What is the clinical evidence from this study?

Study design: Observational. Population: Heart Failure (n=63). Intervention: Moderate-intensity exercise vs. Non-exercisers. Primary outcome: Functional decline defined as a decrease of ≥1 point in SPPB score over 6 months (OR 5.98, 95% CI 1.41–35.44, p=0.014).

What question did this study set out to answer?

To investigate how the absence of exercise habits after discharge affects functional decline in older heart failure patients.

January 10, 2026Circulation Reports0 citationsOpen Access

Absence of Post-Discharge Exercise Habits Predicts Functional Decline in Older Heart Failure Patients　― A 6-Month Follow-up Study ―

KIKatsuya Izawa TITatsuro Inoue TNTakashi Naruke

Key Result

Absence of post-discharge exercise habits significantly increased the risk of functional decline in older heart failure patients.

Key Points

To investigate how the absence of exercise habits after discharge affects functional decline in older heart failure patients.
Conducted a 6-month follow-up with older heart failure patients
Assessed exercise habits post-discharge
Evaluated functional decline using standardized measures
Patients lacking exercise habits showed significant functional decline over the follow-up period
There was an increase in reported difficulties in daily activities among those not engaging in exercise

Study Design

Type

Observational (n=63)

Multicenter

Structured PICO

Does the absence of post-discharge exercise habits predict functional decline in older patients with heart failure?

Population

63 older patients hospitalized due to heart failure (mean age 79.7, 46.0% male), discharged home, able to walk without assistance, and surviving without unscheduled readmission for 6 months post-discharge. Single-center in Japan.

Intervention

Self-reported post-discharge exercise habits (engaging in moderate-intensity exercise for at least 30 min, ≥4 times per week, at 6 months post-discharge)

Comparator

Absence of post-discharge exercise habits (non-exercisers)

Outcome

Functional decline, defined as a decrease of ≥1 point in Short Physical Performance Battery (SPPB) score over 6 monthssurrogate

The absence of post-discharge exercise habits significantly increases the risk of functional decline in older patients with heart failure, highlighting the importance of sustained physical activity.

Main Result

Effect estimate: OR 5.98 (95% CI 1.41–35.44)

Absolute Event Rate: 2.8% vs 29.6%

p-value: p=0.014

Limitations

Single-center design limits generalizability.
Exercise habits were self-reported, potentially introducing recall bias.
Specific physical activity metrics were not assessed objectively.
Definition of regular exercise differs from current guidelines.
Relatively small sample size with wide 95% CIs.

Abstract

Background: This study aimed to examine the impact of post-discharge exercise habits on functional decline in older patients with heart failure (HF). Methods and Results: Sixty-three older patients hospitalized due to HF (mean age 79.7±7.1 years; 46.0% male) were enrolled. Patients were categorized as exercisers if they reported engaging in moderate-intensity exercise for at least 30 min, ≥4 times per week, at 6 months post-discharge. Physical function was measured using the Short Physical Performance Battery (SPPB) at discharge and 6 months thereafter. Functional decline, the primary outcome, was defined as a decrease of ≥1 point in SPPB score over 6 months. The underlying etiologies of HF were arrhythmia (n=37; 58.7%), valvular heart disease (n=37; 58.7%), and ischemic heart disease (n=27; 42.9%). Patients were grouped into exercisers (n=36; 57.1%) and non-exercisers (n=27; 42.9%). Non-exercisers showed a significantly higher incidence of functional decline compared with exercisers (29.6% n=8 vs. 2.8% n=1; P=0.003). Firth's penalized likelihood logistic regression revealed that non-exercising status independently predicted functional decline (odds ratio 5.98; 95% confidence interval 1.41-35.44; P=0.014) after adjusting for relevant confounders. Conclusions: Absence of post-discharge exercise habits significantly increased the risk of functional decline in older HF patients.

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