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Self-Care in the Older Adult Living with Heart Disease
- Szuba, Rochelle
- Advisor(s): Park, Linda
Abstract
Background: Self-care is an important part of the comprehensive treatment plan for people living with heart disease, specifically, coronary heart disease and heart failure. Physical activity is a key self-care healthy behavior. Older adults face barriers to self-care including symptom burden, comorbidities, depression, and age as well as cognitive in the heart failure population
Objectives: To study factors related to self-care on an individual’s mental health, perceived health, and quality of life of older adults living with heart disease. To examine the direct association of physical activity as a primary predictor on these important outcomes. To evaluate the role of depression as a mediator of physical activity and quality of life
Methods: A systematic review was used to evaluate reported cognitive impairment in the older adult living with heart failure. Additionally, survey of 20-year surviving cohort of people living with chronic coronary disease was used to conduct a cross-sectional survey to evaluate the relationship of quality of life and physical activity as well as the mediation effect of depression on the relationship of physical activity and quality of life.
Results: The systematic review found that cognitive impairment was either diagnosed or measured using a validated tool in 8-66% of people living with heart failure over the age of 80 years. However, the population living with heart failure over 80 years old had poorer cognition by either measurement or physician diagnosis when compared to the population living with the heart failure less than 80 years old. Three studies did find the population living with heart failure had poorer measured cognition or a higher amount of diagnosed cognitive impairment when compared to the general population of the same age.Important findings from the cross-sectional study revealed that regular physical activity is associated with better perceived health and quality of life when adjusted for age, socioeconomic factors, and comorbidities. Heart failure was significantly associated with lower quality of life. It is known from evidence that having heart failure is associated with lower quality of life. Other significant findings included the effect of physical activity on quality of life being mediated by depressive symptoms in the population living with chronic CHD.
Conclusions: Self-care is part of any medical treatment. Physical activity is an essential self-care behavior in CHD, but the benefits reach beyond the heart. Associated with hypertension and diabetes control, physical activity is also known to have primary prevention properties related to the brain including cognition and depression. Importantly, these papers found physical activity is associated with quality of life and better perceived health. Public investment and promotion of physical activity could have lasting benefits towards a healthy aging population. It is our responsibility since any self-care not done, is care not given.
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