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Prognostic value of instrumental activity of daily living in initial heart failure hospitalization patients aged 65 years or older

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Abstract

Although the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) is useful to assess decline of instrumental activities of daily living (IADL) in Japanese individuals, limited data are available in patients with heart failure (HF). This study was performed to investigate the prognostic value of IADL evaluated by TMIG-IC in initial HF hospitalization patients aged ≥ 65 years. We reviewed 297 elderly HF patients with independent basic ADL before hospitalization. Patients with prior HF were excluded. Five TMIG-IC items were investigated as IADL parameters. Patients with full IADL scores were defined as “independent” and others were defined as “dependent”. The endpoint was all-cause mortality, and multivariable analysis was performed to identify IADL risk. The median age was 76 years, and 55% of the patients were male. Forty-one deaths occurred over a median follow-up period of 1.01 years. After adjusting for existing risk factors, including Seattle Heart Failure Score, dependent patients had higher mortality risk than independent patients [hazard ratio 3.64, 95% confidence interval (CI) 1.57–8.43], and mortality risk decreased by 16% for each 1-point increase in IADL score (hazard ratio 0.84, 95% CI 0.71–0.99). In conclusion, limited IADL indicated by TMIG-IC was associated with poorer long-term mortality rate in elderly patients with HF. This inexpensive and easily applicable tool will support decision making in cardiac rehabilitation.

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Authors and Affiliations

  1. Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan

    Masashi Yamashita, Kentaro Kamiya, Takeshi Nakamura & Atsuhiko Matsunaga

  2. Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0373, Japan

    Kentaro Kamiya, Minako Yamaoka-Tojo & Atsuhiko Matsunaga

  3. Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan

    Nobuaki Hamazaki, Kohei Nozaki & Takafumi Ichikawa

  4. Department of Physical Therapy, School of Rehabilitation, Hyogo University of Health Sciences, Kobe, Japan

    Ryota Matsuzawa

  5. Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan

    Emi Maekawa & Junya Ako

Authors
  1. Masashi Yamashita
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  2. Kentaro Kamiya
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  3. Nobuaki Hamazaki
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  6. Takafumi Ichikawa
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  9. Minako Yamaoka-Tojo
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  10. Atsuhiko Matsunaga
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Correspondence to Kentaro Kamiya.

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Yamashita, M., Kamiya, K., Hamazaki, N. et al. Prognostic value of instrumental activity of daily living in initial heart failure hospitalization patients aged 65 years or older. Heart Vessels 35, 360–366 (2020). https://doi.org/10.1007/s00380-019-01490-2

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  • DOI: https://doi.org/10.1007/s00380-019-01490-2

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