Abstract 16921: Atrial Fibrillation is Associated with Significant Physical Function Decline in Older Adults

Abstract

Introduction: Atrial fibrillation (AF) is associated with significant morbidity in older adults. The effect of AF on physical function has had limited investigation. We related incident AF to prospective change in physical function across serial assessments in the Dynamics of Health, Aging, and Body Composition Study (HABC). Methods: HABC is a prospective study of older adults age 70-79 initiated in 1997-98. Physical function has been assessed in the cohort with the HABC performance battery (HABCPPB), scored 0-4, consisting of gait speed, chair stands, and balance assessments, administered at years 1, 4, 6, 8 and 10. Incident AF was ascertained from linkage with Center for Medicare and Medicaid Services, and dated by the first in-patient or second of 2 out-patient encounters. We used mixed effects regression analysis to relate incident AF to 4-year decline in the HABCPPB. Analyses incorporated age and AF as time-varying covariates and relevant multivariable adjustment (demographics; smoking, alcohol; cardiovascular disease [CVD] risk factors; prevalent CVD; and time varying hypertension, diabetes, CVD, and cancer). Results: Following exclusions, 2753 (age 73.6±2.9 years, 52% women, 41% black race) HABC participants were eligible for the analysis. We determined that older adults who developed AF at ages 74, 78, and 82 had significantly greater ( P <0.001) 4-year decline in physical function than those without AF. The Figure compares the trajectories of 4-year HABCPPB decline in those with and without AF at ages 70, 74, 78, and 82. For age centered at 74, the difference in 4-year decline in HABCPPB in those with and without AF was -0.10 (95% CI -0.21, 0.00); -0.21 (-0.31, -0.11) at age 78; and -0.32 (-0.48, -0.15) at age 82. These differences in physical function decline remained significant (P<0.001) following multivariable adjustment. Conclusions: In a community-dwelling cohort of older adults, AF was associated with significant 4-year decline in physical function.