03069nas a2200457 4500008004100000022001400041245009800055210006900153260001300222300001100235490000700246520178800253653003102041653000902072653002202081653002402103653002602127653002402153653001102177653002502188653001102213653001402224653001402238653002502252653000902277653001302286653001502299653002402314653001802338653001802356100002102374700002402395700002402419700001902443700002402462700002302486700002202509700002102531700002302552856003602575 2016 eng d a1532-541500aIncident Atrial Fibrillation and Disability-Free Survival in the Cardiovascular Health Study.0 aIncident Atrial Fibrillation and DisabilityFree Survival in the c2016 Apr a838-430 v643 a
OBJECTIVES: To assess the associations between incident atrial fibrillation (AF) and disability-free survival and risk of disability.
DESIGN: Prospective cohort study.
SETTING: Cardiovascular Health Study.
PARTICIPANTS: Individuals aged 65 and older and enrolled in fee-for-service Medicare followed between 1991 and 2009 (MN = 4,046). Individuals with prevalent AF, activity of daily living (ADL) disability, or a history of stroke or heart failure at baseline were excluded.
MEASUREMENTS: Incident AF was identified according to annual study electrocardiogram, hospital discharge diagnosis, or Medicare claims. Disability-free survival was defined as survival free of ADL disability (any difficulty or inability in bathing, dressing, eating, using the toilet, walking around the home, or getting out of a bed or chair). ADLs were assessed at annual study visits or in a telephone interview. Association between incident AF and disability-free survival or risk of disability was estimated using Cox proportional hazards models.
RESULTS: Over an average of 7.0 years of follow-up, 660 individuals (16.3%) developed incident AF, and 3,112 (77%) became disabled or died. Incident AF was associated with shorter disability-free survival (hazard ratio (HR) for death or ADL disability = 1.71, 95% confidence interval (CI) = 1.55-1.90) and a higher risk of ADL disability (HR = 1.36, 95% CI = 1.18-1.58) than in individuals with no history of AF. This association persisted after adjustment for interim stroke and heart failure.
CONCLUSION: These results suggest that AF is a risk factor for shorter functional longevity in older adults, independent of other risk factors and comorbid conditions.
10aActivities of Daily Living10aAged10aAged, 80 and over10aAtrial Fibrillation10aDisability Evaluation10aElectrocardiography10aFemale10aGeriatric Assessment10aHumans10aIncidence10aLongevity10aLongitudinal Studies10aMale10aMedicare10aPrevalence10aProspective Studies10aSurvival Rate10aUnited States1 aWallace, Erin, R1 aSiscovick, David, S1 aSitlani, Colleen, M1 aDublin, Sascha1 aMitchell, Pamela, H1 aOdden, Michelle, C1 aHirsch, Calvin, H1 aThielke, Stephen1 aHeckbert, Susan, R uhttps://chs-nhlbi.org/node/7002