{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T07:41:21Z","timestamp":1778658081994,"version":"3.51.4"},"reference-count":26,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2021,6,4]],"date-time":"2021-06-04T00:00:00Z","timestamp":1622764800000},"content-version":"unspecified","delay-in-days":3,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"NIHR\/Health Education England","award":["DGJM is an NIHR Academic Clinical Fellow"],"award-info":[{"award-number":["DGJM is an NIHR Academic Clinical Fellow"]}]},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["PG\/09\/024\/26857"],"award-info":[{"award-number":["PG\/09\/024\/26857"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["RG\/19\/4\/34452"],"award-info":[{"award-number":["RG\/19\/4\/34452"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2021,5,16]]},"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Frailty and heart failure (HF) are cross-sectionally associated. Published longitudinal data are very limited. We sought to investigate associations between frailty and incident HF.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Prospective study of 1722 men, examined at age 72\u201391 years. Scores based on the Fried phenotype, Gill index and a novel frailty score, based on the Health Ageing and Body Composition Battery, incorporating slow walking speed, low chair-stand time and subjective difficulty with balance, were calculated. Associations between these scores and incident HF were analysed with Cox proportional hazard modelling.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>1445 men with frailty data and without prevalent HF were included. 99 developed HF (mean follow-up 6.1 years). Men scoring 3\/3 on our novel frailty score had elevated risk of incident HF (HR 2.77, 95% CI 1.25 to 6.15), which persisted after adjustment for established risk factors and interleukin-6 (HR 3.14, 95% CI 1.35 to 7.31). This risk remained increased, although attenuated, after excluding HF events within 2 years of baseline (HR 2.05, 95% CI 0.61 to 6.92). The frailty phenotype showed a non-significant association with HF (age-adjusted HR 1.92, 95% CI 0.99 to 3.73), which was further attenuated after adjustment for prevalent coronary heart disease and Body mass index (HR 1.60, 95% CI 0.81 to 3.15). Gill-type scores were weakly associated with HF risk after these adjustments (HR 1.31, 95% CI 0.47 to 3.70).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In these older men, the combination of slow walk speed, low sit-stand time and balance problems were associated with high risk of incident HF, independent of established risk factors and inflammatory markers. However, undiagnosed HF at baseline may still be a confounder. There is a differential association between aspects of the frailty phenotype and incident HF.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2021-001571","type":"journal-article","created":{"date-parts":[[2021,6,4]],"date-time":"2021-06-04T11:34:26Z","timestamp":1622806466000},"page":"e001571","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Frailty and incident heart failure in older men: the British Regional Heart Study"],"prefix":"10.1136","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3477-1503","authenticated-orcid":false,"given":"Douglas GJ","family":"McKechnie","sequence":"first","affiliation":[{"name":"Department of Primary Care and Population Health, University College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8781-6747","authenticated-orcid":false,"given":"A Olia","family":"Papacosta","sequence":"additional","affiliation":[{"name":"Department of Primary Care and Population Health, University College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1738-1351","authenticated-orcid":false,"given":"Lucy T","family":"Lennon","sequence":"additional","affiliation":[{"name":"Department of Primary Care and Population Health, University College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0391-9704","authenticated-orcid":false,"given":"Sheena E","family":"Ramsay","sequence":"additional","affiliation":[{"name":"Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, Newcastle upon Tyne, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5589-4107","authenticated-orcid":false,"given":"Peter H","family":"Whincup","sequence":"additional","affiliation":[{"name":"Population Health Research Institute, St George's University of London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9484-9977","authenticated-orcid":false,"given":"S Goya","family":"Wannamethee","sequence":"additional","affiliation":[{"name":"Department of Primary Care and Population Health, University College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,6,4]]},"reference":[{"key":"2025081612320830000_8.1.e001571.1","doi-asserted-by":"crossref","DOI":"10.1186\/s12877-017-0423-6","article-title":"Prevalence of frailty in Canadians 18-79 years old in the Canadian health measures survey","volume":"17","author":"Kehler","year":"2017","journal-title":"BMC Geriatr"},{"key":"2025081612320830000_8.1.e001571.2","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.ijcard.2017.01.153","article-title":"The prevalence of frailty in heart failure: a systematic review and meta-analysis","volume":"236","author":"Denfeld","year":"2017","journal-title":"Int J Cardiol"},{"key":"2025081612320830000_8.1.e001571.3","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1002\/ejhf.518","article-title":"Prevalence and prognostic impact of frailty and its components in non-dependent elderly patients with heart failure","volume":"18","author":"Vid\u00e1n","year":"2016","journal-title":"Eur J Heart Fail"},{"key":"2025081612320830000_8.1.e001571.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2019.10.005"},{"key":"2025081612320830000_8.1.e001571.5","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.ijcard.2020.04.043","article-title":"Heart failure, frailty, and pre-frailty: a systematic review and meta-analysis of observational studies","volume":"316","author":"Marengoni","year":"2020","journal-title":"Int J Cardiol"},{"key":"2025081612320830000_8.1.e001571.6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2005.53405.x"},{"key":"2025081612320830000_8.1.e001571.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2013.07.032"},{"key":"2025081612320830000_8.1.e001571.8","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/56.10.M644"},{"key":"2025081612320830000_8.1.e001571.9","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa020423"},{"key":"2025081612320830000_8.1.e001571.10","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2014-306472"},{"key":"2025081612320830000_8.1.e001571.11","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/56.3.M146"},{"key":"2025081612320830000_8.1.e001571.12","doi-asserted-by":"crossref","unstructured":"Prineas RJ , Crow RS , Zhang Z-M . 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