학술논문
Frailty and cognitive function in middle-aged and older adults with congenital heart disease
Document Type
Author
Daelman, Bo; Van Bulck, Liesbet; Luyckx, Koen; Kovacs, Adrienne H.; Van De Bruaene, Alexander; Ladouceur, Magalie; Yang, Hsiao-Ling; Moon, Ju Ryoung; Schmidt, André; Lykkeberg, Birgitte; Callus, Edward; de Hosson, Michèle; Sandberg, Camilla; Johansson, Bengt; Hlebowicz, Joanna; Areias, Maria Emília; Amedro, Pascal; Coats, Louise; Mandalenakis, Zacharias; Kaneva, Anna; Moons, Philip; Goossens, Eva; Sasikumar, Navaneetha; Enomoto, Junko; Mizuno, Yoshiko; Leong, Ming Chern; Binto Sabran, Izzatun Nafsi; Ladak, Laila Akbar; Hasan, Babar; Siddiqui, Ayat; Huh, June; Wang, Jou-Kou; Lu, Chun-Wei; Demir, Fatma; Öden, Tuğba; Tefera, Endale; Mwita, Julius; Ambassa, Jean-Claude; Mvondo, Charles; Fanka, Marcel; Yadeta, Dejuma; Alemayehu, Mulualem; Leye, Mohamed; Gueye, Khadija; Gabriel, Harald; Svhneider, Matthias; Seeliger, Selina; Budts, Werner; Rassart, Jessica; De Backer, Julie; Markova, Mila; Biyai, Miriam; Boubrit, Anissa; Thambo, Jean-Benoît; Ruissel, Amandine; Jore, Cecile; Abassi, Hamouda; Soltani, Sonia; Bredy, Charlene; Giannakoulas, George; Kosmidis, Diamantis; Ntiloudi, Despina; Pagliuca, Silvana; Bertoldo, Enrico Giuseppe; Fiolo, Valentina; Caruana, Maryanne; Swain, Justine; Grech, Neil; Xuereb, Rachel; Craus, Sarah; Bonello, Maria; Borg, Darren; Farrugia, Paul; Cardona, Joanne; Estensen, Mette-Elise; Andresen, Brith; Eriksen, Katrine; Miranda, Joana; Areias, José Carlos; Cruz, Cristina; Macedo, Filipe; Ribeiro Nunes, Filipa Manuela; Barbosa de Bessa, Ana Maria; Espírito Santo, Sara Mafalda; Brito, Paula; Pereira, Marisa; Teixeira, Sofia; Marques, Brenda; Marques, Ana Raquel; Cronesten, Helena; Dellborg, Mikael; Mattson, Eva; Christersson, Christina; Robertsson, Louise; Ternrud, Linda; Thomet, Corina; Ruperti, Javier; Bouchardy, Judith; Brand, Fanny; Rutz, Tobias; Blanche, Coralie; van Melle, Joost P.; Boer, Anna; Constantine, Andrew; Gatzoulis, Michael A.; Dimopoulos, Konstantinos; McParlin, Debbie; Khairy, Paul; Proietti, Anna; Roy, Veronique; Windram, Jonathan; Jandura, Deborah; Jameson, Susan; Major, Melissa; Mahadevan, Vaikom Subremanian; Nguyen, Thomas; Sarwary, Shabir; Saidi, Arwa; Breault, Leah; Colon, Dalia Lopez; Cedars, Ari; Kutty, Shelby; Ko, Jong; Valente, Anne Marie; Brainard, Sarah; Reichman, Jeffrey; Zaidi, Ali; Amlani, Amrin; Jackson, Jamie; Swenski, Taylor; Neville, Steven; Kovacs, Adrienne; McGrath, Lidija; Taunton, Marshall; Kim, Yuli; Carducci, Jessica; Bashey, Saffy; Alday, Luis; Lousararian, Marina; Maisuls, Héctor; Quinteros, Marisa; Lucero, Mónica; Ortiz, Lucia; Amaral, Fernando; Schmidt, Andre; Manso, Paulo Henrique; Pavão, Rafael Brolio; Reyes, Fernando Baraona; Arancibia, M. Francisca; Araujo, John Jairo; Súarez, Alberto Hernadez; Menahem, Samuel; Wijayarathne, Pasangi Madhuka
Source
Journal of the American College of Cardiology. 83(12):1149-1159
Subject
Language
English
ISSN
0735-1097
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.