Multimorbidity, physical frailty, and self-rated health in older patients with atrial fibrillation
Abu, Hawa Ozien ; Saczynski, Jane ; Mehawej, Jordy ; Paul, Tenes J ; Awad, Hamza ; Bamgbade, Benita A. ; Pierre-Louis, Isabelle C. ; Tisminetzky, Mayra ; Kiefe, Catarina I. ; Goldberg, Robert J. ... show 1 more
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Saczynski, Jane
Mehawej, Jordy
Paul, Tenes J
Awad, Hamza
Bamgbade, Benita A.
Pierre-Louis, Isabelle C.
Tisminetzky, Mayra
Kiefe, Catarina I.
Goldberg, Robert J.
McManus, David D
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Abstract
BACKGROUND: Holistic care models emphasize management of comorbid conditions to improve patient-reported outcomes in treatment of atrial fibrillation (AF). We investigated relations between multimorbidity, physical frailty, and self-rated health (SRH) among older adults with AF.
METHODS: Patients (n = 1235) with AF aged 65 years and older were recruited from five medical centers in Massachusetts and Georgia between 2015 and 2018. Ten previously diagnosed cardiometabolic and 8 non-cardiometabolic conditions were assessed from medical records. Physical Frailty was assessed with the Cardiovascular Health Study frailty scale. SRH was categorized as either "excellent/very good", "good", and "fair/poor". Separate multivariable ordinal logistic models were used to examine the associations between multimorbidity and SRH, physical frailty and SRH, and multimorbidity and physical frailty.
RESULTS: Overall, 16% of participants rated their health as fair/poor and 14% were frail. Hypertension (90%), dyslipidemia (80%), and heart failure (37%) were the most prevalent cardiometabolic conditions. Arthritis (51%), anemia (31%), and cancer (30%), the most common non-cardiometabolic diseases. After multivariable adjustment, patients with higher multimorbidity were more likely to report poorer health status (Odds Ratio (OR): 2.15 [95% CI: 1.53-3.03], > /= 8 vs 1-4; OR: 1.37 [95% CI: 1.02-1.83], 5-7 vs 1-4), as did those with more prevalent cardiometabolic and non-cardiometabolic conditions. Patients who were pre-frail (OR: 1.73 [95% CI: 1.30-2.30]) or frail (OR: 6.81 [95% CI: 4.34-10.68]) reported poorer health status. Higher multimorbidity was associated with worse frailty status.
CONCLUSIONS: Multimorbidity and physical frailty were common and related to SRH. Our findings suggest that holistic management approaches may influence SRH among older patients with AF.
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Abu HO, Saczynski J, Mehawej J, Paul T, Awad H, Bamgbade BA, Pierre-Louis IC, Tisminetzky M, Kiefe CI, Goldberg RJ, McManus DD. Multimorbidity, physical frailty, and self-rated health in older patients with atrial fibrillation. BMC Geriatr. 2020 Sep 11;20(1):343. doi: 10.1186/s12877-020-01755-w. PMID: 32917137; PMCID: PMC7488548. Link to article on publisher's site