Noncardiac comorbidities (NCCs) are common in older adults with heart failure (HF), yet their relationship with functional decline and long-term outcomes remains incompletely characterized. A subanalysis of the prospective, nationwide J-Proof HF registry evaluated the prevalence of NCCs and their association with hospitalization-associated disability (HAD) and 1-year clinical outcomes. The subanalysis results were published in the Journal of Cardiology. 

Among 10,052 eligible patients, 9200 older adults with HF (mean age 82 ± 8 years; 48.8% women) were included. Of 10,052 eligible patients, 852 were excluded based on study exclusion criteria, leaving 9200 older adults with HF included in the subanalysis. Fourteen predefined NCCs, based on the Charlson Comorbidity Index plus anemia, were assessed. Patients were categorized by NCC count (0, 1, 2, or ≥3 NCCs), and outcomes were examined across these predefined categories.

Overall, 12.0% had no NCCs, 28.4% had 1, 31.7% had 2, and 27.8% had ≥3 NCCs. The incidence of HAD increased progressively with greater NCC burden (28.6%, 32.9%, 34.9%, and 39.8%; p for trend <0.001). After adjustment for confounders, higher NCC categories were associated with increased 1-year all-cause mortality, with hazard ratios of 1.099 (95% CI 0.860–1.403) for 1 NCC, 1.382 (95% CI 1.092–1.748) for 2 NCCs, and 1.873 (95% CI 1.482–2.368) for ≥3 NCCs. Higher NCC burden was also significantly associated with 1-year HF hospitalization and 1-year noncardiovascular hospitalization.

As an observational registry analysis, these findings demonstrate association rather than causation.