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

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

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)208-213
Number of pages6
JournalCongestive heart failure (Greenwich, Conn.)
Volume16
Issue number5
DOIs
StatePublished - Sep 2010
Externally publishedYes

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Heart Failure
Mortality
Interleukin-6
Confidence Intervals
Dilatation and Curettage
Survival Rate
Biomarkers
Survival
Proteins

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Emergency Medicine
  • Emergency

Cite this

The 6-minute walk is associated with frailty and predicts mortality in older adults with heart failure. / Boxer, Rebecca; Kleppinger, Alison; Ahmad, Amir; Annis, Kristin; Hager, David Northrop; Kenny, Anne.

In: Congestive heart failure (Greenwich, Conn.), Vol. 16, No. 5, 09.2010, p. 208-213.

Research output: Contribution to journalArticle

Boxer, Rebecca ; Kleppinger, Alison ; Ahmad, Amir ; Annis, Kristin ; Hager, David Northrop ; Kenny, Anne. / The 6-minute walk is associated with frailty and predicts mortality in older adults with heart failure. In: Congestive heart failure (Greenwich, Conn.). 2010 ; Vol. 16, No. 5. pp. 208-213.
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