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

  • Masashi Yamashita
  • Kentaro KamiyaEmail author
  • Nobuaki Hamazaki
  • Ryota Matsuzawa
  • Kohei Nozaki
  • Takafumi Ichikawa
  • Takeshi Nakamura
  • Emi Maekawa
  • Minako Yamaoka-Tojo
  • Atsuhiko Matsunaga
  • Junya Ako
Original Article
  • 35 Downloads

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.

Keywords

All-cause mortality First admitted Heart failure patients Instrumental activities of daily living 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

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Copyright information

© Springer Japan KK, part of Springer Nature 2019

Authors and Affiliations

  • Masashi Yamashita
    • 1
  • Kentaro Kamiya
    • 1
    • 2
    Email author
  • Nobuaki Hamazaki
    • 3
  • Ryota Matsuzawa
    • 4
  • Kohei Nozaki
    • 3
  • Takafumi Ichikawa
    • 3
  • Takeshi Nakamura
    • 1
  • Emi Maekawa
    • 5
  • Minako Yamaoka-Tojo
    • 2
  • Atsuhiko Matsunaga
    • 1
    • 2
  • Junya Ako
    • 5
  1. 1.Department of Rehabilitation SciencesKitasato University Graduate School of Medical SciencesSagamiharaJapan
  2. 2.Department of Rehabilitation, School of Allied Health SciencesKitasato UniversitySagamiharaJapan
  3. 3.Department of RehabilitationKitasato University HospitalSagamiharaJapan
  4. 4.Department of Physical Therapy, School of RehabilitationHyogo University of Health SciencesKobeJapan
  5. 5.Department of Cardiovascular MedicineKitasato University School of MedicineSagamiharaJapan

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