Managing frailty to improve outcomes for heart failure patients

Associate Professor Quan Huynh, University of Tasmania

Future Leader Fellowship - Level 2

Years funded: 2025 - 2028

Heart failure (HF) patients are often frail – cognitively, physically and socially, with different contributions of each. The bidirectional relationships of frailty with HF lead to greater risks of adverse outcomes and significant burdens on our healthcare system. Like many high-income countries, Australian population is aging. This makes HF, dementia, and frailty particular health concerns for Australia and globally.

My preliminary findings show that cognitive and physical frailty may increase the risk of HF development almost as much as that of cardiac dysfunction and that people with these comorbidities benefit most from intervention to reduce adverse outcomes in HF.

Assessment of frailty and cognitive function in HF is not routinely implemented in clinical practice. There is little guidance on how to manage HF patients with cognitive impairment and frailty due to lacking evidence-based care models and treatment for these high-risk patients.

My research program will address these issues:

Scheme 1 will develop an intervention program for people who have already developed heart failure (HF):

• Study 1: determine (1) how cardioprotective medicines are administered to HF patients who are frail and (2) if these patients respond to optimal guideline-based treatment for HF
• Study 2: test a novel disease management program to improve outcomes in HF patients who are cognitively and physically frail

Scheme 2 will develop a prevention program for people at risk of heart failure (HF):

• Study 3: examine the impact of changes in cognition and frailty on HF development
• Study 4: test an innovative healthcare program for people at high risk of developing HF

This research will establish an innovative program for managing multimorbidity in HF, which will enhance cognition and reduce frailty while lowering the risk of both cardiovascular events and dementia. The interventions will be tailored to individual needs and supported by cutting-edge technology that is suitable for widespread adoption. They have the potential to shift the treatment strategy for HF from a single disciplinary focus to an integrated multidisciplinary care model that addresses multimorbidity, transforming healthcare practices.