Health-related quality of life in elderly patients hospitalized with chronic heart failure.

BACKGROUND: Chronic heart failure is a very common condition in the elderly, characterized not only by high mortality rates, but also by a strong impact on health-related quality of life (HRQOL). Previous studies of HRQOL in elderly heart failure subjects have included mostly outpatients, and little is known about determinants of HRQOL in hospitalized elderly population, especially in Serbia. In this study, we tried to identify factors that influence HRQOL in elderly patients hospitalized with chronic heart failure in Serbia. METHODS: The study population consisted of 136 patients aged 65 years or older hospitalized for chronic heart failure. HRQOL was assessed using the Minnesota Living with Heart Failure questionnaire. Predictors of HRQOL were identified by multiple linear regression analysis. RESULTS: Univariate analysis showed that patients with lower income, a longer history of chronic heart failure, and longer length of hospital stay, as well as those receiving aldosterone antagonists and digoxin, taking multiple medications, in a higher NYHA class, and showing signs of depression and cognitive impairment had significantly worse HRQOL. Presence of depressive symptoms (P<0.001), higher NYHA class (P=0.021), lower income (P=0.029), and longer duration of heart failure (P=0.049) were independent predictors of poor HRQOL. CONCLUSION: Depressive symptoms, higher NYHA class, lower income, and longer duration of chronic heart failure are independent predictors of poor HRQOL in elderly patients hospitalized with chronic heart failure in Serbia. Further, there is an association between multiple medication usage and poor HRQOL, as well as a negative impact of cognitive impairment on HRQOL. Hence, measures should be implemented to identify such patients, especially those with depressive symptoms, and appropriate interventions undertaken in order to improve their HRQOL.

[Evaluation of effect of therapy of somatic diseases and cognitive impairment in geriatric patients].

INTRODUCTION: Human aging is characterized by progressive decrease of the homeostatic reserves of every organ system with a possible impairment of cognitive functions. The study was aimed at examining and proving the correlations between cognitive failure and somatic diseases in patients belonging to geriatric population as well as at following the efficiency of treatment of somatic diseases by Mini mental examination test score. MATERIAL AND METHODS: A group of 100 geriatric patients did Mini mental examination test at the beginning of hospitalisation and after three weeks of treatment of different.somatic diseases. The patients underwent many examination tests-biochemical analyses of blood and urin, ultrasound examination, X-ray examination of lungs and heart, hormones of thyroid gland, concentrations of B12 vitamin, folan acid. RESULTS: The statistical study showed that there was a significant correlation between the recovery of somatic diseases and the score of cognitive functions of patients. MMSE score was significantly increased after three weeks of successful treatment of somatic diseases in hospital. CONCLUSION: The highest statistical significance in the difference of M'ISE score at the beginning and after three weeks of hospital treatment was found in the group of patients with successful results of the treatment of their somatic diseases such as cardiomyopathies and disorders of respiratory system, such as pneumonia. MMSE score did not increase in patients chronic disease with malignant diseases of lungs or liver and chronic disease with frequent exacerbations. It was a group of patients without significant change in their somatic state.