FUNCTIONAL ABILITIES OF ELDERLY CORONARY HEART-DISEASE PATIENTS

The impact of coronary heart disease (CHD) on elderly patients' functi onal abilities is of growing interest because of the increasing number of people that survive the disease. The aim of our study was, firstly , to describe functional abilities among elderly CHD patients and, sec ondly, to analyze the relationships between physical disability and th e severity of chest pain or dyspnea. The third aim was to assess wheth er there is an independent association between physical disability and CHD. The study was carried out at the health center of the municipali ty of Lieto, southwestern Finland. From a population of 1196 community -dwelling persons aged greater than or equal to 64 years, 89 men and 7 3 women with CHD (angina pectoris and/or a past myocardial infarction) were selected along with 178 male and 146 female sex- and age-matched controls without CHD. Physical functioning was assessed by means of i nterviewer-based questionnaires, compared between patients and control s and described in relation to the severity of chest pain and dyspnea among patients. The associations between dependence or difficulties in mobility, ADL (activities of daily living) and IADL (instrumental act ivities of daily living) and CHD, age, smoking, comorbidities, drug th erapy and clinical characteristics were assessed by logistic regressio n analyses. On items representing mobility and managing in IADL, patie nts reported more difficulties or dependence than controls. Among fema le patients, more severe chest pain was associated with poor managing in IADL and tended to be associated with poor mobility. More severe dy spnea was associated with poor mobility among both male and female pat ients, and with poor managing in IADL among male patients. Logistic re gression analyses Jailed to show that CHD was associated independently with physical disability among the elderly. However, physical disabil ity was associated with the use of cardiovascular drugs in the models among both genders, which probably indirectly indicated an association between physical disability and CHD. Several confounding factors, suc h as higher age, depression, cancer and the use of psychotropic drugs, contributed to the decline in Junctional abilities even among persons with CHD. In conclusion, elderly CHD patients have greater limitation s in their functional ability than matched controls, which may depend on the severity of the disease. Especially male patients' limitations in physical abilities may be influenced by the fact that men with CHD are move likely to be depressed. Although an independent association b etween physical disability and CHD was not found, the associations fou nd between physical disability and the use of cardiovascular drugs pro bably indicate a causal relationship between CHD and physical disabili ty. (Aging Clin. Exp. Res. 10: 127-136, 1998) (C)1998, Editrice Kurtis .