Symptom severity and quality of life in patients with atrial fibrillation: Psychological function outweighs clinical predictors

Walters, Tomos E.; Wick, Kate; Tan, Gabriel; Mearns, Megan; Joseph, Stephen; Morton, Joseph B.; Sanders, Prashanthan; Bryant, Christina; Kalman, Jonathan M.

doi:10.1016/j.ijcard.2018.10.101

Cited by 27 publications

(33 citation statements)

References 39 publications

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“…Additionally, we found that psychosocial and cognitive multimorbidity was associated with high symptom burden. This finding aligns with literature showing associations between individual impairments (e.g., depression only, anxiety only) and higher symptom burden ( Walters, Wick, & Tan, 2019 ; Kang, 2006 ; Katon, Lin, & Kroenke, 2007 ; Thompson et al, 2014 and extends existing literature by showing associations between cognitive impairment only and higher symptom burden. Regarding associations of each impairment with HRQoL ( supplemental Table 1 ), except for cognitive impairment only, a greater proportion of participants with all individual impairments and impairment combinations had low HRQoL compared to those with no impairment.…”

Section: Discussionsupporting

confidence: 90%

“…To our knowledge, there are no studies evaluating the impact of cognitive impairment on symptom burden. There is limited evidence showing an association between symptom burden and anxiety ( Charitakis et al, 2017 ; Thompson et al, 2014 ; Walters et al, 2019 ). Our findings suggest that depression may play a larger and unexplored role in the relationship between other impairments and symptom burden.…”

Section: Discussionmentioning

confidence: 99%

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Psychosocial and cognitive multimorbidity and health-related quality of life and symptom burden in older adults with atrial fibrillation: The systematic assessment of geriatric elements in atrial fibrillation (SAGE-AF) cohort study

Bamgbade

Sanghai

McManus

et al. 2020

Archives of Gerontology and Geriatrics

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Background: Depression, anxiety, and cognitive impairments occur in up to 40 % of adults with AF and are associated with poorer health-related quality of life (HRQoL) and higher symptom burden. However, it is unknown how often these impairments co-occur, or multimorbidity, and how multimorbidity effects HRQoL and symptom burden. Methods: Patients with AF age ≥65 years with a CHA 2 DS 2 VASC risk score ≥ 2 and eligible for oral anticoagulation therapy were recruited from five clinics in a prospective cohort study. Participants completed validated measures of depression (PHQ9) and anxiety (GAD7), cognitive impairment (MoCA), and HRQOL and AF symptom burden (AFEQT). Multinomial logistic regression was used. Results: Participants (N = 1244, 49 % female) were on average 76 ± 7 years; 86 % were non-Hispanic white. Approximately 35 % of participants had 1 impairment, 17 % had 2 impairments and 8% had 3 impairments; 39 % had none of the 3 impairments examined. Compared to participants with no impairments, patients with 1, 2 and 3 impairments had higher odds of poor HRQoL (adjusted OR [AOR] = 1.77, 95 % CI 1.21, 2.60; AOR = 6.64, 95 % CI 4.43, 9.96; and AOR = 7.50, 95 % CI 4.40, 12.77, respectively) and those with 2 and 3 impairments had higher odds of high symptom burden (AOR = 3.69 95 % CI 2.22, 6.13; and AOR = 5.41 95 % CI 2.85, 10.26). Conclusions: Psychosocial/cognitive multimorbidity is common among older adults with AF and is associated with poor HRQoL and high symptom burden. Clinicians might consider incorporating psychosocial and cognitive screens into routine care as this may identify a high-risk population.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Psychosocial and cognitive multimorbidity and health-related quality of life and symptom burden in older adults with atrial fibrillation: The systematic assessment of geriatric elements in atrial fibrillation (SAGE-AF) cohort study

Bamgbade

Sanghai

McManus

et al. 2020

Archives of Gerontology and Geriatrics

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“…However, most of these studies have used generic questionnaires and these are influenced not only by the arrhythmia but also by other causes, for example, concomitant diseases . In two recent studies, disease‐specific questionnaires were used confirming previously reported gender differences.…”

Section: Discussionmentioning

confidence: 99%

“…The reasons suggested range from socioeconomic factors to fundamental gender differences regarding perception of illness . Bazemore et al made use of disease‐specific questionnaires but merely states that “this gender gap in enrolment for catheter ablation is unclear and likely due to multiple patient and provider factors.” Walters et al evaluated symptom severity and HRQoL also with disease‐specific instruments and found that psychological factors outweighed clinical predictors …”

Section: Discussionmentioning

confidence: 99%

“…6 Walters et al evaluated symptom severity and HRQoL also with disease-specific instruments and found that psychological factors outweighed clinical predictors. 16 The main finding that older patients report a more severe impact on HRQoL, particularly on the physical subscale, is not surprising. That increasing age correlates with reduced HRQoL is a common finding.…”

Section: Health-related Quality Of Life From a Gender And Age Perspecmentioning

confidence: 96%

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Gender and age differences in symptoms and health‐related quality of life in patients with atrial fibrillation referred for catheter ablation

Walfridsson

Hansen²,

Charitakis

et al. 2019

Pacing Clinical Electrophis

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Background Primary indication for catheter ablation of atrial fibrillation (AF) is to reduce symptoms and improve health‐related quality of life (HRQoL). There are data showing differences between the genders and between younger and older patients. To evaluate this, we studied a large Scandinavian cohort of patients referred for catheter ablation of AF. Methods Consecutive patients filled out the ASTA questionnaire, assessing symptoms, HRQoL, and perception of arrhythmia, prior to ablation. Patients were recruited from four Swedish and one Danish tertiary center. Results A total of 2493 patients (72% men) filled out the ASTA questionnaire. Women experienced eight of the nine ASTA scale symptoms more often than men. Patients <65 years reported four symptoms more often, only tiredness was more frequent in those ≥65 years (P = .007). Women and patients <65 years experienced more often palpitations and regarding close to fainting and this was more common among women, no age differences were seen. Women and men scored differently in 10 of the 13 HRQoL items. Only negative impact on sexual life was more common in men (P < .001). Older patients reported more negative influence in four of the HRQoL items and the younger in one; ability to concentrate. Conclusions Women experienced a more pronounced symptom burden and were more negatively affected in all HRQoL concerns, except for the negative impact on sexual life, where men reported more influence of AF. Differences between age groups were less pronounced. Disease‐specific patient‐reported outcomes measures (PROMs) add important information where gender differences should be considered in the care.

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Severity of heart failure and health-related quality of life in beta-thalassemia patients: a cross-sectional study

et al. 2020

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Symptom severity and quality of life in patients with atrial fibrillation: Psychological function outweighs clinical predictors

Cited by 27 publications

References 39 publications

Psychosocial and cognitive multimorbidity and health-related quality of life and symptom burden in older adults with atrial fibrillation: The systematic assessment of geriatric elements in atrial fibrillation (SAGE-AF) cohort study

Psychosocial and cognitive multimorbidity and health-related quality of life and symptom burden in older adults with atrial fibrillation: The systematic assessment of geriatric elements in atrial fibrillation (SAGE-AF) cohort study

Gender and age differences in symptoms and health‐related quality of life in patients with atrial fibrillation referred for catheter ablation

Severity of heart failure and health-related quality of life in beta-thalassemia patients: a cross-sectional study

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