Introduction:
Although women with heart failure (HF) are potentially more likely to be physically frail compared with men with HF, the underlying contributors to this gender difference are poorly understood. The purpose of this study was to characterize gender differences in physical frailty phenotypes in HF with a focus on physiological, clinical, and symptom characteristics.
Methods:
We prospectively enrolled adults with Class I-IV HF. Physical frailty was measured with the Frailty Phenotype Criteria: unintentional weight loss, weakness, slowness, physical exhaustion, and low physical activity; those who met 0-2 criteria were not physically frail, and those who met 3-5 criteria were physically frail. Body composition was measured using dual energy x-ray absorptiometry. Clinical data were extracted from the medical record. Symptoms of dyspnea, sleep-related impairment, pain interference, depression, and anxiety were assessed. Simple comparative statistics and multivariate logistic regression were used to identify gender differences in physical frailty.
Results:
The average age of the sample (n = 115) was 63.6±15.7 years, 49% were women, and 73% had non-ischemic etiology. About 43% of the sample was physically frail. Women were 4.5 times as likely to be physically frail compared with men, adjusting for covariates (OR = 4.52, 95%CI [1.69, 12.08],
p
= 0.003). Both physically frail men and women had significantly more type 2 diabetes and worse dyspnea symptoms compared with non-physically frail men and women, respectively. Physically frail men had significantly lower appendicular muscle mass, higher percent body fat, trunk fat, and appendicular fat, and lower hemoglobin compared with non-physically frail men (all
p
< 0.05). Physically frail women had significantly higher comorbidity burden and worse sleep-related impairment, pain interference, and depressive symptoms compared with non-physically frail women (all
p
< 0.05).
Conclusions:
Women are significantly more likely to be physically frail in HF. Physical frailty in men with HF may be primarily characterized by comorbidities and sarcopenic obesity; whereas physical frailty in women with HF may be predominantly characterized by comorbidities and worse symptoms.
