Purpose Of Review: Frailty is highly prevalent in the dialysis population and is associated with mortality. Recent studies have suggested that other dialysis outcomes are compromised in frail individuals. While we do not yet have a consensus as to the best measure of frailty, identification of these poor outcomes and their magnitude of association with frailty will help improve prognostication, allow for earlier interventions, and improve provider-to-patient communication.
Recent Findings: The most widely used assessment of frailty is Fried's physical performance criteria. However, regardless of assessment method, frailty remains highly associated with mortality. More recently, frailty has been associated with falls, fractures, cognitive impairment, vascular access failure, and poor quality of life. Recent large cohort studies provide strong evidence that frailty assessment can provide important prognostic information for providers and patients both before and after initiation of dialysis. Trials aimed at improving frailty are limited and show the promise of augmenting quality of life, although more studies are needed to firmly establish mortality benefits.
Summary: We underscore the importance of frailty as a prognostic indicator and identify other recently established consequences of frailty. Widespread adoption of frailty assessment remains limited and researchers continue to find ways of simplifying the data collection process. Timely and regular assessment of frailty may allow for interventions that can mitigate the onset of poor outcomes and identify actionable targets for dialysis providers.
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| http://dx.doi.org/10.1097/MNH.0000000000000364 | DOI Listing |
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Article Synopsis
- People with frailty have a higher risk of developing atrial fibrillation (AF), and this study aimed to investigate how long-term changes in frailty influence this risk.
- The study involved over 50,000 UK Biobank participants who were assessed on their frailty levels and monitored for new cases of AF, heart failure (HF), coronary heart disease (CHD), and stroke over approximately 5 years.
- Results indicated that even small increases in frailty (ΔFI) significantly raised the risk of AF, and participants who remained frail had nearly double the risk compared to those who maintained non-frail status; however, those who improved their frailty status saw a notable decrease in risk.
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