MedicalResearch.com Interview with:
Shannon M. Dunlay, M.D. M.S.
Advanced Heart Failure and Cardiac Transplantation
Assistant Professor of Medicine and Health Care Policy and Research
Mayo Clinic Rochester
MedicalResearch: What is the background for this study?
Dr. Dunlay: Loss of mobility and independence can complicate the care of patients with chronic conditions such as heart failure, and can degrade their quality of life. However, we have a very poor understanding of the burden of disability in patients with heart failure and how it impacts outcomes. What are the main findings? In this study, patients with heart failure were asked whether they had difficulty performing activities of daily living (ADLs)—these include normal activities that most people do in daily life such as eating, bathing, dressing, and walking. Most patients with heart failure reported having difficulty with at least one ADL at the beginning of the study, and over 1/3 had moderate or severe difficulty with activities of daily living. Patients who were older, female and had other chronic conditions such as diabetes, dementia and obesity had more difficulty with activities of daily living. Patients that reported more difficulty with ADLs (worse mobility) were more likely to die and be hospitalized over time. Some patients had a decline in function over time, and this was also predictive of worse outcomes.
MedicalResearch: What should clinicians and patients take away from your report?
1) Difficulty with activities of daily living is easy to assess in a routine clinical visit, and can provide important information to help guide patient-clinician conversations about goals of care and
2) Patients who report difficulties with activities of daily living may be candidates for a more thorough assessment and physical therapy evaluation to improve or halt the decline in mobility.
MedicalResearch: What recommendations do you have for future research as a result of this study?
Dr. Dunlay: We need additional studies to better understand whether intervening in early stages of disability can result in less functional decline and improvement in quality of life in patients with chronic conditions such as heart failure.