ArticleJournal of the American Geriatrics Society2021
Long-term individual and population functional outcomes in older adults with atrial fibrillation.
Article in Journal of the American Geriatrics Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
9 citing papers in PubMed, 46 citations in OpenAlex.
- Identifying a Heterogeneous Effect of Atrial Fibrillation Screening in Older Adults: A Secondary Analysis of the VITAL-AF Trial.Circulation. Cardiovascular quality and outcomes · 2025Trial
- Anticoagulation Outcomes in Nursing Home Residents With Atrial Fibrillation and ADL Disability.JAMA network open · 2026Article
- Systematic Review and Meta-Analysis of the Frequency of Thromboembolic Events, Bleeding, and Mortality in Patients with Atrial Fibrillation and End-Stage Renal Disease Undergoing Percutaneous Left Atrial Appendage Closure.Journal of clinical medicine · 2026Review
- Development and Validation of a Prognostic Model for One-year Mortality in Older Adults with Acute Myocardial Infarction Incorporating Activities of Daily Living Impairment.Clinical interventions in aging · 2026Article
- Prognostic role of short physical performance battery in elderly hospitalized atrial fibrillation patients.Internal and emergency medicine · 2025Article
- Resilience, Survival, and Functional Independence in Older Adults Facing Critical Illness.Chest · 2024Article
- Interactions between patterns of multimorbidity and functional status among hospitalized older patients: a novel approach using cluster analysis and association rule mining.Journal of translational medicine · 2024Article
- Association between atrial fibrillation, frailty, and geriatric syndromes in the late elderly in a south Belgian outpatient and inpatient setting.American heart journal plus : cardiology research and practice · 2022Article
- Gait Speed and Instrumental Activities of Daily Living in Older Adults After Hospitalization: A Longitudinal Population-Based Study.The journals of gerontology. Series A, Biological sciences and medical sciences · 2021Article
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
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 < 0.05 for all). Accounting for comorbidities, of those who experienced a stroke, 31.9% developed new ADL dependence, 26.5% developed new IADL dependence, and 8.6% newly moved to a nursing home (p < 0.05 for all). Considering all causes of function loss, 1.7% of ADL disability-years, 1.2% of IADL disability-years, and 7.3% of nursing home years could be attributed to stroke over 7.4 years.
conclusionOlder adults lose substantial function over time following AF diagnosis, independent of stroke. Stroke was associated with a significant functional decline and increase in the likelihood of nursing home move, but stroke did not accelerate subsequent disability accrual. Because of the high background rate of disability, stroke was not the dominant determinant of population-level disability in older adults with AF.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.