title: Activities of daily living at different levels of renal function in elderly hospitalized heart failure patients.
abstract: BACKGROUND
  Renal function (RF) and activities of daily living (ADL) are risk factors for heart failure (HF) patients.
  
  
  OBJECTIVE
  We evaluated differences in motor and cognitive ADL in relation to RF in elderly hospitalized HF patients.
  
  
  METHODS
  Participants were selected from 414 consecutive hospitalized HF patients based on certain criteria. We investigated patient characteristics including Functional Independence Measure (FIM) and estimated glomerular filtration rate (eGFR). Subjects were divided into three groups by RF level and analyzed with one-way ANOVA and Chi-square tests and two-way ANCOVA and multiple comparison tests.
  
  
  RESULTS
  Of the 414 patients, 165 met the inclusion criteria (high RF: 41, moderate RF: 84, low RF: 40). There were significant differences between the three groups in age, eGFR, hemoglobin level, mobility, cognitive function, and length of hospital stay (p < 0.05). Motor FIM showed an interaction between term and group, and cognitive FIM showed a main effect on the group (p < 0.05). In the multiple comparisons, motor FIM of all groups indicated significant recovery, but it was significantly lower after 1 week in the low RF versus moderate/high RF groups (p < 0.05). Cognitive FIM showed no significant recovery in the low RF group; the FIM score after 2 weeks was significantly lower than that in the moderate/high RF groups (p < 0.05).
  
  
  CONCLUSIONS
  In elderly hospitalized HF patients, the motor ADL recovery process in the low RF group was delayed compared to the high RF group. Cognitive ADL in hospitalized HF patients is difficult to recover, especially in those with low RF.
authors.affiliation: Kokura Rehabilitation College, Kitakyushu, Japan.|Department of International Health, Kobe University Graduates School of Health Sciences, 10-2 Tomogaoka 7-chome Suma, Kobe, 654-0142, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kitamura
authors.affiliation: Department of International Health, Kobe University Graduates School of Health Sciences, 10-2 Tomogaoka 7-chome Suma, Kobe, 654-0142, Japan. izawapk@harbor.kobe-u.ac.jp.
authors.forename: Kazuhiro P
authors.initials: KP
authors.lastname: Izawa
authors.affiliation: Department of Rehabilitation, Shinyukuhashi Hospital, Yukuhashi, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Taniue
authors.affiliation: Department of Rehabilitation, Shinyukuhashi Hospital, Yukuhashi, Japan.
authors.forename: Yumi
authors.initials: Y
authors.lastname: Mimura
authors.affiliation: Department of Rehabilitation, Shinyukuhashi Hospital, Yukuhashi, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ikeda
authors.affiliation: Department of Rehabilitation, Shinyukuhashi Hospital, Yukuhashi, Japan.
authors.forename: Hitomi
authors.initials: H
authors.lastname: Nagashima
authors.affiliation: Department of Health and Exercise Science, Healthy Exercise and Lifestyle Program S, Wake Forest University, Winston-Salem, NC, USA.
authors.forename: Peter H
authors.initials: PH
authors.lastname: Brubaker
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D060825:Cognitive Dysfunction / Q000145:classification / Q000150:complications / Q000534:rehabilitation*; D005260:Female; D015577:Geriatric Assessment; D005919:Glomerular Filtration Rate / Q000502:physiology; D006333:Heart Failure / Q000145:classification / Q000150:complications / Q000534:rehabilitation*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D051437:Renal Insufficiency / Q000145:classification / Q000150:complications / Q000534:rehabilitation*; D012189:Retrospective Studies
keywords: Activities of daily living; Elderly; Estimated glomerular filtration rate; Heart failure; Hospitalized; Renal function