Objective:

To explore the transitions of potential frailty subtypes and their influencing factors in patients with chronic heart failure (CHF), and to provide evidence for the development of targeted frailty intervention strategies.

Approach:

• Study Design: A longitudinal follow-up study was conducted with 324 hospitalized CHF patients from two general hospitals in Xinjiang, China, with assessments at baseline (T1), 3 months (T2), and 6 months (T3) post-discharge.
• Analytical Methods: Latent Profile Analysis (LPA) identified frailty subtypes, Latent Transition Analysis (LTA) analyzed dynamic transitions, and multivariate logistic regression explored factors associated with transitions.

Key Findings:

• Three frailty subtypes identified: healthy type (low frailty), social-dominant type (moderate frailty characterized by insufficient social support), and psychological-dominant type (high frailty characterized by heavier psychological burden and more severe functional impairment).
• The moderate frailty subtype showed the lowest stability, with a transition rate to high frailty of 24.4% from T1 to T2 and 34.0% from T2 to T3.
• Significant factors influencing frailty transitions included age, medical insurance status, NYHA classification, NT-proBNP levels, eGFR, insomnia, depression, and home volume management.
• Dynamic transitions were observed across all subtypes during follow-up.

Interpretation:

Frailty among CHF patients is dynamic and heterogeneous, with specific subtypes exhibiting different risks and characteristics.

Limitations:

• The study was conducted in a specific geographic area, which may limit generalizability.
• The follow-up duration may not capture long-term frailty transitions.

Conclusion:

Stratified management targeting different frailty subtypes may help reduce frailty progression and improve health outcomes in CHF patients.