Heart Failure Clinical Trial
Official title:
Frailty in Community Dwelling Older Adults With Heart Failure
A prospective longitudinal cohort study aimed at measuring frailty and its associated risk
factors community dwelling older adults aged 65 years or older.
The geriatric domains evaluated will include: frailty status, hearing impairment, visual
impairment, polypharmacy, sarcopenia, malnutrition, cognitive impairment, depression,
fatigue, sleep difficulties, and disabilities.
The primary outcome is all-cause mortality at 1-year post enrollment.
The overarching research question is as follows: Is frailty predictive of patient-centered
outcomes in older adults with heart failure (HF)? Hypotheses regarding this research question
are: 1) Frailty is associated with increased 12-month mortality, 2) Frailty is associated
with increased 3-month mortality or unplanned hospitalization, 3) Frailty is associated with
lower baseline health-related quality of life (HrQOL), and 4) Frailty is associated with
worsening HrQOL at 3 months.
There are three specific study objectives. 1) To compare the ability of various frailty
measures to predict all-cause mortality, hospitalizations, and HrQOL in patients attending an
outpatient HF clinic. 2) To examine the determinants of longitudinal changes in frailty
measures over time. Lastly, 3) To examine the clinical and frailty related determinants of
fatigue in older adults
A prospective longitudinal cohort study will be conducted at a specialized heart failure (HF)
clinic at the Jewish General Hospital (JGH) and Royal Victoria Hospital (RVH). The study aims
to measure frailty and its associated risk factors in community dwelling individuals, aged 65
years or older and who have been diagnosed with HF (preserved or reduced ejection fraction)
for at least 3 months. The multi-domain geriatric assessment will include questionnaires
administered by interview, physical performance tests, body composition analysis using a
bioimpedance machine, review of clinically acquired biochemical and imaging tests, and chart
review. The geriatric domains evaluated will include: frailty status, hearing impairment,
visual impairment, polypharmacy, sarcopenia, malnutrition, cognitive impairment, depression,
fatigue, sleep difficulties, and disabilities. Baseline assessment will approximate to 40
minutes of patient contact time while follow up phone interviews at 3 and 12 months will
approximate to 20 minutes. Outcome measures such as all-cause mortality, HrQOL, unplanned
hospitalization will be assessed at 3 months and 1-year post enrollment.
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