title: New potential determinants of disability in aged persons with myocardial infarction: results from the KORINNA-study.
abstract: BACKGROUND
  Elderly individuals with coronary heart disease are a population particularly burdened by disability. However, to date many predictors of disability established in general populations have not been considered in studies examining disability in elderly acute myocardial infarction (AMI) survivors. Our study explores factors associated with the ability to perform basic activities of daily living in elderly patients with AMI.
  
  
  METHODS
  Baseline data from 333 AMI-survivors older than 64 years included within the randomized controlled KORINNA-study were utilized to examine disability assessed by the Stanford Health Assessment Questionare Disability Index (HAQ-DI). Numerous potential determinants including demographic characteristics, clinical parameters, co-morbidities, interventions, lifestyle, behavioral and personal factors were measured.Disability was defined as a HAQ-DI ≥ 0.5. After bi-variate testing the probability of disability was modeled with logistic regression. Missing covariate values were imputed using a Markov Chain Monte Carlo method.
  
  
  RESULTS
  Disability was significantly more frequent in older individuals (Odds Ratio (OR): 1.10, 95% Confidence Interval (CI): 1.05-1.16), patients with deficient nutrition (OR: 3.38, 95% CI: 1.60-7.15), coronary artery bypass graft (CABG) (OR: 3.26, 95% CI: 1.29-8.25), hearing loss in both ears (OR: 2.85, 95% CI: 1.41-5.74), diabetes mellitus (OR: 2.56, 95% CI: 1.39-4.72), and heart failure (OR: 3.32, 95% CI: 1.79-6.16). It was reduced in patients with percutaneous transluminal coronary angioplasty (PTCA) (OR: 0.41, 95% CI: 0.21-0.80) and male sex (OR: 0.48, 95% CI: 0.27-0.85).
  
  
  CONCLUSIONS
  Effects of nutrition, hearing loss, and diametrical effects of PTCA and CABG on disability were identified as relevant for examination of causality in longitudinal trials.
  
  
  BACKGROUND
  ISRCTN02893746.
authors.affiliation: Institute of Epidemiology II, Helmholtz-Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany. philip.quinones@helmholtz-muenchen.de.
authors.forename: Philip Andrew
authors.initials: PA
authors.lastname: Quinones
authors.forename: Hildegard
authors.initials: H
authors.lastname: Seidl
authors.forename: Rolf
authors.initials: R
authors.lastname: Holle
authors.forename: Bernhard
authors.initials: B
authors.lastname: Kuch
authors.forename: Christa
authors.initials: C
authors.lastname: Meisinger
authors.forename: Matthias
authors.initials: M
authors.lastname: Hunger
authors.forename: Inge
authors.initials: I
authors.lastname: Kirchberger
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology*; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D006233:Persons with Disabilities; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000453:epidemiology*