Assessment of frailty in heart failure

Heart failure (HF) is a major public health problem. Approximately six million Americans live with HF, with approximately 1,000,000 new cases each year (Benjamin et al., 2018). HF is one of the leading causes of hospitalization in people over age 65 (Heidenreich et al., 2013; Roger, 2021), and managing HF has become one of the biggest challenges in the care of patients with cardiovascular disease (Benjamin et al., 2018; Uchmanowicz et al., 2019). Although the inability of the heart to pump adequately is the primary cause, HF is a complex syndrome of multi-system impairment that contributes to significant morbidity and mortality. The concept of frailty, originally developed in geriatrics, has recently been applied to individuals with HF and is recognized as an important measure for prognostication of health status. The purpose of this article is to describe frailty, how it has been applied to the HF population, and how occupational therapy practitioners (OTPs) can integrate frailty assessment into clinical practice across settings for individuals with HF.