Predictors of the quality of life of older people with heart failure recruited from primary care
1 Sheffield Institute for Studies on Ageing, University of Sheffield, Elmfield, Northumberland Road, Sheffield S10 2TU, UK
2 School of Nursing and Midwifery, University of Sheffield, Sheffield, UK
3 Institute of General Practice, University of Exeter, Exeter, UK
4 School of Health Studies, University of Bradford, Bradford, UK
Address correspondence to: M. Gott. Tel: (+44) 114 222 6264. Email: m.gott{at}sheffield.ac.uk
Background: current understanding of quality of life in heart failure is largely derived from clinical trials. Older people, women and those with co-morbidities are underrepresented in these. Little is known about factors predictive of quality of life amongst older people with heart failure recruited from community settings.
Objective: to identify factors predictive of quality of life amongst older people recruited from community settings.
Design: prospective questionnaire survey.
Setting: general practice surgeries located in four areas of the UK: Bradford, Barnsley, East Devon and West Hampshire.
Subjects: a total of 542 people aged >60 years with heart failure.
Methods: participants completed a postal questionnaire, which included a disease-specific measure (Kansas City Cardiomyopathy Questionnaire), a generic quality-of-life measure (SF-36) and sociodemographic information.
Results: a multiple linear regression analysis identified the following factors as predictive of decreased quality of life: being female, being in New York Heart Association (NYHA) functional class III or IV, showing evidence of depression, being in socioeconomic groups III–V and experiencing two or more co-morbidities. Older age was associated with decreased quality of life, as measured by a generic health-related quality-of-life tool (the SF-36 mental and physical health functioning scales) but not by a disease-specific tool (the Kansas City Cardiomyopathy Questionnaire).
Conclusion: findings from the study suggest that quality of life for older people with heart failure can be described as challenging and difficult, particularly for women, those in a high NYHA class, patients showing evidence of depression, patients in socioeconomic groups III–V, those experiencing two or more co-morbidities and the ‘oldest old’. Such information can help clinicians working with older people identify those at risk of reduced quality of life and target interventions appropriately.
Keywords: community, elderly, heart failure, older people, quality of life
Received June 1, 2005; accepted in revised form December 6, 2005.
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