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Younger women with heart failure have worse quality of life than older women and men, but they also tend to improve more over time

Heart failure not only has a high mortality rate, but it also causes shortness of breath, fatigue, and emotional problems. The resulting lower quality of life affects younger women with heart failure more than elderly women or men of any age, according to a study supported by the Agency for Healthcare Research and Quality (HS09822).

Researchers led by Nan Hou, R.N., M.S.N., and Susan J. Bennett, R.N., D.N.S., from the School of Nursing at Indiana University, examined differences in health-related quality of life (HRQOL) among four groups of patients on the basis of age (younger than 65 and 65 years or older) and sex to evaluate the relationships of age and sex to changes in HRQOL over a 6-month period. They asked patients from two urban hospital outpatient clinics at baseline and 26 weeks later to rate shortness of breath (dyspnea) they experienced while doing each of five activities during the previous 4 weeks to identify changes in dyspnea and fatigue. They measured patients' HRQOL using the 21-item Minnesota Living With Heart Failure Questionnaire (LHFQ) and the 16-item Chronic Heart Failure Questionnaire (CHQ).

Of the 165 patients who completed baseline and later interviews, those younger than 65 years had poorer HRQOL scores on total scales and some subscales compared with older patients. Women had poorer scores than men on some scales, particularly the emotional subscales, but their scores did improve over time. With demographic and clinical factors controlled for, women younger than 65 had more improvement in fatigue over time than older women and more improvement in emotional symptoms over time than men less than 65 years of age as measured by the CHQ. There were no significant differences among the four groups over time in the LHFQ. The CHQ may be more sensitive for detecting individual changes in clinical conditions, particularly in dyspnea and fatigue, conclude the researchers.

See "Relationship of age and sex to health-related quality of life in patients with heart failure," by Nan Hou, R.N., M.S.N., Michelle A. Chui, Pharm.D., Ph.D., George J. Eckert, M.A.S., and others, in the March 2004  American Journal of Critical Care 13(2), pp. 153-161.

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