Abstract 17251: Predictors of Functional Decline One Year Post-Myocardial Infarction in Older Adults
Background: Declines in activities of daily living (ADLs) occur in a subset of older adults after hospitalization for acute myocardial infarction (AMI), and can result in loss of independence and impaired quality of life. Predictors of ADL decline after AMI in this population have been incompletely defined.
Methods: We studied 540 older adults (≥65 years) with AMI enrolled in the TRIUMPH registry who completed ADL (mobility, self care, performing usual activities) questions at baseline and 1 year. Patients with severe baseline impairment (maximum impairment in ≥2 ADL's) were excluded. A decline in physical functioning (worsening of ≥ 1 ADL at 1 year) was considered clinically significant. Multivariable modified Poisson regression hierarchical models that accounted for within-site variability were used to identify independent predictors of ADL loss.
Results: At one year, 28% of older adults had new-onset disability (worsening of ADLs). Disability was predicted by age, female gender, non-Caucasian race, prior history of CAD, and GFR <30 ml/min (Figure). There was no significant effect of marital status, type of MI (STEMI vs. NSTEMI), revascularization, depression, or history of CVA, CHF, PVD, or diabetes.
Conclusion: Disability occurs within 1 year in over one quarter of older adults after AMI. It is associated with age, gender, race, prior history of CAD, and advanced renal insufficiency at the time of AMI. Identifying these variables may aid in selecting patients at-risk for subsequent functional decline. Further study is needed to determine if specific interventions can reduce disability in these patients.
- © 2010 by American Heart Association, Inc.