Psychosocial factors as predictors of functional status at 1 year in patients with left ventricular dysfunction

Chronic heart failure patients often experience significant functional impa irments. A better understanding of the biopsychosocial correlates of functi onal status may lead to interventions that improve quality of life in this population. Social isolation, mood disturbance, low socioeconomic status, a nd non-White ethnicity were evaluated as possible correlates of impaired fu nctional status in 2,992 U.S. patients with left ventricular election fract ions (LVEFs) less than or equal to 35%. Even after controlling for ase and clinical characteristics, all of the psychosocial variables examined were s ignificant predictors of risk for experiencing severe limitations in interm ediate and social activities of daily living at 1 year, with adjusted odds ratios in the 1.5-2.0 range. The ability of psychosocial characteristics to predict future functional status was also independent of baseline function al status, comorbid medical conditions, and deterioration in heart failure signs and symptoms over the intervening year. These results suggest that ps ychosocial factors influence patient functional status even in the later ph ases of cardiac disease. (C) 2000 John Wiley & Sons, Inc.