Translation of the Frailty Paradigm from Older Adults to Children with Cardiac Disease

AbstractChildren and adolescents with cardiac disease (CCD) have significant morbidity and lower quality of life. However, there are no broadly applicable tools similar to the frailty score as described in the elderly, to define functional phenotype in terms of physical capability and psychosocial wellbeing in CCD. The purpose of this study is to investigate the domains of the frailty in CCD. We prospectively recruited CCD (8 –17.5 years old, 70% single ventricle, 27% heart failure, 12% pulmonary hypertension; NYHA classes I, II and III) and age and gender matched healthy controls (totaln = 56; CCDn = 34, controlsn = 22; age 12.6 ± 2.6 years; 39.3% female). We measured the five domains of frailty: slowness, weakness, exhaustion, body composition and physical activity using developmentally appropriate methods. Age and gender-based population norms were used to obtainZ scores and percentiles for each measurement. Two-tailedt-tests were used to compare the two groups. The CCD group performed significantly worse in all five domains of frailty compared to healthy controls. Slowness: 6-min walk test withZ score −3.9 ± 1.3 vs −1.4 ± 1.3,p <  0.001; weakness: handgrip strength percentile 18.9 ± 20.9 vs 57.9 ± 26.0,p <  0.001; exhaustion: multidimensional fatigue scale percentile 63.7 ± 13.5 vs 83.3 ± 14.4,p <  0.001; body composition: height percentile 43.4 ± 29.5 vs 71.4 ± 25.2,p <  0.001, weight pe...
Source: Pediatric Cardiology - Category: Cardiology Source Type: research