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Multimorbidity, physical frailty, and self-rated health in older patients with atrial fibrillation
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...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7488548/ https://www.ncbi.nlm.nih.gov/pubmed/32917137 http://dx.doi.org/10.1186/s12877-020-01755-w |
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author | Abu, Hawa O. Saczynski, Jane Mehawej, Jordy Paul, Tenes Awad, Hamza Bamgbade, Benita A. Pierre-Louis, Isabelle C. Tisminetzky, Mayra Kiefe, Catarina I. Goldberg, Robert J. McManus, David D. |
author_facet | Abu, Hawa O. Saczynski, Jane Mehawej, Jordy Paul, Tenes Awad, Hamza Bamgbade, Benita A. Pierre-Louis, Isabelle C. Tisminetzky, Mayra Kiefe, Catarina I. Goldberg, Robert J. McManus, David D. |
author_sort | Abu, Hawa O. |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-7488548 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-74885482020-09-16 Multimorbidity, physical frailty, and self-rated health in older patients with atrial fibrillation Abu, Hawa O. Saczynski, Jane Mehawej, Jordy Paul, Tenes Awad, Hamza Bamgbade, Benita A. Pierre-Louis, Isabelle C. Tisminetzky, Mayra Kiefe, Catarina I. Goldberg, Robert J. McManus, David D. BMC Geriatr Research Article 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. BioMed Central 2020-09-11 /pmc/articles/PMC7488548/ /pubmed/32917137 http://dx.doi.org/10.1186/s12877-020-01755-w Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Abu, Hawa O. Saczynski, Jane Mehawej, Jordy Paul, Tenes Awad, Hamza Bamgbade, Benita A. Pierre-Louis, Isabelle C. Tisminetzky, Mayra Kiefe, Catarina I. Goldberg, Robert J. McManus, David D. Multimorbidity, physical frailty, and self-rated health in older patients with atrial fibrillation |
title | Multimorbidity, physical frailty, and self-rated health in older patients with atrial fibrillation |
title_full | Multimorbidity, physical frailty, and self-rated health in older patients with atrial fibrillation |
title_fullStr | Multimorbidity, physical frailty, and self-rated health in older patients with atrial fibrillation |
title_full_unstemmed | Multimorbidity, physical frailty, and self-rated health in older patients with atrial fibrillation |
title_short | Multimorbidity, physical frailty, and self-rated health in older patients with atrial fibrillation |
title_sort | multimorbidity, physical frailty, and self-rated health in older patients with atrial fibrillation |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7488548/ https://www.ncbi.nlm.nih.gov/pubmed/32917137 http://dx.doi.org/10.1186/s12877-020-01755-w |
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