Gait Speed and Mood, Cognition, and Quality of Life in Older Adults With Atrial Fibrillation

Author:

Marino Francesca R.1,Lessard Darleen M.2,Saczynski Jane S.3,McManus David D.12,Silverman‐Lloyd Luke G.45,Benson Christopher M.6,Blaha Michael J.5,Waring Molly E.7

Affiliation:

1. Division of Cardiology Department of Medicine University of Massachusetts Medical School Worcester MA

2. Department of Population and Quantitative Health Sciences University of Massachusetts Medical School Worcester MA

3. Department of Pharmacy and Health System Sciences Northeastern University Boston MA

4. University of California, Berkeley – University of California, San Francisco Joint Medical Program UC Berkeley School of Public Health Berkeley CA

5. Ciccarone Center for the Prevention of Cardiovascular Disease Johns Hopkins School of Medicine Baltimore MD

6. School of Medicine Albany Medical College Albany NY

7. Department of Allied Health Sciences University of Connecticut Storrs CT

Abstract

Background Low gait speed has been linked with impaired mood, cognition, and quality of life ( QOL ) in older adults. We examined whether low gait speed was associated with impaired mood, cognition, and QOL among older adults with atrial fibrillation ( AF ). Methods and Results Participants (n=1185) had a diagnosis of AF , aged ≥65 years, CHA 2 DS 2 VAS c ≥2 and had no contraindications to anticoagulation. Participants completed a 15‐foot walk test, and low gait speed was categorized using cutoffs from the Fried Frailty Index. Participants self‐reported measures of depressive symptoms (Patient Health Questionnaire 9 ≥10), anxiety symptoms (Generalized Anxiety Disorder 7 ≥10), cognitive impairment (Montreal Cognitive Assessment ≤23), and potentially impaired Atrial Fibrillation Effect Quality‐of‐Life Questionnaire <80. Participants were on average aged 75.3 ( SD : 7.0) years, 48.0% were women, and 85.5% were non‐Hispanic white; 85.6% were taking an oral anticoagulant, 26.1% had low gait speed, 8.4% had elevated depressive symptoms, 5.7% had elevated anxiety symptoms, 41.1% were cognitively impaired, and 41.6% had potentially impaired AF ‐related QOL . Participants with low gait speed were significantly more likely to have elevated depressive symptoms (adjusted odds ratio: 2.1, 95% CI : 1.3–3.4), elevated anxiety symptoms (adjusted odds ratio: 2.2, 95% CI : 1.2–3.9), and cognitive impairment (adjusted odds ratio: 1.5, 95% CI : 1.1–2.1). Impaired AF ‐related QOL did not differ by gait speed after adjustment for clinical characteristics (adjusted odds ratio: 1.1, 95% CI : 0.8–1.5). Conclusions Twenty‐six percent of older adults with AF had low gait speed, and low gait speed was associated with impaired mood and cognition. Further research is needed to determine whether declines in gait speed lead to impaired mood and cognition or whether these conditions develop concurrently.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine

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