TY - JOUR
T1 - Frailty and Cognitive Function in Middle-Aged and Older Adults With Congenital Heart Disease
AU - Daelman, Bo
AU - Van Bulck, Liesbet
AU - Luyckx, Koen
AU - Kovacs, Adrienne H
AU - Van De Bruaene, Alexander
AU - Ladouceur, Magalie
AU - Yang, Hsiao-Ling
AU - Moon, Ju Ryoung
AU - Schmidt, André
AU - Lykkeberg, Birgitte
AU - Callus, Edward
AU - de Hosson, Michèle
AU - Sandberg, Camilla
AU - Johansson, Bengt
AU - Hlebowicz, Joanna
AU - Areias, Maria Emília
AU - Amedro, Pascal
AU - Coats, Louise
AU - Mandalenakis, Zacharias
AU - Kaneva, Anna
AU - Moons, Philip
AU - Goossens, Eva
AU - APPROACH-IS II consortium
N1 - Copyright © 2024 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
PY - 2024/3/26
Y1 - 2024/3/26
N2 - BACKGROUND: Life expectancy of patients with congenital heart disease (CHD) has increased rapidly, resulting in a growing and aging population. Recent studies have shown that older people with CHD have higher morbidity, health care use, and mortality. To maintain longevity and quality of life, understanding their evolving medical and psychosocial challenges is essential.OBJECTIVES: The authors describe the frailty and cognitive profile of middle-aged and older adults with CHD to identify predictor variables and to explore the relationship with hospital admissions and outpatient visits.METHODS: Using a cross-sectional, multicentric design, we included 814 patients aged ≥40 years from 11 countries. Frailty phenotype was determined using the Fried method. Cognitive function was assessed by the Montreal Cognitive Assessment.RESULTS: In this sample, 52.3% of patients were assessed as robust, 41.9% as prefrail, and 5.8% as frail; 38.8% had cognitive dysfunction. Multinomial regression showed that frailty was associated with older age, female sex, higher physiologic class, and comorbidities. Counterintuitively, patients with mild heart defects were more likely than those with complex lesions to be prefrail. Patients from middle-income countries displayed more prefrailty than those from higher-income countries. Logistic regression demonstrated that cognitive dysfunction was related to older age, comorbidities, and lower country-level income.CONCLUSIONS: Approximately one-half of included patients were (pre-)frail, and more than one-third experienced cognitive impairment. Frailty and cognitive dysfunction were identified in patients with mild CHD, indicating that these concerns extend beyond severe CHD. Assessing frailty and cognition routinely could offer valuable insights into this aging population.
AB - BACKGROUND: Life expectancy of patients with congenital heart disease (CHD) has increased rapidly, resulting in a growing and aging population. Recent studies have shown that older people with CHD have higher morbidity, health care use, and mortality. To maintain longevity and quality of life, understanding their evolving medical and psychosocial challenges is essential.OBJECTIVES: The authors describe the frailty and cognitive profile of middle-aged and older adults with CHD to identify predictor variables and to explore the relationship with hospital admissions and outpatient visits.METHODS: Using a cross-sectional, multicentric design, we included 814 patients aged ≥40 years from 11 countries. Frailty phenotype was determined using the Fried method. Cognitive function was assessed by the Montreal Cognitive Assessment.RESULTS: In this sample, 52.3% of patients were assessed as robust, 41.9% as prefrail, and 5.8% as frail; 38.8% had cognitive dysfunction. Multinomial regression showed that frailty was associated with older age, female sex, higher physiologic class, and comorbidities. Counterintuitively, patients with mild heart defects were more likely than those with complex lesions to be prefrail. Patients from middle-income countries displayed more prefrailty than those from higher-income countries. Logistic regression demonstrated that cognitive dysfunction was related to older age, comorbidities, and lower country-level income.CONCLUSIONS: Approximately one-half of included patients were (pre-)frail, and more than one-third experienced cognitive impairment. Frailty and cognitive dysfunction were identified in patients with mild CHD, indicating that these concerns extend beyond severe CHD. Assessing frailty and cognition routinely could offer valuable insights into this aging population.
KW - Aged
KW - Middle Aged
KW - Humans
KW - Female
KW - Frailty/diagnosis
KW - Frail Elderly/psychology
KW - Cross-Sectional Studies
KW - Quality of Life
KW - Cognition
KW - Cognitive Dysfunction/complications
KW - Heart Defects, Congenital/complications
KW - Geriatric Assessment/methods
KW - cognition
KW - frailty
KW - frailty phenotype
KW - aging
KW - congenital heart defects
UR - http://www.scopus.com/inward/record.url?scp=85187024075&partnerID=8YFLogxK
U2 - 10.1016/j.jacc.2024.01.021
DO - 10.1016/j.jacc.2024.01.021
M3 - Journal article
C2 - 38508848
SN - 0735-1097
VL - 83
SP - 1149
EP - 1159
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 12
ER -