Activities of daily living for old persons in primary health care with chronic heart failure

Abstract

Chronic heart failure (CHF) is a common condition among Europe's aging population. Findings indicate that CHF patients must make significant changes in many aspects of daily life. Previous studies of older primary health-care participants and their activities of daily living (ADL)-ability are rare. The aim of this study was to describe ADL-ability in older people with CHF syndrome. The factors considered were dependence on others, perceived strain, quality of performance, and the association between The New York Heart Association classification (NYHA) and ADL-ability. The participants, recruited from a primary health-care centre, had symptoms indicating CHF and were diagnosed by a cardiologist. Forty persons over 65 years (mean age 81), participated in the study and self-reported co-morbidity was frequent. The Assessment of Motor and Process Skills (AMPS) and the Staircase of ADL were used to describe ADL-ability. Most participants were independent with respect to personal activities of daily living (PADL), and 75% were dependent in one or more instrumental activities of daily living (IADL), usually shopping. Most participants perceived strain, and only three could perform all ADL without strain. Age had a significant impact on ADL performance (motor measures: OR 7.11, CI 1.19-42.32, p = 0.031 and process measures: OR 8.49, CI 1.86-38.79, p = 0.006). However, participants showed lower ADL motor and process ability in AMPS compared with well persons of the same age. Participants in NYHA III/IV (adjusted for age), had significantly increased effort (under motor cut-off) when performing ADL-tasks (OR: 15.5, CI 2.40-100.1, p = 0.004) compared to those in NYHA I/II. Older persons in primary health care with CHF exhibit a high amount of dependence, perceived strain and increased effort during performance of ADL. There is an association between NYHA class III/IV and a decreased ADL-ability (AMPS motor ability) even when adjusted for age.

Reduced functionality in everyday activities of patients with self-reported heart failure hospitalization — Population-based study results

“…Both aging and HF contribute to the reduction of physical capacity and thereby to functional limitations, often aggravated by coexisting diseases. Similarly as it has been demonstrated in our study, also other authors showed a higher rate of dependency in HF patients [14,15,27]. In contrast to our results, which demonstrated 22% of subjects with ADL impairment and less than 5% ADL-disabled, other investigators showed higher rates of self-care problems, reported by 37% to 59% of HF patients, depending on a participant's age [15,17,28].…”

Activities of daily living for patients with chronic heart failure: a partnership care model evaluation

“…This can be attributed to the severity of the condition of subjects in their study (III and IV), which was more serious than those in the present study (II to IV). The findings of the present study were similar to those reported by Norberg et al (Norberg, et al 2008). Their research was conducted in Sweden for subjects of similar average age with a disease classification of I to V. They reported that 25% of Persons with CHF were completely independent and that most patients were partially independent or dependent.…”

“…Treatment of CHF is more complicated in seniors (Norberg, et al 2008). Although pharmacological therapy has improved the outcome for the disease markedly in the last 10-15 years, management programs are needed to optimize care (Ekman, et al 2012).…”

“…Most patients have difficulty in activities of daily living (ADL); their quality of life (Barents, et al 2011;Bowling, et al 2012;Gallanagh, et al 2011;Spruit et al 2011)and ability to carry out ADLs is limited (Norberg, et al 2008).…”

The prevalence of cardiac dysfunction and the correlation with poor functioning among the very elderly

“…Previous research has shown a relationship between cardiac dysfunction and limited physical capacity, depression and cognitive impairment [4][5][6][7][8]. However, little is known about this relationship in the very elderly.…”