A new direction in the assessment of adherence to treatment is an emphasis on geriatric syndromes

Author:

Chukaeva I.I., Larina V.N., Karpenko D.G., Larin V.G.

Place of publication:

Cardiovascular therapy and prevention, 2017; 16 (3)

Target. To study the factors that determine the commitment of optimal therapy of elderly patients with chronic heart failure (COM) observed on an outpatient basis.

Material and methods. In an open, comparative simultaneous, incomplete study, 80 patients with heart failure at the age of ≥60 years were included. The comparison group consisted of 40 patients (18 men and 22 women) with diseases of the cardiovascular system without heart failure. Patients were evaluated by the Comorbidity index, laboratory and echocardiographic parameters, a 6-minute walk test, cognitive status, adherence to treatment, and a two-photon X-ray absorption was carried out. The criteria of senile asthenia was considered the presence of 3 signs according to the Frail scale (Fatigue, Resistance, Ambulation, Illnesses, Loss of Weight).

Results. The committed treatment was 40% of patients with heart failure and 75% - comparison groups (p <0.001). In a single-factor analysis, a relationship of adherence to treatment with the level of cognitive status by the Mini-Mental State Examination questionnaire is established-the ratio of chance (OS) 1.5; 95% confidential interval (DI) 1.2-1.9 (p <0.001), senile asthenia-Osh 3.5; 95% DI 1.3-9.5 (p = 0.011), osteoporosis-Osh 2.98; 95% DI 1.0-8.9 (p = 0.050), Cherlson coomorbitability-Osh 1.21; 95% DI 1.0-1.5 (p = 0.050).

Conclusion. 40% of outpatient patients with heart failure at the age of ≥60 years were committed to treatment. Multiple concomitant pathology, impaired cognitive status, osteoporosis, senile asthenia have a negative effect on commitment to the treatment of older people with heart failure.

Key words: commitment to treatment, elderly age, heart failure, senile asthenia, osteoporosis.