Atrial Fibrillation and Declining Physical Performance in Older Adults: The Health, Aging, and Body Composition Study

Jared W Magnani; Na Wang; Emelia J Benjamin; Melissa E Garcia; Douglas C Bauer; Javed Butler; Patrick T Ellinor; Stephen Kritchevsky; Gregory M Marcus; Anne Newman; Caroline L Phillips; Hiroyuki Sasai; Suzanne Satterfield; Lisa M Sullivan; Tamara B Harris; Health, Aging, and Body Composition Study

doi:10.1161/CIRCEP.115.003525

Atrial Fibrillation and Declining Physical Performance in Older Adults: The Health, Aging, and Body Composition Study

Circ Arrhythm Electrophysiol. 2016 May;9(5):e003525. doi: 10.1161/CIRCEP.115.003525.

Authors

Jared W Magnani¹, Na Wang², Emelia J Benjamin², Melissa E Garcia², Douglas C Bauer², Javed Butler², Patrick T Ellinor², Stephen Kritchevsky², Gregory M Marcus², Anne Newman², Caroline L Phillips², Hiroyuki Sasai², Suzanne Satterfield², Lisa M Sullivan², Tamara B Harris²; Health, Aging, and Body Composition Study

Affiliations

¹ From the Section of Cardiovascular Medicine, Boston University School of Medicine & National Heart, Lung and Blood Institute and Boston University's Framingham Heart Study, MA (J.W.M., E.J.B.); Department of Biostatistics, Boston University School of Public Health, MA (N.W., L.M.S.); Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, MD (M.E.G., C.L.P.); Division of General Internal Medicine, University of California, San Francisco (D.C.B.); Stony Brook University, NY (J.B.); Cardiovascular Research Center, Massachusetts General Hospital, Charlestown & Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston (P.T.E.); Program in Population and Medical Genetics, The Broad Institute of Harvard and MIT, Cambridge, MA (P.T.E.); Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, NC (S.K.); Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, University of California, San Francisco (G.M.M.); Department of Epidemiology, University of Pittsburgh, PA (A.N.); University of Tsukuba Faculty of Medicine, Tsukuba, Japan (H.S.); Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis (S.S.); and Geriatric Epidemiology Section, National Institute on Aging, Bethesda, MD (T.B.H.). jmagnani@bu.edu.
² From the Section of Cardiovascular Medicine, Boston University School of Medicine & National Heart, Lung and Blood Institute and Boston University's Framingham Heart Study, MA (J.W.M., E.J.B.); Department of Biostatistics, Boston University School of Public Health, MA (N.W., L.M.S.); Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, MD (M.E.G., C.L.P.); Division of General Internal Medicine, University of California, San Francisco (D.C.B.); Stony Brook University, NY (J.B.); Cardiovascular Research Center, Massachusetts General Hospital, Charlestown & Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston (P.T.E.); Program in Population and Medical Genetics, The Broad Institute of Harvard and MIT, Cambridge, MA (P.T.E.); Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, NC (S.K.); Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, University of California, San Francisco (G.M.M.); Department of Epidemiology, University of Pittsburgh, PA (A.N.); University of Tsukuba Faculty of Medicine, Tsukuba, Japan (H.S.); Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis (S.S.); and Geriatric Epidemiology Section, National Institute on Aging, Bethesda, MD (T.B.H.).

Abstract

Background: Age is the foremost risk factor for atrial fibrillation (AF), and AF has a rising prevalence in older adults. How AF may contribute to decline in physical performance in older adults has had limited investigation. We examined the associations of incident AF and 4-year interval declines in physical performance at ages 70, 74, 78, and 82 years in the Health, Aging, and Body Composition (Health ABC) Study.

Methods and results: Health ABC is a prospective cohort of community-dwelling older adults (n=3075). The study conducted serial assessments of physical performance with the Health ABC physical performance battery (scored 0-4), grip strength, 2-minute walk distance, and 400-m walking time. Incident AF was identified from the Center for Medicare and Medicaid Services and related to 4-year interval decline in physical performance. After exclusions, the analysis included 2753 Health ABC participants (52% women, 41% black race). Participants with AF had a significantly greater 4-year physical performance battery decline than those without AF at age 70, 74, 78, and 82, with mean estimated decline ranging from -0.08 to -0.10 U (95% confidence interval, -0.18 to -0.01; P<0.05 for all estimates) after multivariable adjustment. Grip strength, walk distance, and walk time similarly showed significantly greater declines at each 4-year age interval in participants with AF.

Conclusions: In community-based cohort older adults, incident AF was associated with increased risk of decline in physical performance. Further research is essential to identify mechanisms and preventive strategies for how AF may contribute toward declining physical performance in older adults.

Keywords: aging; atrial fibrillation; epidemiology; medicare; physical exercise.

Publication types

Multicenter Study
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, N.I.H., Intramural
Research Support, Non-U.S. Gov't

MeSH terms

Age Factors
Aged
Aged, 80 and over
Aging*
Atrial Fibrillation / epidemiology
Atrial Fibrillation / physiopathology*
Atrial Fibrillation / rehabilitation
Body Composition*
Disability Evaluation*
Electrocardiography
Female
Follow-Up Studies
Health Status*
Humans
Male
Motor Activity / physiology*
Prevalence
Prospective Studies
Risk Assessment / methods*
Risk Factors
Time Factors
United States / epidemiology

Abstract

Publication types

MeSH terms

Grants and funding