Frailty and Cognitive Function in Middle-Aged and Older Adults With Congenital Heart Disease
(2024) In Journal of the American College of Cardiology 83(12). p.1149-1159- Abstract
- 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... (More)
- 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. © 2024 American College of Cardiology Foundation (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/d5882585-1c0f-40ed-9274-74030e602779
- author
- Daelman, B. ; Hlebowicz, J. LU and Goossens, Eva
- author collaboration
- organization
- publishing date
- 2024
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- aging, cognition, congenital heart defects, frailty, frailty phenotype, adult, aged, Article, body mass, Charlson Comorbidity Index, cognitive defect, comorbidity, congenital heart disease, cross-sectional study, demographics, female, high income country, hospital admission, human, logistic regression analysis, major clinical study, male, maximum likelihood method, medical record, middle aged, middle income country, Mini Mental State Examination, Montreal cognitive assessment, multicenter study, multinomial logistic regression, New York Heart Association class, outpatient, phenotype, physical activity, physiologic monitoring, predictor variable, questionnaire, six minute walk test
- in
- Journal of the American College of Cardiology
- volume
- 83
- issue
- 12
- pages
- 11 pages
- publisher
- Elsevier
- external identifiers
-
- scopus:85187024075
- pmid:38508848
- ISSN
- 0735-1097
- DOI
- 10.1016/j.jacc.2024.01.021
- language
- English
- LU publication?
- yes
- additional info
- Number of authors = 153 EID = 85187024075 Start page = 1149 End page = 1159 Affiliation = Daelman B., KU Leuven Department of Public Health and Primary Care, KU Leuven–University of Leuven, Leuven, Belgium Affiliation = Menahem S., Melbourne Children's Cardiology/Adult Congenital Heart, Monash University Affiliation = Wijayarathne P.M., Melbourne Children's Cardiology/Adult Congenital Heart, Monash University
- id
- d5882585-1c0f-40ed-9274-74030e602779
- date added to LUP
- 2024-04-03 16:05:49
- date last changed
- 2024-04-04 03:00:09
@article{d5882585-1c0f-40ed-9274-74030e602779,
abstract = {{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. © 2024 American College of Cardiology Foundation}},
author = {{Daelman, B. and Hlebowicz, J. and Goossens, Eva}},
issn = {{0735-1097}},
keywords = {{aging; cognition; congenital heart defects; frailty; frailty phenotype; adult; aged; Article; body mass; Charlson Comorbidity Index; cognitive defect; comorbidity; congenital heart disease; cross-sectional study; demographics; female; high income country; hospital admission; human; logistic regression analysis; major clinical study; male; maximum likelihood method; medical record; middle aged; middle income country; Mini Mental State Examination; Montreal cognitive assessment; multicenter study; multinomial logistic regression; New York Heart Association class; outpatient; phenotype; physical activity; physiologic monitoring; predictor variable; questionnaire; six minute walk test}},
language = {{eng}},
number = {{12}},
pages = {{1149--1159}},
publisher = {{Elsevier}},
series = {{Journal of the American College of Cardiology}},
title = {{Frailty and Cognitive Function in Middle-Aged and Older Adults With Congenital Heart Disease}},
url = {{http://dx.doi.org/10.1016/j.jacc.2024.01.021}},
doi = {{10.1016/j.jacc.2024.01.021}},
volume = {{83}},
year = {{2024}},
}