The 6-minute walk is associated with frailty and predicts mortality in older adults with heart failure

Rebecca Boxer, Alison Kleppinger, Amir Ahmad, Kristin Annis, David Hager, Anne Kenny

Research output: Contribution to journalArticlepeer-review

75 Scopus citations


Heart failure (HF) may contribute to the development of functional decline and frailty in older adults. Sixty HF patients with an ejection fraction ≤40% evaluated in 2004 and 2005 were reevaluated in 2008. Six-minute walk distance (6MW), frailty score, and biomarkers (25-hydroxyvitamin D, C-reactive protein, and interleukin-6 [IL-6]) were measured. Participants were categorized at baseline and follow-up into 3 groups: nonfrail/normal endurance (NF/NE), nonfrail/low endurance (NF/LE) and frail/low endurance (F/LE). Survival time was assessed according to frailty/endurance status and associated predictors of mortality. Forty-three men, 17 women (mean age, 78±12 years) were contacted. At follow-up, 20 had died, 20 participated, and 20 did not participate. There were no changes in frailty/endurance status over time (McNemar;P=19). Deaths occurred in 18% of NF/NE, 45% of NF/LE, and 60% of F/LE persons. The NF/NE group had greater survival rates than the NF/LE (P=032) and F/LE (P=014) groups. The 6MW and frailty score were independently predictive of mortality, with hazard ratios of 0.82 (95% confidence interval, 0.72-0.94) and 1.64 (95% confidence interval, 1.19-2.26), respectively, as was New York Heart Association class and IL-6. Backward stepwise Cox regression revealed that 6MW and frailty each were associated with mortality (P=005) and highly correlated. Physical function is an important predictor of mortality in older adults with HF. The 6MW may be useful as a measure of frailty.

Original languageEnglish (US)
Pages (from-to)208-213
Number of pages6
JournalCongestive Heart Failure
Issue number5
StatePublished - Sep 2010
Externally publishedYes

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency
  • Cardiology and Cardiovascular Medicine


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