Abstract 2505: Predictors of Disability in Activity of Daily Living among Persons with Heart Failure
Heart failure (HF) contributes to disability in activities of daily living and results in significant health care expenditures and the involvement of social networks to maintain community living. This is the first study to use the Nagi Model of disability to identify factors related to disability with HF patients. The Model proposes a sequential effect of pathology, functional impairment, and limitation on disability and has been validated in community dwelling elders. The study included 48 men and 54 women over 18 years of age (mean 59.6 years) diagnosed with HF (NYHA Class II-IV) and were recruited at a specialty outpatient HF clinic. More than 50% of patients were African American and were categorized as a NYHA II. Functional limitations were measured by the 6-Minute Walk (6-MW) and the Timed Get Up & Go(TGUG). Table The majority of patients reported that they modified ‘minimally’ to ‘greatly’ their activities from the Function subscale of the Late Life Function & Disability Instrument (LLFDI) and instrumental activities of daily living (IADLs). (See Table). In multiple regressions, 50% of the variance in LLFDI-function and 48% of the variance in IADLs were explained after controlling for age, gender, depression, and social support. The shorter time to complete the 6-MW was only significantly related to greater disability in LLFDI-function and IADLs (β= −.54 and−.53, respectively). Interestingly, among the covariates, greater depression predicted greater modifications in LLFDI-Function (β= .35) and in IADLs (β= .30). Clinical implications include the incorporation of assessment of the 6-MW and depression. This information will help identify patients at risk for disability. In addition, interventions targeted to improve endurance and reduce depression may prevent or reduce disability in HF patients.