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Is heart failure associated with disability ?

Is heart failure associated with disability ?. European Academy for Medicine of Ageing , Martigny , January 24th 2013 Marius Myrstad. Outline of the presentation. Short review of epidemiological research Underlying mechanisms for disability Prevention of disability

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Is heart failure associated with disability ?

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  1. Is heartfailureassociatedwithdisability? European Academyfor MedicineofAgeing, Martigny, January 24th 2013 Marius Myrstad

  2. Outlineofthepresentation • Short reviewofepidemiologicalresearch • Underlying mechanisms for disability • Preventionofdisability • Take-homemessages

  3. PrevalenceofHeartFailure (HF) • 80 % of HF patients are 65 years or older • 25 % of HF patients are 80 years or older AHA HeartDisease and Stroke statistics 2006 • Wong C. Am J Med 2011 ;124 :136-43. • .

  4. Prevalenceofdisability in HF • 54% with ≥ 1 basic ADL disability • Mobility disability (42%) most common limitation • 57 % withmobilitydisability • 11 % anyother ADL limitation • Proportionwithdisability stable over 20 years Gure TR. J Gen Intern Med 2007.:23(1):70-76. • Wong C. Am J Med 2011 ;124 :136-43. • . • .

  5. HF is associatedwithdisability Table: Crude and adjustedassociationof ADL and I-ADL limitations, by Heartdiseasecategory Gure TR. J Gen Intern Med 2007.:23(1):70-76.

  6. Major predictors for disability in HF • Impairedgait speed • Depressive symptoms • Cognitiveimpairment Chaudry S. J Card Fail2011;17(9) :764-70..

  7. Mechanisms for disability in HF • Mobilitydisability • Muscleweakness Loncar G. Int J Cardiol2013;162(2) :77-85. • Reducedlungcapacity • Reducedperipheroxygenconsumption • Anemia • Fatigue

  8. Mechanisms for disability in HF • Cognitiveimpairment • Lowcardiac output • Hypotension • Impaired cerebral vesselreactivity • Microembolism Dardiotis E. Cardiol Res Pract 2012;2012:595821 (Epub).

  9. Othercontributingfactors

  10. Preventionofdisability in HF • Optimal heartfailuretreatment • Angiotensin-convertingenzyme inhibitors Zuccalà G. EurHeart J 2005;26(3):226-233. Pedone C. J Gerontol A BiolSci Med 2004;59(7):716-721 • Treatmentof co-morbid conditions • Treatmentofdepression Vaccarino V. J Am Coll Cardiol 2001;38:199-205.

  11. Preventionofdisability in HF • Regular physical exercise - prevents age-related decline in cardiac function Molmen HE. Scand Cardiovasc Journ 2012;46(3):163-71 - increases muscle strength in HF patients Savage P. Med Sci Sports Exerc 2011;43(8):1379-1386. - is safe in patiets with heartdisease RognmoØ. Circulation 2012;126(12):1436-40.

  12. Take-homemessages • HF is independentlyassociatedwithdisability • Disabilitycan be prevented • HF patientsshouldpracticeregularphysicalexercise

  13. Thanks for yourattention!

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