Understanding frailty in elderly patients with heart failure: associations with quality of life and illness acceptance
M Lisiak, Z Proc, M Wleklik, I UchmanowiczAbstract
Background
Heart failure (HF) affects many older adults and is frequently accompanied by frailty syndrome (FS). In this population, frailty is a multidimensional syndrome encompassing not only physical but also psychosocial domains, including illness acceptance. Understanding these associations supports a patient-centred, nursing-oriented approach to heart failure care.
Aim
The aim of this study was to examine associations between frailty, illness acceptance, and quality of life in elderly patients with heart failure.
Methods
A cross-sectional study was conducted among 100 patients aged ≥65 years who were hospitalised for heart failure. Quality of life was assessed using the WHOQOL-BREF questionnaire. Frailty was evaluated with the Tilburg Frailty Indicator (TFI), and illness acceptance was measured using the Acceptance of Illness Scale. Sociodemographic and clinical data were obtained from medical records and an author-designed questionnaire. Associations were analysed using non-parametric tests and Pearson correlation coefficients.
Results
The study group consisted of 63% men, with a mean age of 73.6±7.7 years. The burden of multimorbidity was high, with a mean number of comorbid conditions of 4.7±1.8 (median 5 [Q1–Q3: 4–6]). Frailty (TFI ≥5) was present in 77 patients. A positive correlation was observed between frailty score and age (r=0.312, p=0.002), with each additional year of age associated with an average increase of 0.135 points in the TFI score. The lowest quality of life scores were observed in the physical domain of WHOQOL-BREF (mean 46.0±22.0), while the overall quality of life score was 59.2±18.5. Frailty was significantly negatively associated with overall quality of life, with the strongest associations observed in the physical and psychological domains (p<0.05). Illness acceptance demonstrated strong positive associations with perceived overall quality of life and all WHOQOL-BREF domains (p<0.001). Higher frailty levels and lower illness acceptance consistently co-occurred with poorer perceived quality of life.
Conclusions
Frailty and illness acceptance show strong associations with quality of life in elderly patients with heart failure. Integrating geriatric and psychosocial perspectives into nursing assessment may support a more comprehensive, patient-centred evaluation of quality of life.