Frailty Is Intertwined With Heart Failure: Mechanisms, Prevalence, Prognosis, Assessment, and Management

Ambarish Pandey, Dalane Kitzman, Gordon Reeves

Research output: Contribution to journalReview articlepeer-review

155 Scopus citations


Frailty, a syndrome characterized by an exaggerated decline in function and reserve of multiple physiological systems, is common in older patients with heart failure (HF) and is associated with worse clinical and patient-reported outcomes. Although several detailed assessment tools have been developed and validated in the geriatric population, they are cumbersome, not validated in patients with HF, and not commonly used in routine management of patients with HF. More recently, there has been an increasing interest in developing simple frailty screening tools that could efficiently and quickly identify frail patients with HF in routine clinical settings. As the burden and recognition of frailty in older patients with HF increase, a more comprehensive approach to management is needed that targets deficits across multiple domains, including physical function and medical, cognitive, and social domains. Such a multidomain approach is critical to address the unique, multidimensional challenges to the care of these high-risk patients and to improve their functional status, quality of life, and long-term clinical outcomes. This review discusses the burden of frailty, the conceptual underpinnings of frailty in older patients with HF, and potential strategies for the assessment, screening, and management of frailty in this vulnerable patient population.

Original languageEnglish (US)
Pages (from-to)1001-1011
Number of pages11
JournalJACC: Heart Failure
Issue number12
StatePublished - Dec 2019


  • Fried phenotype
  • aging
  • frailty
  • heart failure
  • physical function
  • quality of life

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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