title: The prevalence of frailty in heart failure: A systematic review and meta-analysis.
abstract: BACKGROUND
  There is a growing interest in the intersection of heart failure (HF) and frailty; however, estimates of the prevalence of frailty in HF vary widely. The purpose of this paper was to quantitatively synthesize published literature on the prevalence of frailty in HF and to examine the relationship between study characteristics (i.e. age and functional class) and the prevalence of frailty in HF.
  
  
  METHODS
  The prevalence of frailty in HF, divided into Physical Frailty and Multidimensional Frailty measures, was synthesized across published studies using a random-effects meta-analysis of proportions approach. Meta-regression was performed to examine the influence of age and functional class (at the level of the study) on the prevalence of frailty.
  
  
  RESULTS
  A total of 26 studies involving 6896 patients with HF were included in this meta-analysis. Despite considerable differences across studies, the overall estimated prevalence of frailty in HF was 44.5% (95% confidence interval, 36.2%-52.8%; z=10.54; p<0.001). The prevalence was slightly lower among studies using Physical Frailty measures (42.9%, z=9.05; p<0.001) and slightly higher among studies using Multidimensional Frailty measures (47.4%, z=5.66; p<0.001). There were no significant relationships between study age or functional class and prevalence of frailty.
  
  
  CONCLUSIONS
  Frailty affects almost half of patients with HF and is not necessarily a function of age or functional classification. Future work should focus on standardizing the measurement of frailty and on broadening the view of frailty beyond a strictly geriatric syndrome in HF.
authors.affiliation: Oregon Health & Science University Knight Cardiovascular Institute, Portland, OR, USA; Oregon Health & Science University School of Nursing, Portland, OR, USA. Electronic address: denfeldq@ohsu.edu.
authors.forename: Quin E
authors.initials: QE
authors.lastname: Denfeld
authors.affiliation: Oregon Health & Science University School of Nursing, Portland, OR, USA; Oregon Health & Science University Knight Cancer Institute, Portland, OR, USA.
authors.forename: Kerri
authors.initials: K
authors.lastname: Winters-Stone
authors.affiliation: Oregon Health & Science University Knight Cardiovascular Institute, Portland, OR, USA.
authors.forename: James O
authors.initials: JO
authors.lastname: Mudd
authors.affiliation: Oregon Health & Science University Knight Cardiovascular Institute, Portland, OR, USA.
authors.forename: Jill M
authors.initials: JM
authors.lastname: Gelow
authors.affiliation: The University of Arizona College of Pharmacy, Tucson, AZ, USA.
authors.forename: Sawsan
authors.initials: S
authors.lastname: Kurdi
authors.affiliation: Oregon Health & Science University Knight Cardiovascular Institute, Portland, OR, USA; Oregon Health & Science University School of Nursing, Portland, OR, USA.
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Lee
mesh_terms: D002986:Clinical Trials as Topic / Q000379:methods; D000073496:Frailty / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D006333:Heart Failure / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D015995:Prevalence
keywords: Aging; Frailty; Heart failure; Meta-analysis