The role of comorbidity and frailty in shaping the burden of atrial fibrillation: a multinational cross-sectional survey
Abstract
Abstract Atrial fibrillation (AF) is the most common arrhythmia in older adults and often coexists with other chronic conditions, exacerbating physical and cognitive decline and contributing to frailty. The interplay between frailty and comorbidity in AF remains underexplored, particularly regarding quality of life (QoL), health management, and outcome prioritization. Within the AFFIRMO project, this study investigated the experiences of older adults with AF and at least one chronic condition via an online survey. Frailty was assessed using the FRAIL questionnaire, and participants were grouped by frailty status and number of comorbidities. Health-related quality of life (HRQoL) was measured using the EQ-5D-3L and Visual Analogue Scale (VAS). Challenges in health management and prioritized outcomes were also explored. We included 659 participants (median age 72 years, 52.8% female). Those with pre-frailty or frailty and ≥ 3 comorbidities reported the poorest HRQoL. Comorbidity, particularly combined with frailty, was associated with health management difficulties, including healthcare visits, polypharmacy, and mobility limitations. Across all groups, maintaining independence and improving QoL were prioritized outcomes. Pain relief was especially important for those with higher comorbidities. In older adults with AF, comorbidity and frailty significantly affect QoL and health burden. Tailored, patient-centred care strategies and routine assessment of frailty and comorbidity are essential to improve care coordination and outcomes.
Article Details
Authors (62)
Adele Ravelli
Bruno Micael Zanforlini
Søren Paaske Johnsen
Donato Giuseppe Leo
Deirdre A. Lane
Søren Påske Johnsen
Riccardo Proietti
Pia Cordsen
Gregory Lip
Deirdre Lane
Martin O’Flaherty
Carrol Gamble
Liverpool Clinical Trials Centre, University of Liverpool, Liverpool, United Kingdom
Iain Buchan
Christodoulos Kypridemos
Brendan Collins
Donato Leo
Mirko Petrovic
Delphine De Smedt
Stefanie De Buyser
Cheima Amrouch
Davide Liborio Vetrano
Amaia Calderón-Larrañaga
Lu Dai
Stefania Maggi
Marianna Noale
Gheorghe-Andrei Dan
Anca Rodica Dan
Nicola Ferri
Alessandra Buja
Giuseppe Sergi
Vincenzo Stefano Rebba
Caterina Trevisan
Tatjana Potpara
Laura Vivani
Silvia Anastasia
Alessandro Ferri
Gehad Shehata
Nadia Rosso
Marco Cicerone
Jacek Marczyk
Trudie Lobban
Georg Ruppe
Federica Censi
Roberto Da Cas
Cecilia Damiano
Benedetta Marcozzi
Guendalina Graffigna
Caterina Bosio
Lorenzo Palamenghi
Serena Barello
Aldo Pietro Maggioni
Andrea Lorimer
Donata Lucci
Dipak Kalra
Nathan Lea
John Ainsworth
Charlotte Stockton-Powdrell
Alam Sanaullah
Francisco Marín Ortuno
José Miguel Rivera-Caravaca
Vanessa Roldán
Mariya Tokmakova