Differences in nutritional status and activities of daily living and mobility in elderly hospitalized patients with heart failure

Abstract

Aims This study aims to examine the effect of differences in nutritional status on activities of daily living (ADL) and mobility recovery of hospitalized elderly patients with heart failure (HF). Methods and results From among 377 consecutive HF patients who underwent rehabilitation at one acute‐care hospital from January 2013 to August 2015, those who were aged ≥ 65 years could walk with assistance before hospitalization and who were hospitalized for the first time were included in this retrospective cohort study. Exclusion criteria were pacemaker surgery during hospitalization, change to other departments, death during hospitalization, and unmeasured ADL. We investigated patient characteristics, basic attributes, Geriatric Nutritional Risk Index (GNRI), ADL [motor Functional Independence Measure (motor FIM)], and Rivermead Mobility Index (RMI). Of these 377 patients, 96 met the inclusion criteria and were divided into the low GNRI group ( n = 38, 83.5 ± 8.3 years, 44.7% male) and high GNRI group ( n = 58, 81.0 ± 6.6 years, 55.2%). Patient characteristics and the difference between motor ADL and motility recovery and nutrition data were analysed with unpaired t ‐test, χ 2 test, and two‐way analysis of covariance. In comparing the two groups, the following parameters were significantly lower in the low GNRI group than in the high GNRI group: body mass index (18.7 ± 2.2 vs. 23.2 ± 2.7 kg/m 2 , P < 0.01), albumin (3.4 ± 0.4 vs. 3.8 ± 0.4 g/dL, P < 0.01), diabetes mellitus ratio (21.1% vs. 50.0%, P < 0.01), RMI at discharge (6.8 ± 2.6 vs. 8.2 ± 2.2, P = 0.01), and motor FIM at discharge (67.2 ± 19.5 vs. 75.6 ± 13.3, P = 0.02). RMI showed a significant group and term main effect and interaction effect ( P < 0.05). Motor FIM showed a significant main effect of group and term ( P < 0.05), and no significant interaction effect. Conclusions Low nutritional status in hospitalized elderly HF patients affected their recovery of mobility but did not appear to affect the recovery of ADL.

Relationship among Activities of Daily Living, Nutritional Status, and 90 Day Readmission in Elderly Patients with Heart Failure

“…From previous studies, ADL and nutrition of elderly HF patients are known independent factors of readmission [9,14]. However, the relation between ADL and nutrition has been only partially reported [36], and its causal relationship is unknown. In contrast, some studies reported that ADL in hospitalized HF patients with poor nutritional status is reduced, perhaps due to a decrease in muscle mass and function [37,38].…”

Effectiveness and safety of rehabilitation on minimal change nephrotic syndrome in remission for elderly patients with low activity of daily living: a case report

“…The 3.0-kg improvement in maximal grip strength, in our case, was clinically meaningful because a 1-kg improvement in grip strength is associated with a 5% improvement in all-cause mortality [22]. The reason for the improvement of physical function in this patient was the high rate of rehabilitation because there were few instances of refusal or difficulty in rehabilitation, and her nutritional status improved because the anorexia improved and the amount of food consumed increased [23] (Fig. 2).…”

Muscle Wasting and Sarcopenia in Heart Failure—The Current State of Science

“…Contributing elements to the deleterious changes in body composition in patients with cardiac cachexia are anorexia, malnutrition, intestinal congestion [144], and an inflammatory cytokine storm, which have also been described as common complications in severe HF [145,146]. High serum levels of adiponectin [147], a protein involved in the cellular energy control of several tissues, have been found in HF patients with cachexia, unrelated to their body mass index [148].…”