Cardiac Structure and Function Predicts Functional Decline in the Oldest Old - The 65th Annual Conference of the Israel Heart Society & The Israel Society of Cardiothoracic Surgery, 24-25 April 2018

David Leibowitz Heart Institute, Hadassah-Hebrew University Medical Center, Jerusalem, Israel, Israel Jeremy M Jacobs Geriatrics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel, Israel Irit Lande-Stessman Geriatrics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel, Israel Jochanan Stessman Geriatrics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel, Israel Dan Gilon Heart Institute, Hadassah-Hebrew University Medical Center, Jerusalem, Israel, Israel

Background: The aim of the study was to examine the association between cardiac structure and function and deterioration in activities of daily living (ADL) over five-year follow-up in an age-homogenous community-dwelling population of subjects born in 1920-1921.

Methods: Subjects were recruited from the jerusalem Longitudinal Cohort Study that has followed an age homogenous chort of Jerusalem residents born in 1920-1921. Subjects underwent home echocardiography and were followed for 5 years. dependence was defined as needing assistance with one or more basic activites of daily living. Standard echocardiographic assessment of cardiac structure and function including systolic and diastolic function was performed. Reassessment of performance of ADL`s was don at 5 year follow-up.

Results: 459 subjects were included in the study. 362 (79%) subjects had deterioration in at least one ADL at follow-up. Subjects with functional deterioration had significantly higher left ventricular mass index (LVMI) and left atrial volume with lower ejection fraction. There were no significant differences between the groups in diastolic parameters. When the data were examined categorically, a significantly larger percent of subjevts with functional decline had abnormal LV ejection fraction as well as left ventricular hypertrophy. In the multivariate models the association between LVMI and functional decline remained significant in all models.

Conclusions: In this cohort of the oldest old, eleavted LVMI, higher LA volumes and systolic but not diastolic dysfunction were predictive of functional disability.