Atrial Fibrillation Is Associated With Impaired Mobility in Community-Dwelling Older Adults

Objectives: To examine the independent associations between atrial fibrillation (AF) and objectively measured mobility in a nationally representative cohort. Design: Wave 1 of The Irish Longitudinal Study on Ageing (TILDA), a population-based study assessing health, economic, and social aspects of ageing. Setting: Community-dwelling adults completed a home-based interview and a center-based health assessment. Participants: Participants aged 50 years or older, with Mini-Mental State Examination score of 24 or higher, and who completed at least 1 mobility test (n = 4525). Measurements: Mobility was assessed with the Timed Up-and-Go (TUG) test and usual and dual task gait speed obtained using a 4.88-m GAITRite (R) mat. AF was diagnosed using a 10-minute surface electrocardiogram recording. Linear regression analyses were performed to compare mobility in participants with and without AF, adjusting for confounders. Results: In this sample (mean age 62.3 years; range 51-89), overall prevalence of AF was 3.1%, increasing to 6.7% in the over 70s (11.8% men; 2.8% women). In multivariate analysis, AF was independently associated with slower TUG (beta 0.37; 95% confidence interval [CI] 0.07-0.71; P = .043) and slower usual gait speed (beta -3.59; 95% CI -7.05 to -0.12; P = .030). There was a significant age*AF interaction effect for usual gait speed (beta -0.480, 95% CI -0.907 to -0.053, P = .028). Adults with AF walked 3.77 cm/s more slowly than adults without AF at age 70, declining by 4.8 cm/s for each additional decade. Conclusion: AF is independently associated with lower usual gait speed in community-dwelling adults and this effect is magnified in those aged 70 and older. This may place them at increased risk of falls, hospitalization, cognitive decline, and mortality, as well as stroke and heart failure. Early recognition and treatment of AF is vital to improve physical function and reduce this risk. (C) 2014 AMDA - The Society for Post-Acute and Long-Term Care Medicine.