Frailty assessment instruments in heart failure: A systematic review

Frailty is an independent predictor of mortality across many conditions. Reported rates of frailty in heart failure range from 15% to 74%. There are several instruments available to assess frailty; however, to date there has been no consensus on the most appropriate instrument for use in individuals with heart failure.

To identify how frailty is assessed in individuals with heart failure and to elucidate which domains of frailty are most frequently assessed.

Key electronic databases were searched (MEDLINE, COCHRANE Central and CINAHL) to identify studies that assessed frailty in individuals with heart failure using a formal frailty instrument.

Twenty studies published in 24 articles were included, for which a total of seven unique frailty instruments were identified. The most commonly used instrument was the Frailty Phenotype (n= 11), with the majority of studies using a modified version of the Frailty Phenotype (n= 8). The second most commonly used instrument identified was the Comprehensive Geriatric Assessment (n= 4).

There is an increasing interest in the assessment of frailty, but, to date, there is no frailty instrument validated specifically in the heart failure population.