Lilamand Matthieu, Saintout Mariannick, Vigan Marie, Bichon Astrid, Tourame Laure, Diet Aurélie Brembilla, Iung Bernard, Himbert Dominique, Laouenan Cédric, Raynaud-Simon Agathe
Assistance Publique Hôpitaux de Paris Nord, Department of Geriatrics, Bichat University Hospital, France.
University of Paris, France.
J Geriatr Cardiol. 2020 Jul 28;17(7):410-416. doi: 10.11909/j.issn.1671-5411.2020.07.004.
Quality of life (QoL) is a priority outcome in older adults suffering from cardiovascular diseases. Frailty and poor nutritional status may affect the QoL through mobility disorders and exhaustion. The objective of this study was to determine if physical frailty and nutritional status were associated with QoL, in older cardiology patients.
Cross sectional, observational study conducted in a cardiology department from a university hospital. Participants ( = 100) were aged 70 and older. Collected data included age, sex, cardiac diseases, New York Heart Association (NYHA) classification, comorbidities (Charlson Index) and disability. A Short Physical Performance Battery (SPPB), including walking speed assessment was performed; handgrip strength were measured as well as Fried's frailty phenotype. Nutritional status was assessed using the Mini Nutritional Assessment (MNA) and Body Mass Index (BMI), inflammation by C-reactive protein (CRP). QoL was assessed using the EORTC-QLQ questionnaire. Univariate and multivariate analyses were performed to study the associations between all recorded parameters and QoL.
In participants (mean age: 79.3 ± 6.7 years; male: 59%), Charlson index, arrhythmia, heart failure, NYHA classⅢ-Ⅳ, MNA, disability, walking speed, SPPB score, frailty and CRP were significantly associated with QoL in univariate analysis. Multivariate analysis showed that NYHA classⅢ-Ⅳ ( < 0.001), lower MNA score ( = 0.03), frailty ( < 0.0001), and higher CRP ( < 0.001) were independently associated with decreased QoL.
Frailty, nutritional status and inflammation were independently associated with poor QoL. Further studies are needed to assess the efficacy of nutritional and physical interventions on QoL in this population.
生活质量（QoL）是老年心血管疾病患者的首要预后指标。身体虚弱和营养状况不佳可能通过行动障碍和疲惫影响生活质量。本研究的目的是确定老年心脏病患者的身体虚弱和营养状况是否与生活质量相关。
在一家大学医院的心脏病科进行横断面观察性研究。参与者（n = 100）年龄在70岁及以上。收集的数据包括年龄、性别、心脏病、纽约心脏协会（NYHA）分级、合并症（Charlson指数）和残疾情况。进行了简短体能表现电池测试（SPPB），包括步行速度评估；测量了握力以及Fried虚弱表型。使用微型营养评定法（MNA）和体重指数（BMI）评估营养状况，通过C反应蛋白（CRP）评估炎症。使用欧洲癌症研究与治疗组织生活质量问卷（EORTC-QLQ）评估生活质量。进行单因素和多因素分析以研究所有记录参数与生活质量之间的关联。
在参与者中（平均年龄：79.3±6.7岁；男性：59%），在单因素分析中，Charlson指数、心律失常、心力衰竭、NYHAⅢ-Ⅳ级、MNA、残疾、步行速度、SPPB评分、虚弱和CRP与生活质量显著相关。多因素分析显示，NYHAⅢ-Ⅳ级（P < 0.001）、较低的MNA评分（P = 0.03）、虚弱（P < 0.0001）和较高的CRP（P < 0.001）与生活质量下降独立相关。
虚弱、营养状况和炎症与生活质量差独立相关。需要进一步研究以评估营养和身体干预对该人群生活质量的疗效。
