Impact of comorbid conditions on disease-specific quality of life in older men and women with atrial fibrillation

Qual Life Res. 2020 Dec;29(12):3285-3296. doi: 10.1007/s11136-020-02578-3. Epub 2020 Jul 11.

Abstract

Background: Older persons with atrial fibrillation (AF) experience significant impairment in quality of life (QoL), which may be partly attributable to their comorbid diseases. A greater understanding of the impact of comorbidities on QoL could optimize patient-centered care among older persons with AF.

Objective: To assess impairment in disease-specific QoL due to comorbid conditions in older adults with AF.

Methods: Patients aged ≥ 65 years diagnosed with AF were recruited from five medical centers in Massachusetts and Georgia between 2015 and 2018. At 1 year of follow-up, the Quality of Life Disease Impact Scale-for Multiple Chronic Conditions was used to provide standardized assessment of patient self-reported impairment in QoL attributable to 34 comorbid conditions grouped in 10 clusters.

Results: The mean age of study participants (n = 1097) was 75 years and 48% were women. Overall, cardiometabolic, musculoskeletal, and pulmonary conditions were the most prevalent comorbidity clusters. A high proportion of participants (82%) reported that musculoskeletal conditions exerted the greatest impact on their QoL. Men were more likely than women to report that osteoarthritis and stroke severely impacted their QoL. Patients aged < 75 years were more likely to report that obesity, hip/knee joint problems, and fibromyalgia extremely impacted their QoL than older participants.

Conclusions: Among older persons with AF, while cardiometabolic diseases were highly prevalent, musculoskeletal conditions exerted the greatest impact on patients' disease-specific QoL. Understanding the extent of impairment in QoL due to underlying comorbidities provides an opportunity to develop interventions targeted at diseases that may cause significant impairment in QoL.

Keywords: Atrial fibrillation; Comorbidities; Disease-specific quality of life; Older adults.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Atrial Fibrillation / psychology*
  • Comorbidity
  • Female
  • Humans
  • Male
  • Middle Aged
  • Musculoskeletal Diseases / epidemiology
  • Musculoskeletal Diseases / psychology*
  • Osteoarthritis / epidemiology
  • Osteoarthritis / psychology*
  • Patient-Centered Care
  • Quality of Life / psychology*
  • Self Report
  • Stroke / epidemiology
  • Stroke / psychology*