Abstract
Objectives: Lower physical performance, assessed using the Short Physical Performance Battery (SPPB), is associated with adverse outcomes in older adults with heart failure (HF). Executive function contributes to gait and postural control and may decline with aging and HF; however, its association with SPPB performance remains understudied in this population. This study examined the association between executive function, assessed using the Frontal Assessment Battery (FAB), and SPPB performance in ambulatory older adults with HF. Methods: This retrospective cross-sectional study included ambulatory patients aged ≥65 years with HF. Executive function was evaluated using the total FAB score. Logistic regression analyses examined the association between the FAB score and an SPPB score of >9 after multivariable adjustment. Receiver operating characteristic (ROC) analysis assessed discriminative ability. Exploratory analyses evaluated FAB subtests. Results: Of the 85 patients included, 52 had an SPPB score of >9. Higher total FAB scores were associated with an SPPB score of >9 after multivariable adjustment across all models. The ROC analysis yielded an area under the curve of 0.735. Exploratory analyses suggested that subdomains related to inhibitory control and conflict processing may be associated with SPPB performance. Conclusions: Executive function was associated with SPPB performance in older adults with HF. Reduced executive function may represent 1 of several factors related to lower physical performance. Because causality cannot be inferred from this cross-sectional design, longitudinal studies are needed to clarify temporal relationships and determine whether executive dysfunction is prospectively associated with subsequent declines in lower-extremity function.
