The impact of CVD on independence

In the year following a heart attack, more than 40% of patients experience health declines in physical function and/or ability to live independently.⁴

While cardiovascular disease (CVD) is the leading cause of death globally, it is also a major threat to function, independence and quality of life,¹ which are all important health priorities for older adults.²

Older adults make up the majority of people who have a heart attack.³ In the year following a heart attack, more than 40% of patients experience health declines in physical function and/or ability to live independently.⁴

A common complication of a heart attack is heart failure,⁵ which poses a risk to independence. The inability of seniors with heart failure to perform daily tasks and participate in social activities has been linked to a higher risk of mortality and/or hospitalisation.^6,7

A specific risk to the independence of older adults with heart failure or following a heart attack is a greater propensity to fall, which is associated with increased mortality, morbidity, and re-hospitalisation rates.⁸

An analysis of out-of-hospital cardiac arrest registry data found that 76% of heart attacks occur in the home and 63% are unwitnessed.⁹ The analysis also showed that the majority of out-of-hospital heart attacks occur in older adults and their survival rate after a heart attack is half that of younger adults (6.5% vs 13% in those aged ≥65 years vs 0–64 years).¹⁰ A longer time between the onset of symptoms and arrival at hospital (≥ 4 vs < 4hrs) leading to a delay in receiving coronary reperfusion after a heart attack has been demonstrated to be associated with significantly (p<0.03) higher mortality.¹¹

This highlights the importance of timely medical intervention after a heart attack or other acute CVD event in community-living seniors to minimise the risk of serious health outcomes and loss of independence.

Many older adults are aware of the unpredictable nature of their health and the risk to their continued independence.¹² Anxiety, fear, and uncertainty about their future are among the challenges of living with CVD.¹³ Unpredictable health is a reality for individuals with coronary artery disease who are at risk of a potentially serious adverse CVD event at any moment.¹⁴ Furthermore, CVD in older adults typically occurs in a context of multimorbidity in which multiple medical conditions can interact with unpredictable consequences including increased risk of falling.^8,15

Having access to timely medical intervention may help to mitigate the anxiety associated with the unpredictable nature of CVD and the potential for loss of independence in your older patients.

Referring your community-living older patients with CVD for a St John Medical Alarm is one way to support their independence. This can provide reassurance by giving them a direct link to expert care in an emergency.

Users of a medical alarm report feeling safer, more secure, and less anxious than non-users (including reduced anxiety about falling), giving them the confidence to continue living in their own home.^16,17 Users of a medical alarm also report being more active around the home than non-users, potentially helping them to avert functional decline and allowing them to continue to live independently.¹⁶

A St John Medical Alarm offers 24/7 response and is the only medical alarm that connects directly to Hato Hone St John. Your patients can access a FREE trial, and a referral is easily arranged using your Practice Management System via Healthlink or ERMS.

For additional information visit: stjohnalarms.org.nz/hcp