ArticleJournal of the American Geriatrics Society2024
The impact of multimorbidity and functional limitation on quality of life in patients with heart failure: A multi-site study.
Article in Journal of the American Geriatrics Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Characterising Multimorbidity in Adults With Heart Failure: A Latent Class Analysis.Heart, lung & circulation · 2026Article
- Multidimensional functional limitations in American cancer survivors: Characteristics and their effects on survival and healthcare utilization.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Depression and risk of hospital readmission in older patients with heart failure: a systematic review and meta-analysis.Frontiers in cardiovascular medicine · 2026Review
- Nutritional risk, frailty and functional status in elderly heart failure patients.ESC heart failure · 2025Article
- Associations of chronic disease status and the risk of new-onset hip or femoral fractures in older population.Journal of orthopaedics · 2025Article
- Cardiac Rehabilitation in the Era of CRT and ARNI: A Missing Link in Heart Failure with Reduced Ejection Fraction Care.Journal of clinical medicine · 2025Review
- Can psychological interventions affect cardiac rehabilitation patients' well-being? Preliminary results from a longitudinal study.International journal of cardiology. Cardiovascular risk and prevention · 2025Article
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Authors and funding
11 authors.
Funding
Abstract
backgroundMultimorbidity and functional limitation are associated with poor outcomes in heart failure (HF). However, the individual and combined effect of these on health-related quality of life in patients with HF is not well understood.
methodsPatients aged ≥30 years with two or more HF diagnostic codes and one or more HF-related prescription drugs from four U.S. institutions were mailed a survey to measure patient-centric factors including functional status (activities of daily living [ADLs]) and health-related quality of life (PROMIS-29 Health Profile). Patients with HF from January 1, 2013 to February 1, 2018 were included. Multimorbidity was defined as ≥2 non-cardiovascular comorbidities; functional limitation as any limitation in at least one of eight ADLs. Patients were categorized into four groups by multimorbidity (Yes/No) and functional limitation (Yes/No). We dichotomized the PROMIS-29 sub-scale scores at the median and calculated odd ratios for the four multimorbidity/functional limitation groups.
resultsA total of 3330 patients with HF returned the survey (response rate 31%); 3020 completed the questions of interest and were retained. Among these patients (45% female; mean age 73 [standard deviation: 12] years), 29% had neither multimorbidity nor functional limitation, 24% had multimorbidity only, 22% had functional limitation only, and 25% had both. After adjustment, having functional limitation only was associated with higher anxiety (odds ratio [OR]: 3.44, 95% confidence interval [CI]: 2.66-4.45), depression (OR: 3.11, 95% CI: 2.39-4.06), and fatigue (OR: 4.19, 95% CI: 3.25-5.40); worse sleep (OR: 2.14, 95% CI: 1.69-2.72) and pain (OR: 6.73, 95% CI: 5.15-8.78); and greater difficulty with social activities (OR: 9.40, 95% CI: 7.19-12.28) compared with having neither. Results were similar for having both multimorbidity and functional limitation.
conclusionPatients with only functional limitation have similar poor health-related quality of life scores as those with both multimorbidity and functional limitation, underscoring the important role that physical functioning plays in the well-being of patients with HF.
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