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Clin Interv Aging. 2015 Oct 5;10:1595-600. doi: 10.2147/CIA.S90077. eCollection 2015.

The relationship between frailty, anxiety and depression, and health-related quality of life in elderly patients with heart failure.

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Department of Clinical Nursing, Wrocław Medical University, Wrocław, Poland.
Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Amsterdam, the Netherlands ; Zonnehuisgroep Amstelland, Amstelveen, the Netherlands.



Elderly people constitute over 80% of the population of patients with heart failure (HF). Frailty is a distinct biological syndrome that reflects decreased physiologic reserve and resistance to stressors. Moreover, frailty can serve as an independent predictor of visits to the emergency department, hospitalizations, and mortality. The purpose of this paper was to assess the relationship between frailty, anxiety and depression, and the health-related quality of life (HRQoL) of elderly patients with HF.


The study included 100 patients (53 men and 47 women) with a diagnosis of HF. Frailty was measured using the Tilburg Frailty Indicator (TFI) scale. HRQoL was measured using the 36-Item Short Form Medical Outcomes Study Survey. To determine the prevalence of anxiety and depression, the Hospital Anxiety and Depression Scale was used.


Frailty was found in 89% of the studied population. The study showed significant inverse correlations between the values of the physical component scale (PCS) domain results and TFI score, and a significant inverse correlation between the values of the mental component scale (MCS) domain and TFI score. When participants showed increased levels of frailty as measured by the TFI scale, there was also an increase in the levels of anxiety and depression. With increased anxiety and depression, there was deterioration in the quality of life of patients with HF.


Frailty has a negative impact on the HRQoL results of elderly patients with HF. The assessment of frailty syndrome, and anxiety and depression should be taken into account when estimating risk and making therapeutic decisions for cardiovascular disease treatment and care.


anxiety; depression; elderly; frailty; health-related quality of life; heart failure

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