Frailty phenotype and associated nutritional factors in a sample of Portuguese heart failure outpatients

Abstract Background and aim Frailty Phenotype (FP) is very common in Heart Failure (HF) and both syndromes worsen one another. The aim of this study is to first describe FP in a sample of Portuguese HF patients, and to analyse its association with nutritional and clinical statuses, namely muscle mass, obesity and functional class. Methods and results In this cross-sectional study, a sample of 136 heart failure outpatients (24-81 years, 33.8% women) was randomly selected from the appointments’ listings of a HF and Transplant clinic in a Portuguese University Hospital. FP was assessed according to Fried et al.; muscle mass was estimated from mid-upper arm muscle circumference; weight status was assessed using body mass index; HF functional classes were registered. The association between participants’ characteristics and FP categories was analysed using logistic ordinal regression. The frequency of pre-frailty and frailty is 57.4% and 15.4%, respectively. Within frail individuals, 52.4% were under the age of 65. In multivariable analysis, frailty was positively associated with being 70 or older (OR = 3.44) and obese (OR = 2.66), and negatively associated with muscle mass (OR = 0.77) and with being at class I (OR = 0.14) or class II (OR = 0.29) of HF functional classes. Conclusion Muscle mass seems to be an important predictor of frailty in HF patients and should be taken into account when designing intervention plans that allow for reverting or modifying frailty and pre-frailty. Younger patients should be monitored for the presence and evolution of FP.