Methods and Results: In a cross-sectional design, 48 men and 54 women over 18 years of age (mean 59.6 years) diagnosed with HF (NYHA Class II-IV) were recruited at an outpatient HF clinic. More than 50% of patients were African American and were categorized as a NYHA II. Dyspnea in performing IADLs was low (M = 2.02, SD = 1.79, range of .00 to 7.60), and 40% were mildly to severely depressed (score of > 14 on the Beck Depression Inventory II). In hierarchical multiple regressions, 29% of the variance in activity tolerance (6-Minute Walk) was significantly explained by dyspnea (β = -.47) and depression (β = .26). In contrast, after controlling for covariates (age, gender, and co-morbidity), the overall model explained 85% of variance in modification in IADLs with dyspnea (β = .74) and activity intolerance (β = -.25) being significant while depression was not significant.

Conclusion: The effect of depression on activity intolerance or disability may be attenuated by dyspnea with overlapping depressive symptoms (e.g., tired, level of activity) that may positively influence patient’s performance. In HF patients, assessment of depression may need to be validated by respiratory symptom. Incorporating assessment of the 6-Minute Walk as well as dyspnea into clinical practice may be useful to identify patients at risk for disability. Interventions targeted to improve dyspena and endurance (measured here as the 6-Minute Walk) may prevent or reduce disability in HF patients.