Hartfalen in verpleeghuizen.

Rationale:

Heart failure is an important and increasing problem in older people. The disease affects the experienced quality of life and care dependency negatively. Heart failure is expected to be particularly prevalent in the nursing home population but reliable data about heart failure in this specific population are lacking. Early diagnosis and treatment may lead to improvement of the signs and symptoms and improvement of quality of life; outcomes that are very important also for the nursing home population.



Objective:

The prevalence, diagnosis and management of heart failure in nursing home residents will be investigated. Furthermore we look for the relation between HF versus care dependency and HF versus quality of life in nursing home residents. A one year follow-up is planned to determine whether episodes of heart failure, hospital admissions for heart failure and mortality have occurred.



Study design:

The design of this multicentre study consists of a cross sectional part and a longitudinal part. Data will be collected from actual clinical examinations of nursing home residents (including history, physical examination, ECG, NT-pro BNP marker and echocardiography), patient records and questionnaires. In each resident, all examinations are performed within a period of two weeks. The collected data of the heart failure assessment will be judged by a panel of two cardiologists and a geriatrician.



Study population:

Nursing home residents of five healthcare organizations, who are aged over 65 year and receiving long term somatic or psychogeriatric care.



Main study parameters/endpoints:

The study will lead to a prevalence figure of heart failure in nursing home residents, the insight of the current treatment and course of heart failure in nursing homes and will describe the experienced quality of life and care dependency.

The hypothesis is that the prevalence of heart failure is underestimated in Dutch nursing homes. In addition it is hypothesized that residents with heart failure experience a lower quality of life, have a higher degree of care dependency and have severe cognitive impairments.

1. After inclusion: Extensive clinical examination and questionnaries;

2. Follow-up after one year: Questionnaries.

1. Clinical examination of nursing home residents including history, physical examination, ECG, Cardiac markers (NT pro BNP) and echocardiography;

2. Questionnaires: Care dependency scale, Qualidem, SF-12, VAS, MMSE, MDS.