Association between instrumental activities of daily living frequency and clinical outcomes in older patients with cardiovascular disease
Association between instrumental activities of daily living frequency and clinical outcomes in older patients with cardiovascular disease
复制标题
日常生活频率工具性活动与老年心血管疾病患者临床结果的关系
DOI：
10.1093/eurjcn/zvac043
复制
发表时间：
2022
影响因子：
2.9
通讯作者：
Ako Junya
中科院分区：
文献类型：
--
作者：
Kariya Hidenori;Yamaoka-Tojo Minako;Hamazaki Nobuaki;Obara Shinichi;Kitasato Lisa;Matsunaga Atsuhiko;Ako Junya
目的日常生活活动障碍（ADL）是老年患者预后不良的独立预测因子。然而，辅助ADL （IADL）频率对老年心血管疾病（CVD）患者预后的影响尚不清楚。我们调查老年CVD患者IADL频率与全因死亡率和心血管事件再入院之间的关系。方法和结果共纳入638例≥65岁心血管疾病门诊患者。在研究开始时，采用问卷调查，包括法国活动指数（FAI）参数来确定IADL频率，作为基线观察。主要终点是全因死亡率，次要终点是心血管事件再入院。我们检查了IADL频率与各终点之间的关系。在评估的632例患者中，{中位年龄74.0[四分位间距（IQR） 70.0-78.0]岁；其中男性439例，死亡39例，心血管事件105例，中位随访时间为4.0年（IQR, 2.3-4.0）。在调整临床混杂因素后，FAI点全因死亡率和心血管事件的风险比分别为0.957[95%可信区间（CI）， 0.920-0.996]和0.973 （95% CI, 0.950-0.997）。结论老年CVD患者较高的IADL频率与较好的预后独立相关，提示应将器械活动的保留作为心血管康复的组成部分。
AimsImpairment in activities of daily living (ADL) is an independent predictor of poor prognosis in older patients. Nevertheless, the effects of instrumental ADL (IADL) frequency on prognosis in older patients with cardiovascular disease (CVD) are unclear. We investigate the associations between IADL frequency and all-cause mortality and hospital readmission due to cardiovascular events in older patients with CVD.Methods and resultsA total of 638 consecutive outpatients ≥65 years old with CVD were enrolled. A questionnaire, including Frenchay Activities Index (FAI) parameters, was used to determine IADL frequency at the start of the study as the baseline observation. The primary endpoint was all-cause mortality, and the secondary endpoint was readmission for cardiovascular events. We examined the relationship between IADL frequency and each endpoint. Among the 632 patients evaluated {median age 74.0 [interquartile range (IQR) 70.0–78.0] years; 439 males}, there were 39 deaths and 105 cardiovascular events during the median follow-up period of 4.0 (IQR, 2.3–4.0) years. After adjusting for clinical confounding factors, the hazard ratios for all-cause mortality and cardiovascular events in the FAI points were 0.957 [95% confidence interval (CI), 0.920–0.996] and 0.973 (95% CI, 0.950–0.997), respectively.ConclusionA higher IADL frequency was independently associated with better outcomes in older patients with CVD, suggesting that the preservation of instrumental activities should be focused on as the components of cardiovascular rehabilitation.