Impact of gait speed and instrumental activities of daily living on all-cause mortality in adults ≤65 years with heart failure

Alexander X. Lo*, John P. Donnelly, Gerald McGwin, Vera Bittner, Ali Ahmed, Cynthia J. Brown

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

63 Scopus citations

Abstract

Mobility and function are important predictors of survival. However, their combined impact on mortality in adults ≤65 years with heart failure (HF) is not well understood. This study examined the role of gait speed and instrumental activities of daily living (IADL) in all-cause mortality in a cohort of 1,119 community-dwelling Cardiovascular Health Study participants ≤65 years with incident HF. Data on HF and mortality were collected through annual examinations or contact during the 10-year follow-up period. Slower gait speed (<0.8 m/s vs ≤0.8 m/s) and IADL impairment (≤1 vs 0 areas of dependence) were determined from baseline and follow-up assessments. A total of 740 (66%) of the 1,119 participants died during the follow-up period. Multivariate Cox proportional hazards models showed that impairments in either gait speed (hazard ratio 1.37, 95% confidence interval 1.10 to 1.70; p = 0.004) or IADL (hazard ratio 1.56, 95% confidence interval 1.29-1.89; p <0.001), measured within 1 year before the diagnosis of incident HF, were independently associated with mortality, adjusting for sociodemographic and clinical characteristics. The combined presence of slower gait speed and IADL impairment was associated with a greater risk of mortality and suggested an additive relation between gait speed and IADL. In conclusion, gait speed and IADL are important risk factors for mortality in adults ≤65 years with HF, but the combined impairments of both gait speed and IADL can have an especially important impact on mortality.

Original languageEnglish (US)
Pages (from-to)797-801
Number of pages5
JournalAmerican Journal of Cardiology
Volume115
Issue number6
DOIs
StatePublished - Mar 15 2015

Funding

Dr. Brown is supported by a Veterans Administration Rehabilitation Scientific Merit Award (E7036 R) and by grants R01 AG16062 and 5UL1 RR025777 from the National Institutes of Health (NIH), Bethesda, Maryland. Dr. Ahmed is supported in part by the NIH through grants R01-HL085561 , R01-HL085561-S , and R01-HL097047 from the National Heart, Lung and Blood Institute, Bethesda, Maryland . Mr. Donnelly is supported by the grant T32 HS013852 from the Agency for Healthcare Research and Quality , Rockville, Maryland. Dr. Lo is supported by the University of Alabama at Birmingham Lister Hill Center for Health Policy , Birmigham, Alabama and the John A. Hartford Foundation , New York, NY. The funding agencies had no role in the design, methods, participant recruitment, data collections, analysis and preparation of the manuscript. The authors have no conflicts of interest to disclose.

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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