Trajectory of Multidimensional Frailty Across Recurrent Heart Failure Hospitalizations ― A Single-Center…

Abstract

BACKGROUND: Heart failure (HF) is characterized by recurrent clinical deterioration, and multidimensional frailty (i.e., functional status, nutritional status, sarcopenia-related phenotypes, and cognitive impairment) is a key determinant of prognosis. We explored longitudinal changes in these multidimensional domains across recurrent hospitalizations for HF. METHODS AND RESULTS: This single-center retrospective cohort study analyzed 337 patients initially hospitalized for HF between 2016 and 2024 who subsequently experienced ≥1 rehospitalization (total 780 admissions). Longitudinal changes across repeated hospitalizations were evaluated using age- and sex-adjusted linear mixed-effects models. The median age was 83 years, and 47.2% were women. Across repeated hospitalizations, frailty and functional status worsened (Clinical Frailty Scale, β=0.40, P<0.001; Barthel Index, β=-4.21, P<0.001; Short Physical Performance Battery score, β=-0.56, P=0.043). Gait speed also declined, although this trend did not reach statistical significance (β=-0.03, P=0.089). Nutritional status deteriorated (Controlling Nutritional Status score, β=0.56, P<0.001; Geriatric Nutritional Risk Index, β=-2.37, P<0.001). Sarcopenia-related indices deteriorated (appendicular skeletal muscle index, β=-2.79, P=0.006; grip strength, β=-4.64%, P<0.001). Cognitive function assessed by the Mini-Mental State Examination showed no significant longitudinal change (β=0.11, P=0.501). CONCLUSIONS: Many domains of frailty deteriorated across recurrent hospitalizations for HF, suggesting cumulative frailty progression.

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BibTeX

@article{ozaki2026trajectory,
  title = {{Trajectory of Multidimensional Frailty Across Recurrent Heart Failure Hospitalizations ― A Single-Center Longitudinal Cohort Study ―}},
  author = {Yuta Ozaki and Yusuke Uemura and Shigefumi Honda and Toru Kondo and Shingo Kazama and Kenji Takemoto and Masato Watarai and Toyoaki Murohara},
  journal = {Circulation Journal},
  year = {2026},
  month = oct,
  doi = {10.1253/circj.cj-26-0186},
  url = {https://www.jstage.jst.go.jp/article/circj/90/11/90_CJ-26-0186/_article},
  note = {CC BY-NC-ND},
}

RIS

TY  - JOUR
TI  - Trajectory of Multidimensional Frailty Across Recurrent Heart Failure Hospitalizations ― A Single-Center Longitudinal Cohort Study ―
AU  - Yuta Ozaki
AU  - Yusuke Uemura
AU  - Shigefumi Honda
AU  - Toru Kondo
AU  - Shingo Kazama
AU  - Kenji Takemoto
AU  - Masato Watarai
AU  - Toyoaki Murohara
PY  - 2026
DA  - 2026/10/23
JO  - Circulation Journal
DO  - 10.1253/circj.cj-26-0186
UR  - https://www.jstage.jst.go.jp/article/circj/90/11/90_CJ-26-0186/_article
AB  - BACKGROUND: Heart failure (HF) is characterized by recurrent clinical deterioration, and multidimensional frailty (i.e., functional status, nutritional status, sarcopenia-related phenotypes, and cognitive impairment) is a key determinant of prognosis. We explored longitudinal changes in these multidimensional domains across recurrent hospitalizations for HF. METHODS AND RESULTS: This single-center retrospective cohort study analyzed 337 patients initially hospitalized for HF between 2016 and 2024 who subsequently experienced ≥1 rehospitalization (total 780 admissions). Longitudinal changes across repeated hospitalizations were evaluated using age- and sex-adjusted linear mixed-effects models. The median age was 83 years, and 47.2% were women. Across repeated hospitalizations, frailty and functional status worsened (Clinical Frailty Scale, β=0.40, P<0.001; Barthel Index, β=-4.21, P<0.001; Short Physical Performance Battery score, β=-0.56, P=0.043). Gait speed also declined, although this trend did not reach statistical significance (β=-0.03, P=0.089). Nutritional status deteriorated (Controlling Nutritional Status score, β=0.56, P<0.001; Geriatric Nutritional Risk Index, β=-2.37, P<0.001). Sarcopenia-related indices deteriorated (appendicular skeletal muscle index, β=-2.79, P=0.006; grip strength, β=-4.64%, P<0.001). Cognitive function assessed by the Mini-Mental State Examination showed no significant longitudinal change (β=0.11, P=0.501). CONCLUSIONS: Many domains of frailty deteriorated across recurrent hospitalizations for HF, suggesting cumulative frailty progression.
SN  - 1347-4820
SN  - 1346-9843
ER  -

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