Life-Space Activities Are Associated with the Prognosis of Older Adults with Cardiovascular Disease

Abstract

Life-space activities are a measure of daily activity level. Here, we examined the association between life-space activities and prognosis in 129 cardiovascular diseases (CVD) patients 65 years of age or older (average age, 79.2 ± 7.6 years; mean left ventricular ejection fraction, 56.7 ± 13.2%) who had been admitted to our hospital for worsening CVD. Subjects were followed, and the primary endpoints were cardiovascular hospitalization and cardiovascular death. Receiver operating characteristic analysis produced a cutoff value for life-space assessment (LSA) score for increased risk of cardiovascular hospitalization for two years of 53.0 points (sensitivity, 55.9%; specificity, 82.1%). Kaplan−Meier analysis using this cutoff value revealed that the rates of cardiovascular hospitalization and cardiovascular death were significantly higher in subjects with an LSA score below the cutoff than in those with a score above the cutoff (both p < 0.001). Cox proportional analysis revealed that low LSA score was independently associated with cardiovascular hospitalization (HR, 2.540; 95% CI, 1.135−5.680; p = 0.023) and cardiovascular death (HR, 15.223; 95% CI, 1.689−137.180; p = 0.015), even after adjusting for age, sex, left ventricular ejection fraction, and log-transformed brain natriuretic peptide level. Thus, life-space activities are associated with prognosis in older adults with CVD.

Keywords: cardiovascular disease; cardiovascular events; heart failure; life-space activities; life-space assessment; older adult patient.

Figure 1

Receiver operating characteristic curve. Life-space assessment (LSA) cutoff value was determined by using the maximum value of the Youden Index. AUC, area under the curve.

Figure 2

Kaplan–Meier curve for cardiovascular hospitalization. LSA, life-space assessment.

Figure 3

Kaplan–Meier curve for cardiovascular death. LSA, life-space assessment.