Frailty and Cognitive Function in Middle-Aged and Older Adults With Congenital Heart Disease.

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.

Informations de copyright

Copyright © 2024 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Funding Support and Author Disclosures This work was funded by KU Leuven–University of Leuven, Research Foundation Flanders through grants 1159522N and 12E9819N; the Swedish Heart and Lung Foundation through grant 20190525; Unidade de Investigação Cardiovascular of Faculdade de Medicina da Universidade do Porto, which supported the costs of the translations into Portuguese used in Portugal; Children’s Heart Unit Fund (CHUF); Newcastle upon Tyne through their funding of the CHUF Fontan nurse specialist; The Taiwan Cardiac Children’s Foundation; Greta and Johan Kock’s foundations; and regional research support southern healthcare region, Skane University Hospital funds. The study was partially supported by Ricerca Corrente funding from the Italian Ministry of Health to Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Donato. The authors have reported that they have no relationships relevant to the contents of this paper to disclose.