Abstract 1436: Sensory Loss Associated With Aging May Impair the Ability to Accurately Detect Heart Failure Symptoms
Aging is associated with sensory losses but little is known about how aging affects detection of afferent internal physical stimuli. The purpose was to assess the ability of heart failure (HF) patients to detect shortness of breath (SOB).
Design: Adults (N=29) with chronic HF ≥6 months duration, NYHA class II/III were enrolled into a mixed methods study. Those with a disorder known to cause systemic weakness or fatigue, recent MI or angina were excluded. The sample (72.4% male, 35 to 94 years) was divided at the median to compare older (≥73 years, N=16) vs. younger (<73 years, N=13) patients in symptom detection ability. Groups did not differ in comorbid conditions, oxygen saturation, BNP, or vital signs before testing.
Methods: Shortness of breath was stimulated using a 6-minute walk test (6MWT). Subjects and trained registered nurse research assistants (RNRA) rated SOB immediately after exertion using a 10-point Borg rating scale (RNRA interrater reliability .91). Congruence in subject and RNRA ratings was used to judge ability to accurately detect SOB, comparing older and younger patients. In-depth interviews were used to understand how patients interpreted symptoms.
Findings: Integrated quantitative and qualitative data confirmed that older patients had more variability in the ability to detect SOB than younger patients (Figure⇓). Older patients were half as likely as younger ones to report SOB congruent with that of the RNRA immediately after 6MWT (30.8% vs. 62.5%).
Conclusions: These results support our theory of an age-related decline in ability to detect internal physical stimuli, which may be a cause of delay in seeking care in patients with HF.