Frailty Decompensation: LVEF Cutoff and Incontinence Risk
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Frailty Decompensation in Older Adults: Risk Factors, an LVEF Cutoff and Urinary Incontinence
Background
Frailty is a core manifestation of geriatric syndromes. Its decompensated state is linked to adverse outcomes, yet standardized assessment criteria are lacking.
Methods
From January 2022 to June 2024, we prospectively enrolled 538 patients with geriatric syndromes. We assessed frailty with the Fried phenotype. We used ROC curve analysis to find the optimal left ventricular ejection fraction (LVEF) cutoff (≤51.2%) for identifying frailty decompensation. We then analyzed risk factors for frailty progression and the effect of decompensation on major adverse events (all-cause mortality, stroke, cardiovascular events, urinary incontinence) and hospitalization frequency.
Results
Prevalence: Frailty affected 44.05% of patients.
Risk factors for frailty progression: Advanced age, malnutrition (low MNA-SF score and albumin), impaired cardiac function (low LVEF, NYHA class III–IV), anxiety/depression and low hemoglobin.
LVEF cutoff: LVEF ≤51.2% effectively defined frailty decompensation (AUC = 0.781).
Outcomes: Decompensation was an independent risk factor for urinary incontinence (OR = 4.113, P = 0.049) and for more frequent hospitalization (IRR = 1.628, P = 0.003).
Conclusions
This study identifies multisystem risk factors for frailty progression. It proposes an exploratory, internally derived LVEF threshold for identifying frailty decompensation. That threshold is hypothesis-generating and needs external validation before clinical use. The study also confirms that decompensation significantly raises the risk of urinary incontinence and healthcare burden.
Sun Y, Liu X, Zhang C, Wang A, Wang D. 2026. Analysis of influencing factors for frailty in geriatric syndrome patients and the impact of frailty decompensation on major adverse events. PeerJ 14:e21514 https://doi.org/10.7717/peerj.21514
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