The Effects of Depression on the Course of Functional Limitations in Patients With Chronic Heart Failure

Abstract

Background This study examined whether depressive symptoms are associated with persistent functional limitations and severity classified according to the course of functional limitations in chronic heart failure (CHF) patients after discharge. Methods and Results The Performance Measure for Activities of Daily Living 8 (PMADL-8) was used to measure the course of functional limitations at 1, 3, and 5 months after discharge in a cohort of 148 patients. Depressive symptoms were assessed using the Hospital Anxiety and Depression Scale at 1 month after discharge. Repeated-measures logistic regression adjusting for potential confounders demonstrated that the depression groups had different persistent functional limitations (PMADL-8 scores ≥20 at 1, 3, and 5 months after discharge [χ 2 = 5.3; P < .05]). Using cluster analysis, we identified 4 distinctive courses of functional limitations, and there was a graded relationship between the severity of the course and depressive symptoms (χ 2 = 26.1; P < .001). Conclusions In this prospective study, depression was associated with poorer functional limitations in CHF patients after discharge. The findings of this study suggest that depression may be a treatment target for improving functional limitations in CHF patients during the recovery phase.