Association Between Serum N-Terminal Prohormone of Brain Natriuretic Peptide (NT-proBNP) Levels and Frailty in Community-Dwelling Old-Old Older Adults - SONIC Study.

Background: Heart failure (HF) and frailty are increasing among aging populations, but because data on the association between potential cardiac overload or asymptomatic HF, measured by the serum level of N-terminal prohormone of brain natriuretic peptide (NT-proBNP), and frailty among community-dwelling old-old older adults (≥75 years) are limited, we examined this association.

Methods and results: A cross-sectional analysis was conducted using data from a longitudinal cohort study. Frailty was assessed using the Japanese version of the Cardiovascular Health Study (J-CHS) criteria. Association between log-transformed NT-proBNP levels and frailty were examined using multinomial logistic regression. The discriminative ability of NT-proBNP for frailty was assessed using receiver operating characteristic (ROC) curve analysis. A total of 588 participants (46.9% female, median age: 77 (76-86) years) were included. Log-transformed NT-proBNP was significantly associated with frailty compared to robust (OR 1.69; 95% CI 1.23-2.32; P=0.001), even after adjusting for potential confounding factors. NT-proBNP had modest discriminative ability for frailty (AUC 0.64; 95% CI 0.59-0.70; P<0.001), with an optimal cutoff of 94.5 pg/mL.

Conclusions: Elevated serum NT-proBNP levels are independently associated with frailty onset in community-dwelling old-old older adults, driven by the interaction between potential cardiac overload or asymptomatic HF and frailty. Serum NT-proBNP may be a useful tool for identifying frailty associated with cardiac overload.