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Frailty and cognitive function in middle-aged and older adults with congenital heart disease
KU Leuven Department of Public Health and Primary Care, KU Leuven–University of Leuven, Leuven, Belgium.
KU Leuven Department of Public Health and Primary Care, KU Leuven–University of Leuven, Leuven, Belgium; Research Foundation Flanders, Brussels, Belgium; University Hospitals Leuven, Leuven, Belgium.
School Psychology and Development in Context, KU Leuven–University of Leuven, Leuven, Belgium; Unit for Professional Training and Service in the Behavioural Sciences, University of the Free State, Bloemfontein, South Africa; University Hospitals Leuven, Leuven, Belgium.
Equilibria Psychological Health, ON, Toronto, Canada.
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2024 (English)In: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 83, no 12, p. 1149-1159Article in journal (Refereed) Published
Abstract [en]

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.
Place, publisher, year, edition, pages
Elsevier, 2024. Vol. 83, no 12, p. 1149-1159
Keywords [en]
aging, cognition, congenital heart defects, frailty, frailty phenotype
National Category
Cardiology and Cardiovascular Disease
Identifiers
URN: urn:nbn:se:umu:diva-222575DOI: 10.1016/j.jacc.2024.01.021ISI: 001228252000001PubMedID: 38508848Scopus ID: 2-s2.0-85187024075OAI: oai:DiVA.org:umu-222575DiVA, id: diva2:1849538
Funder
Swedish Heart Lung Foundation, 20190525Available from: 2024-04-08 Created: 2024-04-08 Last updated: 2025-04-24Bibliographically approved

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Sandberg, CamillaJohansson, Bengt

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Sandberg, CamillaJohansson, Bengt
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Department of Surgical and Perioperative SciencesDepartment of Community Medicine and RehabilitationDepartment of Public Health and Clinical Medicine
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Journal of the American College of Cardiology
Cardiology and Cardiovascular Disease

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