DETERMINANTS OF DISABILITY IN OLDER CORONARY PATIENTS

老年冠心病患者的致残率极高。 共有40名患者(31名男性， 9名女性)，年龄65-88岁(平均72±6岁)，患有慢性冠状动脉 疾病(CAD)。所有患者都是社区居民，至少6个月 自诊断为急性心肌梗死(N=15)以来，冠状动脉 13例行搭桥手术，12例行慢性稳定型心绞痛。 残疾的测量使用的身体功能量表的医学 结果研究问卷(MOS SF3)，评分0-100，适用于家庭 布景。数据收集包括临床问卷、锻炼 超声心动图负荷试验与有氧峰值的测定 体能，双X-射线吸光度分析身体成分， 握力和腿部伸展力量，抑郁评分，营养 调查问卷和SF36生活质量调查问卷。最好的 身体机能评分的预测因子是最大有氧能力和 抑郁评分。握力和腿部伸展力量也很重要。 单变量预测因素和脂肪质量百分比一样。左的度量 安静、运动和身体状态下的室壁收缩和舒缩功能 成分测量不能预测身体功能得分。在……里面 相比之下，峰值有氧能力(峰值VO2)的最佳预测因子为 运动心输出量、运动射血分数和瘦体重。 老年女性的身体机能得分低于老年男性。 这些数据表明，旨在提高有氧能力的干预措施 和力量，在减少精神抑郁时，会改善身体状况 老年冠心病患者的功能。

Disability rates are extremely high in older coronary patients. Determinants of disability were studied in a total of 40 patients (31 men, 9 women), age 65-88 years (mean 72 + 6 years) with chronic coronary artery disease (CAD). All patients were community dwelling and at least 6 months since a diagnosis of acute myocardial infarction (N=15), coronary artery bypass surgery (N=13) or had chronic stable angina pectoris (N=12). Disability was measured using the physical function scale of the Medical Outcomes Study questionnaire (MOS SF3) scaled 0-100, applied to the home setting. Data collection included clinical questionnaires, exercise stress testing with echocardiography and measurement of peak aerobic capacity, body composition analysis by dual x-ray absorptiometry, handgrip and leg-extensor strength, a depression score, a nutrition questionnaire and the SF36 quality of life questionnaire. The best predictors of physcial function score are peak aerobic capacity and the depression score. Handgrip and leg extensor strength were also significant univariate predictors as was percent fat mass. Measures of left ventricular systolic and diastolic function at rest and exercise and body composition measures did not predict physical function score. In contrast, the best predictors of peak aerobic capacity (Peak VO2) were exercise cardiac output, exercise ejection fraction and lean body mass. Physical function scores are lower in older women than in older men. These data suggest that interventions aimed at increasing aerobic capacity and strength, and at decreasing mental depression would improve physical functioning in older CAD patients.