Skalska Anna, Wizner Barbara, Więcek Andrzej, Zdrojewski Tomasz, Chudek Jerzy, Klich-Rączka Alicja, Piotrowicz Karolina, Błędowski Piotr, Mossakowska Małgorzata, Michel Jean-Pierre, Grodzicki Tomasz
Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Krakow, Poland.
Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Krakow, Poland.
Int J Cardiol. 2014 Sep 20;176(2):423-9. doi: 10.1016/j.ijcard.2014.07.099. Epub 2014 Aug 4.
To assess daily functioning and geriatric conditions of older subjects suffering from heart failure (HF) as compared to the general population.
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).
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.
评估与普通人群相比,老年心力衰竭(HF)患者的日常功能和老年疾病状况。
数据收集于全国性的PolSenior项目(2007 - 2011年)。在4979名年龄在65 - 104岁的个体中,4795名受试者(96%)有自我报告的HF住院数据。老年评估(GA)包括功能状态(日常生活活动能力量表ADL和工具性日常生活活动能力量表IADL)、认知功能、情绪障碍、感觉器官损害、跌倒和合并症。研究人群的平均年龄±标准差为73.8±6.5岁;62%为女性。HF住院患者的比例从65 - 69岁受试者中的8%增加到85 - 89岁年龄组中的13%,在九十多岁的人群中有所下降(11%)。HF住院患者年龄更大,用药更多,且合并症、情绪障碍、听力损害和功能受限的患病率更高。在逻辑回归中,HF住院使年龄和性别调整后的残疾风险在ADL和IADL中均增加了40%。在调整其他临床和老年疾病状况后,HF住院仍然是ADL(OR = 1.36,95%CI:1.00 - 1.84)和IADL(OR = 1.40,95%CI:1.01 - 1.93)中残疾的独立预测因素。
报告有HF入院的老年人有更多的合并症和老年疾病,如情绪障碍、听力损害和功能受限。此外,在我们的研究中,HF住院独立且显著增加了IADL和ADL受限的风险。因此,需要进一步研究来评估GA对HF患者的益处。