Key result
Diabetes and valvular disease linked to ~67% lower odds of maintaining 12-month ADL in HF.
Why the study?
Impaired activities of daily living significantly affect prognosis and quality of life in heart failure, but the key clinical and self-management predictors of activities of daily living 12 months post-discharge needed identification.
Cohort (n=162)
Diabetes, valvular heart disease, and poor symptom management are key predictors of long-term ADL impairment in heart failure patients, highlighting targets for intervention to improve functional outcomes.
Impaired activities of daily living (ADL) significantly affect the prognosis and quality of life in patients with heart failure (HF). We aimed to identify the key clinical and self-management predictors of ADL 12 months after hospital discharge. This prospective cohort study enrolled 162 hospitalized patients with HF stratified into low-ADL (ADL < 100, n = 66) and high-ADL (ADL = 100, n = 96) groups based on 12 months of follow-up. The baseline characteristics, comorbidities, biomarkers (B-type natriuretic peptide [BNP]), and self-management domains (psychological, drug, dietary, and symptom management) were compared. Logistic regression was used to identify ADL predictors. Subgroup analyses of left ventricular ejection fraction (LVEF) were performed. The low-ADL group had significantly higher rates of valvular heart disease (VHD; 12% vs 3%, P = .025) and diabetes mellitus (29% vs 16%, P = .043), elevated BNP levels (median 474.9 vs 398.0 pg/mL, P = .039), and poorer self-management scores ( P < .05). Multivariable analysis confirmed that diabetes (adjusted odds ratio [aOR], 0.33; 95% confidence interval [CI], 0.14–0.80; P = .014) and VHD (aOR, 0.19; 95% CI, 0.04–0.80; P = .024) were independent negative predictors. Symptom management was the strongest positive predictor (crude OR, 12.71; 95% CI, 3.38–47.74; P < .001; aOR, 6.26; 95% CI, 1.44–27.19; P = .014). Stratification by LVEF revealed that diabetes mellitus disproportionately impaired ADL in patients with heart failure with reduced ejection fraction (HFrEF; defined as LVEF < 50%; OR, 0.21; 95% CI, 0.06–0.82). The factors influencing ADL scores changed over the 12-month follow-up period. Diabetes, VHD, and poor symptom management were key predictors of long-term ADL impairment in patients with HF. Targeted interventions addressing symptom management and comorbidity control, particularly in patients with HFrEF, may improve functional outcomes.
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Ning et al. (2026) conducted a cohort in heart failure (n=162). Diabetes mellitus vs. Absence of diabetes mellitus was evaluated on Activities of daily living (ADL) at 12 months (aOR 0.33, 95% CI 0.14-0.80, p=.014). Diabetes mellitus (aOR 0.33; 95% CI 0.14-0.80) and valvular heart disease were independent negative predictors of activities of daily living at 12 months in patients with heart failure.
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