Department of Medicine, Division of Cardiovascular Medicine; Division of Geriatric Medicine, Department of Medicine; Meyers Primary Care Institute; Department of Population and Quantitative Health Sciences
Cardiovascular Diseases | Geriatrics | Health Services Administration | Health Services Research
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.
Comorbid diseases, Functional status, Geriatric cardiology, Well-being
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DOI of Published Version
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
Abu HO, Saczynski J, Mehawej J, Paul T, Awad H, Bamgbade BA, Pierre-Louis IC, Tisminetzky M, Kiefe CI, Goldberg RJ, McManus DD. (2020). Multimorbidity, physical frailty, and self-rated health in older patients with atrial fibrillation. Open Access Articles. https://doi.org/10.1186/s12877-020-01755-w. Retrieved from https://escholarship.umassmed.edu/oapubs/4346
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This work is licensed under a Creative Commons Attribution 4.0 License.