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Nonaka Y, Fujii R, Tanaka S, Tabira K. Effect of cognitive impairment at admission on activities of daily living at discharge in older patients with heart failure. JAPANESE JOURNAL OF COMPREHENSIVE REHABILITATION SCIENCE 2024; 14:78-83. [PMID: 38196778 PMCID: PMC10776209 DOI: 10.11336/jjcrs.14.78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/06/2023] [Indexed: 01/11/2024]
Abstract
Nonaka Y, Fujii R, Tanaka S, Tabira K. Effect of cognitive impairment at admission on activities of daily living at discharge in older patients with heart failure. Jpn J Compr Rehabil Sci 2023; 14: 78‒83. Objective Hasegawa's Dementia Scale-Revised (HDS-R) is widely used as a screening test for cognitive function in older adults. In this study, we examined the effect of cognitive impairment (CI) at admission on activities of daily living (ADL) at discharge in older patients with heart failure (HF). Methods This retrospective observational study included 394 patients hospitalized for acute decompensated HF between April 2016 and December 2022. Data on age, sex, body mass index, length of hospital stay, initiation of rehabilitation, New York Heart Association (NYHA) class, Charlson Comorbidity Index, medication, brain natriuretic peptide levels, left ventricular ejection fraction, renal function, hemoglobin level, serum albumin level, Geriatric Nutritional Risk Index (GNRI), Barthel Index (BI), and HDS-R score were analyzed using the χ2 test, unpaired t test, Mann-Whitney U test, and multiple linear regression. Results Among 394 patients, 102 who met the final inclusion criteria were included in the study. Based on previous studies, patients were divided into a high BI group (N = 44) and a low BI group (N = 58). Multiple linear regression analysis showed that CI at admission independently affected BI at discharge even after adjusting for confounding effects of age, NYHA class, GNRI, and BI at admission. Conclusions Our study showed that the presence or absence of CI may influence ADL improvement in rehabilitation interventions aimed at improving ADL in older patients with HF.
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Affiliation(s)
- Yuki Nonaka
- Graduate School of Health Science, Kio University, Koryo, Nara, Japan
- Musashigaoka Clinical Research Center, Medical Corporation Tanakakai, Musashigaoka Hospital, Kumamoto, Kumamoto, Japan
| | - Ren Fujii
- Musashigaoka Clinical Research Center, Medical Corporation Tanakakai, Musashigaoka Hospital, Kumamoto, Kumamoto, Japan
| | - Shinichiro Tanaka
- Musashigaoka Clinical Research Center, Medical Corporation Tanakakai, Musashigaoka Hospital, Kumamoto, Kumamoto, Japan
| | - Kazuyuki Tabira
- Graduate School of Health Science, Kio University, Koryo, Nara, Japan
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Fujimoto Y, Maeda D, Kagiyama N, Sunayama T, Dotare T, Jujo K, Saito K, Kamiya K, Saito H, Ogasahara Y, Maekawa E, Konishi M, Kitai T, Iwata K, Wada H, Hiki M, Kasai T, Nagamatsu H, Ozawa T, Izawa K, Yamamoto S, Aizawa N, Wakaume K, Oka K, Momomura SI, Matsue Y. Prognostic implications of six-minute walking distance in patients with heart failure with preserved ejection fraction. Int J Cardiol 2023; 379:76-81. [PMID: 36914073 DOI: 10.1016/j.ijcard.2023.03.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/19/2023] [Accepted: 03/07/2023] [Indexed: 03/15/2023]
Abstract
BACKGROUND The incremental prognostic value of the six-minute walking test over conventional risk factors has not been evaluated in an adequate number of patients with heart failure with preserved ejection fraction (HFpEF). Therefore, we aimed to examine its prognostic significance using data from the FRAGILE-HF study. METHODS AND RESULTS A total of 513 older patients who were hospitalized for worsening heart failure were examined. Patients were classified according to the tertiles of six-minute walking distance (6MWD): T1 (<166 m), T2 (166-285 m), and T3 (≥285 m). During the 2-year follow-up period after discharge, 90 all-cause deaths occurred. Kaplan-Meier curves showed that the T1 group had significantly higher event rates than the other groups (log-rank p = 0.007). Cox proportional hazard analysis revealed that the T1 group was independently associated with lower survival, even after adjusting for conventional risk factors (T3: hazard ratio 1.79, 95% confidence interval 1.02-3.14, p = 0.042). The addition of the 6MWD to the conventional prognostic model showed a statistically significant incremental prognostic value (net reclassification improvement 0.27, 95% confidence interval 0.04-0.49; p = 0.019). CONCLUSIONS The 6MWD is associated with survival in patients with HFpEF and has an incremental prognostic value over conventional well-validated risk factors.
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Affiliation(s)
- Yudai Fujimoto
- Department of Cardiovascular Medicine, Saitama Medical Centre, Jichi Medical University, Saitama, Japan
| | - Daichi Maeda
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Nobuyuki Kagiyama
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Cardiology, The Sakakibara Heart Institute of Okayama, Okayama, Japan; Department of Digital Health and Telemedicine R&D, Juntendo University, Tokyo, Japan
| | - Tsutomu Sunayama
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Taishi Dotare
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kentaro Jujo
- Department of Cardiology, Nishiarai Heart Centre Hospital, Tokyo, Japan
| | - Kazuya Saito
- Department of Rehabilitation, The Sakakibara Heart Institute of Okayama, Okayama, Japan
| | - Kentaro Kamiya
- Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan
| | - Hiroshi Saito
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Rehabilitation, Kameda Medical Centre, Kamogawa, Japan
| | - Yuki Ogasahara
- Department of Nursing, The Sakakibara Heart Institute of Okayama, Okayama, Japan
| | - Emi Maekawa
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Masaaki Konishi
- Division of Cardiology, Yokohama City University Medical Centre, Yokohama, Japan
| | - Takeshi Kitai
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan; Department of Rehabilitation, Kobe City Medical Centre General Hospital, Kobe, Japan
| | - Kentaro Iwata
- Department of Rehabilitation, Kobe City Medical Centre General Hospital, Kobe, Japan
| | - Hiroshi Wada
- Department of Cardiovascular Medicine, Saitama Medical Centre, Jichi Medical University, Saitama, Japan
| | - Masaru Hiki
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takatoshi Kasai
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hirofumi Nagamatsu
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Tetsuya Ozawa
- Department of Rehabilitation, Odawara Municipal Hospital, Odawara, Japan
| | - Katsuya Izawa
- Department of Rehabilitation, Matsui Heart Clinic, Japan
| | - Shuhei Yamamoto
- Department of Rehabilitation, Shinshu University Hospital, Matsumoto, Japan
| | - Naoki Aizawa
- Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus, Okinawa, Japan
| | - Kazuki Wakaume
- Rehabilitation Centre, Kitasato University Medical Centre, Tokyo, Japan
| | - Kazuhiro Oka
- Department of Rehabilitation, Saitama Citizens Medical Centre, Saitama, Japan
| | | | - Yuya Matsue
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
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