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Degree of Disability and Patterns of Caregiving among Older Americans with Congestive Heart Failure

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Abstract

OBJECTIVES

Although congestive heart failure (CHF) is a common condition, the extent of disability and caregiving needs for those with CHF are unclear. We sought to determine: (1) prevalence of physical disability and geriatric conditions, (2) whether CHF is independently associated with disability, (3) rates of nursing home admission, and (4) formal and informal in-home care received in the older CHF population.

METHODS

We used cross-sectional data from the 2000 wave of the Health and Retirement Study. We compared outcomes among three categories of older adults: (1) no coronary heart disease (CHD), (2) CHD, without CHF, and (3) CHF. Compared to those without CHF, respondents reporting CHF were more likely to be disabled (P < 0.001) and to have geriatric conditions (P < 0.001). Respondents reporting CHF were more likely to have been admitted to a nursing home (P < 0.05). CHF respondents were more functionally impaired than respondents without CHF.

RESULTS

The adjusted average weekly informal care hours for respondents reporting CHF was higher than for those reporting CHD but without CHF and those reporting no CHD (6.7 vs 4.1 vs 5.1, respectively; P < 0.05). Average weekly formal caregiving hours also differed among the three groups (1.3 CHF vs 0.9 CHD without CHF vs 0.7 no CHD; P > 0.05).

CONCLUSIONS

CHF imposes a significant burden on patients, families, and the long-term care system. Older adults with CHF have higher rates of disability, geriatric conditions, and nursing home admission.

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Acknowledgments

The National Institute on Aging (NIA) provided funding for the HRS (U01 AG09740), data from which were used for this analysis. The HRS is performed at the Institute for Social Research at the University of Michigan. Dr. Langa was supported by grants from the NIA (K08 AG19180) and R01 AG027010 and a Paul Beeson Physician Faculty Scholars in Aging Research award. Dr. Gure was supported by the VA Center for Practice Management and Outcomes Research and the RWJ Clinical Scholars Program. Dr. Blaum was supported by an NIA grant (R01 AG021493) and the Ann Arbor Veterans Affairs Geriatric Research, Education and Clinical Center (GRECC). The authors would like to thank Drs. Eve Kerr, Laurence McMahon, and Megumi Okumura for their thoughtful review of earlier versions of this manuscript.

Financial disclosures

No financial disclosures were declared.

Authors’ contribution

Dr. Gure was involved in developing the study concept, design, analysis and interpretation of the data, and the preparation of the manuscript. Mr. Kabeto was involved in developing the study design, analysis and interpretation of the data, and the preparation of the manuscript. Dr. Blaum was involved in developing the study concept, design, analysis and interpretation of the data, and preparation of the manuscript. Dr. Langa was involved in developing the study concept, design, analysis and interpretation of the data, and preparation of the manuscript.

Sponsor’s role

No sponsor’s role was declared.

Conflict of interest

None disclosed.

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Authors and Affiliations

  1. Department of Veterans Affairs, VA Center for Practice Management & Outcomes Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA

    Tanya Ruff Gure MD & Kenneth M. Langa MD, PhD

  2. Department of Veterans Affairs, Geriatric Research, Education and Clinical Center (GRECC), Ann Arbor, MI, USA

    Caroline S. Blaum MD, MS

  3. RWJ Clinical Scholars Program, University of Michigan, Ann Arbor, MI, USA

    Tanya Ruff Gure MD

  4. Division of Geriatric Medicine, University of Michigan, Ann Arbor, MI, USA

    Tanya Ruff Gure MD & Caroline S. Blaum MD, MS

  5. Division of General Internal Medicine, University of Michigan, Ann Arbor, MI, USA

    Tanya Ruff Gure MD, Mohammed U. Kabeto MS & Kenneth M. Langa MD, PhD

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  1. Tanya Ruff Gure MD
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  2. Mohammed U. Kabeto MS
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  3. Caroline S. Blaum MD, MS
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  4. Kenneth M. Langa MD, PhD
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Correspondence to Tanya Ruff Gure MD.

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Gure, T.R., Kabeto, M.U., Blaum, C.S. et al. Degree of Disability and Patterns of Caregiving among Older Americans with Congestive Heart Failure. J GEN INTERN MED 23, 70–76 (2008). https://doi.org/10.1007/s11606-007-0456-1

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  • DOI: https://doi.org/10.1007/s11606-007-0456-1

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