Absence of Post-Discharge Exercise Habits Predicts Functional Decline in Older Heart Failure Patients　- A 6-Month Follow-up Study.

Background: This study aimed to examine the impact of post-discharge exercise habits on functional decline in older patients with heart failure (HF). Methods and Results: Sixty-three older patients hospitalized due to HF (mean age 79.7±7.1 years; 46.0% male) were enrolled. Patients were categorized as exercisers if they reported engaging in moderate-intensity exercise for at least 30 min, ≥4 times per week, at 6 months post-discharge. Physical function was measured using the Short Physical Performance Battery (SPPB) at discharge and 6 months thereafter. Functional decline, the primary outcome, was defined as a decrease of ≥1 point in SPPB score over 6 months. The underlying etiologies of HF were arrhythmia (n=37; 58.7%), valvular heart disease (n=37; 58.7%), and ischemic heart disease (n=27; 42.9%). Patients were grouped into exercisers (n=36; 57.1%) and non-exercisers (n=27; 42.9%). Non-exercisers showed a significantly higher incidence of functional decline compared with exercisers (29.6% [n=8] vs. 2.8% [n=1]; P=0.003). Firth's penalized likelihood logistic regression revealed that non-exercising status independently predicted functional decline (odds ratio 5.98; 95% confidence interval 1.41-35.44; P=0.014) after adjusting for relevant confounders. Conclusions: Absence of post-discharge exercise habits significantly increased the risk of functional decline in older HF patients.