Functional decline after congestive heart failure and acute myocardial infarction and the impact of psychological attributes. A prospective study

This article examines the influence of three pre-morbidly assessed psycholo gical attributes (i.e. neuroticism, mastery and self-efficacy expectancies) on functional decline after congestive heart failure (CHF; n = 134) and ac ute myocardial infarction (AMI; n = 79) in late middle-aged and older perso ns. Due to the prospective design of the study initial baseline levels of f unctional disability and number of chronic medical conditions could be adju sted, next to age, gender and the severity of either CHF or AMI. Functional disability was re-assessed 8 weeks after the diagnosis of either CHF or AM I. Significant unique contributions of self-efficacy expectancies were foun d for functional decline after CHF, while mastery significantly contributes to functional decline after AMI: those patients with higher levels of mast ery or self-efficacy expectancies showed less decline. In conclusion, pre-m orbidly assessed psychological attributes substantially influence functiona l decline after cardiac disease in late middle-aged and older persons, but the impact of specific attributes is somewhat different for CHF and AMI.