Abstract 14824: Life-Space Assessment Score is a Prognostic Factor in Older Adults With Cardiovascular Disease

Abstract

Introduction: Older adults with cardiovascular disease (CVD) often have multiple comorbidities. However, to our knowledge, no studies have investigated the association between prognosis and life-space assessment (LSA) score, an indicator of the degree of use of the surrounding home and wider environments by patients, in older adults with CVD. The aim was to investigate whether LSA scores were associated with prognosis in older adults with CVD. Methods: Eligible subjects were aged over 65 years (average age 79.2 ± 7.6 years; left ventricular ejection fraction 56.7% ± 13.2%) and had been admitted to our hospital for worsening CVD. Receiver operating characteristic (ROC) analysis determined the cutoff LSA score (0-120 points, with higher scores reflecting greater life-space activity) in cardiovascular hospitalization. The calculated cutoff value was used to investigate the relationship between LSA score and cardiovascular events by survival analysis (Kaplan-Meier method) and Cox proportional analysis. The points at each level are totaled to achieve LSA scores from 0 to 120, with higher scores reflecting greater life space activity. Results: Over a 2-year period there were 44 cardiovascular hospitalizations and 10 cardiovascular deaths. ROC analysis revealed that the cutoff LSA score in cardiovascular hospitalization was 53.0 points (sensitivity, 55.9%; specificity, 82.1%, P = 0.003). Cardiovascular hospitalization and mortality rates were significantly higher in the low LSA group (P < 0.001 for both, Figure ). Cox proportional analysis revealed that low LSA score was independently associated with cardiovascular hospitalization (hazard ratio; 2.540, 95% CI; 1.135 to 5.680, P = 0.023) and cardiovascular death (hazard ratio; 15.223, 95% CI; 1.689 to 137.180, P = 0.015), even after adjustment for age, sex, and log-transformed BNP level. Conclusions: LSA score is associated with prognosis in older adults with cardiovascular disease.