Nutritional risk, frailty and functional status in elderly heart failure patients

Aims

Heart failure (HF) in elderly patients is frequently associated with frailty, malnutrition and reduced functional status. This study assessed the associations between nutritional risk, functional capacity, frailty and length of hospital stay (LOHS) in elderly patients hospitalized with HF.

Methods and results

A cross-sectional study of 200 patients aged 60–91 years (mean age 72.3 ± 6.6; 70.5% male) hospitalized for HF. Nutritional status was assessed using the Mini Nutritional Assessment (MNA), functional capacity with Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) scales, and frailty using Fried's criteria. BMI, central obesity, comorbidities and LOHS were also recorded. Frailty was present in 65% of participants; 36.5% were malnourished or at nutritional risk. Well-nourished patients had significantly higher IADL scores (P = 0.002). Mean LOHS was longer in frail compared with pre-frail patients (6.18 ± 2.37 vs. 5.41 ± 1.60 days; P = 0.016). In multivariable logistic regression, frailty independently predicted increased LOHS (OR = 4.063, 95% CI: 1.36–12.1; P = 0.012). BMI, central obesity and comorbidity burden were not associated with functional status or LOHS.

Conclusions

Frailty was independently associated with increased LOHS in elderly HF patients. Poor nutritional status was significantly linked to reduced instrumental functional capacity. Routine frailty and nutritional screening may help identify patients who could benefit from early interventions aimed at improving functional outcomes and reducing hospitalization time.