학술논문

Long‐term individual and population functional outcomes in older adults with atrial fibrillation
Document Type
article
Source
Journal of the American Geriatrics Society. 69(6)
Subject
Health Services and Systems
Health Sciences
Clinical Research
Stroke
Physical Rehabilitation
Aging
Brain Disorders
Rehabilitation
Quality Education
Activities of Daily Living
Aged
Aged
80 and over
Atrial Fibrillation
Disabled Persons
Female
Health Surveys
Humans
Independent Living
Male
Risk Factors
United States
atrial fibrillation
disability
stroke
Medical and Health Sciences
Geriatrics
Biomedical and clinical sciences
Health sciences
Psychology
Language
Abstract
BackgroundOlder adults with atrial fibrillation (AF) have multiple risk factors for disablement. Long-term function and the contribution of strokes to disability have not been previously characterized. Our objective was to determine long-term function among older adults with AF and the relative contribution of stroke.MethodsWe used data from the nationally representative Health and Retirement Study (1992-2014) with participants ≥65 years with incident AF. We examined the association of incident stroke with three outcomes: independence with activities of daily living (ADL), instrumental activities of daily living (IADL), and residence outside a nursing home (community-dwelling). We fit logistic regression models with repeated measures adjusting for comorbidities and demographics to estimate the effect of stroke on function. We estimated the contribution of strokes to the overall population burden of disability using the method of recycled predictions.ResultsAmong 3530 participants (median age 79 years, 53% women), 262 had a stroke over 17,396 person-years. Independent of stroke and accounting for comorbidities, annually, ADL independence decreased by 4.4%, IADL independence decreased by 3.9%, and community dwelling decreased by 1.2% (p