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Multicenter Study
. 2017 Jun;16(2):71-75.
doi: 10.1097/HPC.0000000000000101.

Burden of Psychosocial and Cognitive Impairment in Patients With Atrial Fibrillation

John A Bostrom  1 , Jane S Saczynski, Alexandra Hajduk, Kevin Donahue, Lawrence S Rosenthal, Clifford Browning, Cynthia Ennis, Kevin C Floyd, Heather Richardson, Nada Esa, Jessica Ogarek, David D McManus
Affiliations
Multicenter Study

Burden of Psychosocial and Cognitive Impairment in Patients With Atrial Fibrillation

John A Bostrom et al. Crit Pathw Cardiol. 2017 Jun.

Abstract

Background: Impairments in psychosocial status and cognition relate to poor clinical outcomes in patients with atrial fibrillation (AF). However, how often these conditions co-occur and associations between burden of psychosocial and cognitive impairment and quality of life (QoL) have not been systematically examined in patients with AF.

Methods: A total of 218 patients with symptomatic AF were enrolled in a prospective study of AF and psychosocial factors between May 2013 and October 2014 at the University of Massachusetts Medical Center. Cognitive function, depression, and anxiety were assessed at baseline and AF-specific QoL was assessed 6 months after enrollment using validated instruments. Demographic and clinical information were obtained from a structured interview and medical record review.

Results: The mean age of the study participants was 63.5 ± 10.2 years, 35% were male, and 81% had paroxysmal AF. Prevalences of impairment in 1, 2, and 3 psychosocial/cognitive domains (eg, depression, anxiety, or cognition) were 75 (34.4%), 51 (23.4%), and 16 (7.3%), respectively. Patients with co-occurring psychosocial/cognitive impairments (eg, >1 domain) were older, more likely to smoke, had less education, and were more likely to have heart failure (all P < 0.05). Compared with participants with no psychosocial/cognitive impairments, AF-specific QoL at 6 months was significantly poorer among participants with baseline impairment in 2 (B = -13.6, 95% CI: -21.7 to -5.4) or 3 (B = -15.1, 95% CI: -28.0 to -2.2) psychosocial/cognitive domains.

Conclusion: Depression, anxiety, and impaired cognition were common in our cohort of patients with symptomatic AF and often co-occurred. Higher burden of psychosocial/cognitive impairment was associated with poorer AF-specific QoL.

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Figures

FIGURE 1.
FIGURE 1.
InRhythm participants categorized by impairment in psychosocial and cognitive domains. Percentage values refer to the percent of the total study population (n = 218).
See this image and copyright information in PMC

References

    1. Go AS, Hylek EM, Phillips KA, et al. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA. 2001;285:2370–2375.. - PubMed
    1. Steinberg JS. Atrial fibrillation: an emerging epidemic? Heart. 2004;90:239–240.. - PMC - PubMed
    1. Naccarelli GV, Varker H, Lin J, Schulman KL. Increasing prevalence of atrial fibrillation and flutter in the United States. Am J Cardiol. 2009;104:1534–1539.. - PubMed
    1. Kim MH, Johnston SS, Chu BC, Dalal MR, Schulman KL. Estimation of total incremental health care costs in patients with atrial fibrillation in the United States. Circ Cardiovasc Qual Outcomes. 2011;4:313–320.. - PubMed
    1. Knecht S, Oelschläger C, Duning T, et al. Atrial fibrillation in stroke-free patients is associated with memory impairment and hippocampal atrophy. Eur Heart J. 2008;29:2125–2132.. - PubMed

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