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<p>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&#xa0;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.</p>

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The role of comorbidity and frailty in shaping the burden of atrial fibrillation: a multinational cross-sectional survey

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月30日

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  • Adele Ravelli,
  • Caterina Trevisan,
  • José Miguel Rivera-Caravaca,
  • Bruno Micael Zanforlini,
  • Caterina Bosio,
  • Guendalina Graffigna,
  • Giuseppe Sergi,
  • Gheorghe-Andrei Dan,
  • Anca Rodica Dan,
  • Vanessa Roldán,
  • Francisco Marín Ortuno,
  • Søren Paaske Johnsen,
  • Mirko Petrovic,
  • Davide Liborio Vetrano,
  • Donato Giuseppe Leo,
  • Deirdre A. Lane,
  • Søren Påske Johnsen,
  • Riccardo Proietti,
  • Pia Cordsen,
  • Gregory Lip,
  • Deirdre Lane,
  • Martin O’Flaherty,
  • Carrol Gamble,
  • 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 Ortuño,
  • José Miguel Rivera-Caravaca,
  • Vanessa Roldán,
  • Mariya Tokmakova

摘要

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.