UMMS Affiliation

Division of Cardiovascular Medicine, Department of Medicine; Department of Population and Quantitative Health Sciences

Publication Date


Document Type



Cardiology | Cardiovascular Diseases | Geriatrics | Musculoskeletal, Neural, and Ocular Physiology | Psychiatry and Psychology | Psychological Phenomena and Processes


Background: Low gait speed has been linked with impaired mood, cognition, and quality of life (QOL) in older adults. We examined whether low gait speed was associated with impaired mood, cognition, and QOL among older adults with atrial fibrillation (AF).

Methods and Results: Participants (n=1185) had a diagnosis of AF, aged > /=65 years, CHA2DS2VASc > /=2 and had no contraindications to anticoagulation. Participants completed a 15-foot walk test, and low gait speed was categorized using cutoffs from the Fried Frailty Index. Participants self-reported measures of depressive symptoms (Patient Health Questionnaire 9 > /=10), anxiety symptoms (Generalized Anxiety Disorder 7 > /=10), cognitive impairment (Montreal Cognitive Assessment < /=23), and potentially impaired Atrial Fibrillation Effect Quality-of-Life Questionnaire < 80. Participants were on average aged 75.3 (SD: 7.0) years, 48.0% were women, and 85.5% were non-Hispanic white; 85.6% were taking an oral anticoagulant, 26.1% had low gait speed, 8.4% had elevated depressive symptoms, 5.7% had elevated anxiety symptoms, 41.1% were cognitively impaired, and 41.6% had potentially impaired AF-related QOL. Participants with low gait speed were significantly more likely to have elevated depressive symptoms (adjusted odds ratio: 2.1, 95% CI: 1.3-3.4), elevated anxiety symptoms (adjusted odds ratio: 2.2, 95% CI: 1.2-3.9), and cognitive impairment (adjusted odds ratio: 1.5, 95% CI: 1.1-2.1). Impaired AF-related QOL did not differ by gait speed after adjustment for clinical characteristics (adjusted odds ratio: 1.1, 95% CI: 0.8-1.5).

Conclusions: Twenty-six percent of older adults with AF had low gait speed, and low gait speed was associated with impaired mood and cognition. Further research is needed to determine whether declines in gait speed lead to impaired mood and cognition or whether these conditions develop concurrently.


anxiety, atrial fibrillation, cognition, depression, quality of life

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Copyright 2019 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

DOI of Published Version



J Am Heart Assoc. 2019 Nov 19;8(22):e013212. doi: 10.1161/JAHA.119.013212. Epub 2019 Nov 16. Link to article on publisher's site

Journal/Book/Conference Title

Journal of the American Heart Association

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Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.