Yuki Nonaka, PT, MS, Ren Fujii, PT, PhD, Shinichiro Tanaka, MD, Kazuyuki Tabira, PT, PhD
Jpn J Compr Rehabil Sci 14: 78-83, 2023
Objective: Hasegawa's Dementia Scale-Revised
(HDS-R) is widely used as a screening test for
cognitive function in older adults. In this study, we
examined the effect of cognitive impairment (CI) at
admission on activities of daily living (ADL) at
discharge in older patients with heart failure (HF).
Methods: This retrospective observational study
included 394 patients hospitalized for acute
decompensated HF between April 2016 and December
2022. Data on age, sex, body mass index, length of
hospital stay, initiation of rehabilitation, New York
Heart Association (NYHA) class, Charlson
Comorbidity Index, medication, brain natriuretic
peptide levels, left ventricular ejection fraction, renal
function, hemoglobin level, serum albumin level,
Geriatric Nutritional Risk Index (GNRI), Barthel
Index (BI), and HDS-R score were analyzed using the
x2 test, unpaired t test, Mann-Whitney U test, and
multiple linear regression.
Results: Among 394 patients, 102 who met the final
inclusion criteria were included in the study. Based on
previous studies, patients were divided into a high BI
group (N = 44) and a low BI group (N = 58). Multiple
linear regression analysis showed that CI at admission
independently affected BI at discharge even after
adjusting for confounding effects of age, NYHA class,
GNRI, and BI at admission.
Conclusions: Our study showed that the presence or
absence of CI may influence ADL improvement in
rehabilitation interventions aimed at improving ADL
in older patients with HF.
Key words: heart failure, older adults, activities of daily living, cognitive impairment