Anna Skalska1, Barbara Wizner2, Andrzej Więcek3, Tomasz Zdrojewski4, Jerzy Chudek5, Alicja Klich-Rączka2, Karolina Piotrowicz2, Piotr Błędowski6, Małgorzata Mossakowska7, Jean-Pierre Michel8, Tomasz Grodzicki2. 1. Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Krakow, Poland. Electronic address: anskal@su.krakow.pl. 2. Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Krakow, Poland. 3. Department of Nephrology, Endocrinology and Metabolic Diseases, Medical University of Silesia, Katowice, Poland. 4. Department of Arterial Hypertension and Diabetology, Medical University of Gdansk, Gdańsk, Poland. 5. Department of Pathophysiology, Medical University of Silesia, Katowice, Poland. 6. Institute of Social Economy, Warsaw School of Economics, Warsaw, Poland. 7. International Institute of Molecular and Cell Biology, Warsaw, Poland. 8. Geneva Medical School, Geneva University, Geneva, Switzerland.
Abstract
AIM: To assess daily functioning and geriatric conditions of older subjects suffering from heart failure (HF) as compared to the general population. METHODS AND RESULTS: The data were collected as part of the nationwide PolSenior project (2007-2011). Of 4979 individuals (age range 65-104 years), data on self-reported HF hospitalization were available for 4795 subjects (96%). Geriatric assessment (GA) included functional status (ADL, Activities of Daily Living and IADL, Instrumental ADL scales), cognitive function, mood disorders, sensory organ impairment, falls and comorbidity. Mean age ± SD of the study population was 73.8 ± 6.5 years; 62% were female. The proportion of subjects with HF hospitalizations increased from 8% in subjects aged 65-69 years up to 13% in the age group of 85-89 years, and decreased in nonagenarians (11%). Subjects with the HF hospitalization were older, used more drugs, and were characterized by a higher prevalence of comorbid conditions, mood disorders, hearing impairment and functional limitations. In logistic regression, HF hospitalization increased the age-sex adjusted risk of disability by 40%, both in ADL and IADL. After adjustment to other clinical and geriatric conditions, HF hospitalization remained an independent predictor of disability in both ADL (OR=1.36, 95%CI: 1.00-1.84) and IADL (OR=1.40, 95%CI: 1.01-1.93). CONCLUSIONS:Older people who reported HF admissions had a higher number of comorbidities and geriatric conditions: mood disorders, hearing impairment and functional limitations. Besides, in our study, HF hospitalization independently and significantly increased the risk of limitations in IADL and ADL. Therefore, further studies are needed to evaluate the benefits of GA in patients with HF.
RCT Entities:
AIM: To assess daily functioning and geriatric conditions of older subjects suffering from heart failure (HF) as compared to the general population. METHODS AND RESULTS: The data were collected as part of the nationwide PolSenior project (2007-2011). Of 4979 individuals (age range 65-104 years), data on self-reported HF hospitalization were available for 4795 subjects (96%). Geriatric assessment (GA) included functional status (ADL, Activities of Daily Living and IADL, Instrumental ADL scales), cognitive function, mood disorders, sensory organ impairment, falls and comorbidity. Mean age ± SD of the study population was 73.8 ± 6.5 years; 62% were female. The proportion of subjects with HF hospitalizations increased from 8% in subjects aged 65-69 years up to 13% in the age group of 85-89 years, and decreased in nonagenarians (11%). Subjects with the HF hospitalization were older, used more drugs, and were characterized by a higher prevalence of comorbid conditions, mood disorders, hearing impairment and functional limitations. In logistic regression, HF hospitalization increased the age-sex adjusted risk of disability by 40%, both in ADL and IADL. After adjustment to other clinical and geriatric conditions, HF hospitalization remained an independent predictor of disability in both ADL (OR=1.36, 95%CI: 1.00-1.84) and IADL (OR=1.40, 95%CI: 1.01-1.93). CONCLUSIONS: Older people who reported HF admissions had a higher number of comorbidities and geriatric conditions: mood disorders, hearing impairment and functional limitations. Besides, in our study, HF hospitalization independently and significantly increased the risk of limitations in IADL and ADL. Therefore, further studies are needed to evaluate the benefits of GA in patients with HF.
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