Section of General Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut 06520-8093, USA.
J Card Fail. 2011 Sep;17(9):764-70. doi: 10.1016/j.cardfail.2011.04.015.
As the heart failure population continues to age, disability is becoming an increasingly important issue. Our objective was to identify risk factors for the onset of disability in activities of daily living among older persons with heart failure.
The study population included participants with newly diagnosed heart failure from the Cardiovascular Health Study, a longitudinal study of community-living, older persons. Data were collected through annual examinations. Cox regression modeling was used to examine associations between time-dependent predictors and onset of disability.
Of 461 participants newly diagnosed with heart failure (mean age 78.7 [SD 5.89]), 23% subsequently developed disability. The first year after heart failure diagnosis was the period of greatest risk for onset of disability (chi-square P value <.001). Factors that were independently associated with disability included: impaired gait speed (HR 2.29, 95% CI 1.34-3.90); impaired cognition (HR 1.87, 95% CI 1.14-3.05); and depressive symptoms (HR 1.72, 95% CI 1.04-2.83).
Onset of disability is a common occurrence among older persons newly diagnosed with heart failure. Risk factors for onset of disability in this population are potentially modifiable, and should be routinely assessed in an effort to reduce disability in this growing population.
随着心力衰竭患者群体的老龄化，残疾问题变得日益重要。我们的目标是确定心力衰竭老年患者日常生活活动中残疾发生的风险因素。
研究人群包括心血管健康研究中的新诊断心力衰竭患者，该研究是一项针对社区居住的老年人的纵向研究。数据通过年度检查收集。Cox 回归模型用于检查随时间变化的预测因素与残疾发生之间的关联。
在 461 名新诊断为心力衰竭的参与者中（平均年龄 78.7 [5.89] 岁），有 23%随后出现残疾。心力衰竭诊断后的第一年是残疾发生风险最高的时期（卡方 P 值<.001）。与残疾独立相关的因素包括：步态速度受损（HR 2.29，95%CI 1.34-3.90）；认知障碍（HR 1.87，95%CI 1.14-3.05）；和抑郁症状（HR 1.72，95%CI 1.04-2.83）。
新诊断为心力衰竭的老年人中，残疾的发生较为常见。该人群中残疾发生的风险因素具有潜在的可改变性，应常规评估这些因素，以努力减少这一不断增长的人群中的残疾。
