Analysis of influencing factors for frailty in geriatric syndrome patients and the impact of frailty decompensation on major adverse events

Abstract

Background Frailty is a core manifestation of geriatric syndromes, and its decompensated state is associated with adverse outcomes, yet standardized assessment criteria are lacking. Methods From January 2022 to June 2024, 538 patients with geriatric syndromes were prospectively enrolled. Frailty was assessed using the Fried phenotype. The optimal left ventricular ejection fraction (LVEF) cutoff (≤51.2%) for identifying frailty decompensation was determined via ROC curve analysis. Risk factors for frailty progression and the impact of decompensation on major adverse events (all-cause mortality, stroke, cardiovascular events, urinary incontinence) and hospitalization frequency were analyzed. Results The prevalence of frailty was 44.05%. Independent risk factors for frailty progression included advanced age, malnutrition (low MNA-SF score and albumin), impaired cardiac function (low LVEF, NYHA class III–IV), anxiety/depression, and low hemoglobin. LVEF ≤ 51.2% effectively defined frailty decompensation (AUC = 0.781). Decompensation was an independent risk factor for urinary incontinence (OR = 4.113, P = 0.049) and for increased hospitalization frequency (IRR = 1.628, P = 0.003). Conclusions This study identifies multisystem risk factors for frailty progression, proposes an exploratory, internally derived LVEF threshold for identifying frailty decompensation, which should be considered hypothesis-generating and requires external validation before clinical application, and confirms that decompensation significantly increases the risk of urinary incontinence and healthcare burden.