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Impact of gait speed and instrumental activities of daily living on all-cause mortality in adults ≥65 years with heart failure.
Monday,2015-08-03 13:24 America/Los_Angeles — zdrager
| Title | Impact of gait speed and instrumental activities of daily living on all-cause mortality in adults ≥65 years with heart failure. |
| Publication Type | Journal Article |
| Year of Publication | 2015 |
| Authors | Lo, AX, Donnelly, JP, McGwin, G, Bittner, V, Ahmed, A, Brown, CJ |
| Journal | Am J Cardiol |
| Volume | 115 |
| Issue | 6 |
| Pagination | 797-801 |
| Date Published | 2015 Mar 15 |
| ISSN | 1879-1913 |
| Keywords | Activities of Daily Living, Aged, Aged, 80 and over, Early Diagnosis, Female, Follow-Up Studies, Gait, Geriatric Assessment, Heart Failure, Humans, Male, Odds Ratio, Predictive Value of Tests, Proportional Hazards Models, Prospective Studies, Risk Assessment, Risk Factors, Sensitivity and Specificity, Survival Analysis, United States, Walking |
| Abstract | <p>Mobility and function are important predictors of survival. However, their combined impact on mortality in adults ≥65 years with heart failure (HF) is not well understood. This study examined the role of gait speed and instrumental activities of daily living (IADL) in all-cause mortality in a cohort of 1,119 community-dwelling Cardiovascular Health Study participants ≥65 years with incident HF. Data on HF and mortality were collected through annual examinations or contact during the 10-year follow-up period. Slower gait speed (<0.8 m/s vs ≥0.8 m/s) and IADL impairment (≥1 vs 0 areas of dependence) were determined from baseline and follow-up assessments. A total of 740 (66%) of the 1,119 participants died during the follow-up period. Multivariate Cox proportional hazards models showed that impairments in either gait speed (hazard ratio 1.37, 95% confidence interval 1.10 to 1.70; p = 0.004) or IADL (hazard ratio 1.56, 95% confidence interval 1.29-1.89; p <0.001), measured within 1 year before the diagnosis of incident HF, were independently associated with mortality, adjusting for sociodemographic and clinical characteristics. The combined presence of slower gait speed and IADL impairment was associated with a greater risk of mortality and suggested an additive relation between gait speed and IADL. In conclusion, gait speed and IADL are important risk factors for mortality in adults ≥65 years with HF, but the combined impairments of both gait speed and IADL can have an especially important impact on mortality.</p> |
| DOI | 10.1016/j.amjcard.2014.12.044 |
| Alternate Journal | Am. J. Cardiol. |
| PubMed ID | 25655868 |
| PubMed Central ID | PMC4474480 |
| Grant List | 5UL1 RR025777 / RR / NCRR NIH HHS / United States HS013852 / HS / AHRQ HHS / United States KL2 TR000166 / TR / NCATS NIH HHS / United States R01 AG16062 / AG / NIA NIH HHS / United States R01-HL085561 / HL / NHLBI NIH HHS / United States R01-HL085561-S / HL / NHLBI NIH HHS / United States R01-HL097047 / HL / NHLBI NIH HHS / United States T32 HS013852 / HS / AHRQ HHS / United States UL1 TR001417 / TR / NCATS NIH HHS / United States |