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. 2010 Sep-Oct;16(5):208-13.
doi: 10.1111/j.1751-7133.2010.00151.x.

The 6-minute walk is associated with frailty and predicts mortality in older adults with heart failure

Rebecca Boxer  1 , Alison Kleppinger, Amir Ahmad, Kristin Annis, David Hager, Anne Kenny
Affiliations

The 6-minute walk is associated with frailty and predicts mortality in older adults with heart failure

Rebecca Boxer et al. Congest Heart Fail. 2010 Sep-Oct.

Abstract

Heart failure (HF) may contribute to the development of functional decline and frailty in older adults. Sixty HF patients with an ejection fraction ≤ 40% evaluated in 2004 and 2005 were reevaluated in 2008. Six-minute walk distance (6MW), frailty score, and biomarkers (25-hydroxyvitamin D, C-reactive protein, and interleukin-6 [IL-6]) were measured. Participants were categorized at baseline and follow-up into 3 groups: nonfrail/normal endurance (NF/NE), nonfrail/low endurance (NF/LE) and frail/low endurance (F/LE). Survival time was assessed according to frailty/endurance status and associated predictors of mortality. Forty-three men, 17 women (mean age, 78 ± 12 years) were contacted. At follow-up, 20 had died, 20 participated, and 20 did not participate. There were no changes in frailty/endurance status over time (McNemar;P=.19). Deaths occurred in 18% of NF/NE, 45% of NF/LE, and 60% of F/LE persons. The NF/NE group had greater survival rates than the NF/LE ( P=.032) and F/LE ( P=.014) groups. The 6MW and frailty score were independently predictive of mortality, with hazard ratios of 0.82 (95% confidence interval, 0.72-0.94) and 1.64 (95% confidence interval, 1.19-2.26), respectively, as was New York Heart Association class and IL-6. Backward stepwise Cox regression revealed that 6MW and frailty each were associated with mortality (P=.005) and highly correlated. Physical function is an important predictor of mortality in older adults with HF. The 6MW may be useful as a measure of frailty.

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Figures

Figure 1
Figure 1
Functional Group from Baseline to 4 Years NF/NE = non-frail/normal endurance, NF/LE = non-frail/low endurance, F/LE = frail/low endurance
Figure 2
Figure 2
Kaplan-Meier Survival Curve for 59 Heart Failure Subjects categorized by endurance and frailty followed for 4 years
See this image and copyright information in PMC

References

    1. Lloyd-Jones D, Adams R, Carnethon M, De Simone G, Ferguson TB, Flegal K, et al. Heart disease and stroke statistics--2009 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2009;119(3):480–6. - PubMed
    1. Jencks SF, Williams MV, Coleman EA. Rehospitalizations among patients in the Medicare fee-for-service program. N Engl J Med. 2009;360(14):1418–28. - PubMed
    1. Fang J, Mensah GA, Croft JB, Keenan NL. Heart failure-related hospitalization in the U.S., 1979 to 2004. J Am Coll Cardiol. 2008;52(6):428–34. - PubMed
    1. Boyd CM, Xue QL, Guralnik JM, Fried LP. Hospitalization and development of dependence in activities of daily living in a cohort of disabled older women: the Women's Health and Aging Study I. J Gerontol A Biol Sci Med Sci. 2005;60(7):888–93. - PubMed
    1. Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146–56. - PubMed

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