Why the study?
To determine limitations in activities of daily living and instrumental activities of daily living, and identify related factors in elderly persons with severe aortic stenosis.
In elderly patients with severe aortic stenosis, basic activities of daily living are generally well-preserved, but instrumental activities of daily living are often impaired and associated with physical frailty, heart failure, cerebrovascular disease, and cognitive decline.
ADL preserved in elderly severe AS; leaves open whether physical/cognitive factors drive iADL limits and merit targeted trials.
Purpose To determine the level of limitations in activities of daily living (ADL) and instrumental ADL, and identify related factors to instrumental ADL among elderly persons with severe aortic stenosis (AS).Materials and methods We prospectively enrolled 112 consecutive elderly persons (mean age, 84.6 ± 4.4 y) with severe AS. We assessed ADL and instrumental ADL using the Barthel index (BI) and the Frenchay activities index (FAI), respectively. Cardiac, physical, cognitive and kidney functions, nutritional status, medical histories, and comorbidities were assessed. A multiple logistic analysis was developed to explore related factors to the FAI.Results The medians (ranges) of BI and FAI were 100 (15–100) and 21 (0–38), respectively. The multiple logistic analysis revealed that a history of heart failure (sβ = −0.189), a history of cerebrovascular disease (sβ = −0.233), the short physical performance battery score ≤ 8 (sβ = −0.272), the mini-mental state examination score ≤ 23 (sβ = -0.168) were significantly related to the FAI (p < 0.05).Conclusions Physical frailty, a history of heart failure, cerebrovascular disease, and cognitive decline were independently related to declined instrumental ADL.IMPLICATIONS FOR REHABILIATIONActivities of daily living was well-preserved among elderly persons with severe aortic stenosis.Instrumental activities of daily living varied among patients with aortic stenosis and was sometimes impaired.Physical frailty, a history of heart failure, and a history of cerebrovascular disease were independently associated with instrumental activities of daily living in elderly persons with severe aortic stenosis.
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Fukui et al. (2019) studied this question.
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