Symptom network of multidomain frailty in patients with chronic heart failure: a network-based analysis

AIMS: The purpose of this study was to construct a symptom network for identifying core symptoms of frailty in physical, cognitive, and social domains in patients with chronic heart failure (CHF). METHODS AND RESULTS: A total of 269 hospitalized patients with CHF was included in the study. The FRAIL scale, the Montreal Cognitive Assessment (MoCA), and the Help, Participation, Loneliness, Financial, Talk scale (The HALFT scale) were used to assess the frailty in physical, cognitive, and social domains. The construction of symptom networks for frailty in physical, cognitive, and social domains in patients with CHF was conducted by R software. The symptom network analysis indicated that the three symptoms with the highest centrality of strength were 'attention' (rs = 4.178), 'visuospatial/executive function' (rs = 3.940), and 'language' (rs = 3.843). The three symptoms with the highest centrality of betweenness were 'language' (rb = 32.000), 'loneliness' (rb = 28.000), and 'decreased endurance' (rb = 26.000). The three symptoms with the highest centrality of closeness were 'attention' (rc = 0.011621), 'visuospatial/executive function' (rc = 0.011620), and 'language' (rc = 0.011568). The three symptoms with the highest centrality of bridge were 'decreased walking ability' (rbs = 7.608), 'decreased endurance' (rbs = 7.373), and 'inability to help others' (rbs = 4.990). CONCLUSION: The core symptoms of frailty in the physical, cognitive, and social domains among patients with CHF are attention, visuospatial/executive function, and language function. Therefore, prioritizing interventions for core symptoms should be implemented to address frailty in the physical, cognitive, and social domains of patients with CHF in clinical practice.