Although the importance of multidimensional frailty assessment has been highlighted in the past, specific indicators for defining multidimensional frailty and its relationship with prognosis have not been clearly established to date. The FRAGILE-HF cohort study is a multicenter prospective cohort study that investigates the prevalence, overlap, and prognostic impact of multidimensional frailty in older patients with HF. The primary objective of this project was to address issues related to multidimensional frailty in older patients with HF. Additionally, this study provides extensive foundational data not only on frailty but also on sarcopenia and cachexia, which are commonly observed in older patients with HF. This review summarizes the current understanding of physical and non-physical frailty, sarcopenia, and cachexia in patients with HF, with a focus on insights from the FRAGILE-HF registry.