Sociodemographic, Clinical and Geriatric Characteristics Associated with Poor Atrial Fibrillation-Related Quality of Life in Older Adults with Atrial Fibrillation: A cross-sectional study

Abstract

Background. Though previous research has assessed sociodemographic, clinical and geriatric factors associated with poor atrial fibrillation-related quality of life (AFQoL); few studies have examined a battery of geriatric factors. The objective of this study is to describe eight geriatric factors, as well as the sociodemographic and clinical factors, associated with poor AFQoL in older adults with atrial fibrillation. Methods. Cross-sectional analysis of baseline data from a prospective cohort study of participants aged 65 + with high stroke risk and atrial fibrillation. AFQoL was measured using the validated Atrial Fibrillation Effect on Quality of Life (score 0-100) and categorized as poor (< 80) or good (80–100). Chi-square and t-tests were used to evaluate differences in factors across poor AFQoL and significant characteristics (p < 0.05) were entered into a multivariate logistic regression models to identify variables independently related to poor AFQoL. Results. Of 1,244 participants (mean age 75.5 [standard deviations: 7.1] years, 49% female), 42% reported poor AFQoL. Having a fall in the past 6 months, pre/frail & frailty, depression, anxiety, social isolation, vision impairment, oral anticoagulant therapy, chronic obstructive pulmonary disease and taking more than 12 medications daily were associated with higher odds of poor AFQoL. Being married and having a college education were associated with a lower odds of poor AFQoL. Conclusions. More than 4 out 10 older adults with AF reported poor AFQoL. Geriatric characteristics significantly associated with higher odds of reporting poor AFQoL include falls in the past 6 months, frailty, elevated depressive symptoms, elevated symptoms of anxiety, social isolation and vision impairment. Findings from this study may help clinicians screen for patients with poor AFQoL who could benefit from tailored management to ensure the delivery of patient-centered care and improved well-being among older adults with atrial fibrillation.