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

UMMS Affiliation

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

Publication Date


Document Type



Cardiology | Cardiovascular Diseases | Clinical Epidemiology | Epidemiology | Geriatrics | Health Services Research


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.


Atrial fibrillation, Comorbidities, Disease-specific quality of life, Older adults

DOI of Published Version



Abu HO, Saczynski JS, Ware J, Mehawej J, Paul T, Awad H, Bamgbade BA, Pierre-Louis IC, Tisminetzky M, Kiefe CI, Goldberg RJ, McManus DD. Impact of comorbid conditions on disease-specific quality of life in older men and women with atrial fibrillation. Qual Life Res. 2020 Jul 11. doi: 10.1007/s11136-020-02578-3. Epub ahead of print. PMID: 32656722. Link to article on publisher's site

Journal/Book/Conference Title

Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation

PubMed ID


Related Resources

Link to Article in PubMed