While studies of mortality and hospital readmission have been common, little is known about functional status and health-related quality of life (HRQOL) in heart failure patients. Rarer still has been work examining longitudinal changes in HRQOL among these patients and how these measures are related to other outcomes such as hospital admission and mortality. In general, tracking the course of chronic illness has been a difficult challenge. The broad goal of the proposed study is to understand how heart failure affects the HRQOL of older patients over time, thereby informing efforts to develop interventions that will improve care of these patients. Furthermore, it is important to determine the course of illness of older heart failure patients for prognostic and planning purposes. The specific aims of this study are to (1) determine changes in health perception and functional status in older patients with heart failure over a six-year period, and identify correlates of these changes; (2) examine associations of health perception and functional status to each other and to other outcomes including hospital admission, mortality, and use of skilled nursing facilities and home health care; and (3) identify sentinel cardiac events in the course of heart failure patients' illness and to determine what the follow-up effects are.