title: Atrial Fibrillation and Declining Physical Performance in Older Adults: The Health, Aging, and Body Composition Study.
abstract: BACKGROUND
  Age is the foremost risk factor for atrial fibrillation (AF), and AF has a rising prevalence in older adults. How AF may contribute to decline in physical performance in older adults has had limited investigation. We examined the associations of incident AF and 4-year interval declines in physical performance at ages 70, 74, 78, and 82 years in the Health, Aging, and Body Composition (Health ABC) Study.
  
  
  RESULTS
  Health ABC is a prospective cohort of community-dwelling older adults (n=3075). The study conducted serial assessments of physical performance with the Health ABC physical performance battery (scored 0-4), grip strength, 2-minute walk distance, and 400-m walking time. Incident AF was identified from the Center for Medicare and Medicaid Services and related to 4-year interval decline in physical performance. After exclusions, the analysis included 2753 Health ABC participants (52% women, 41% black race). Participants with AF had a significantly greater 4-year physical performance battery decline than those without AF at age 70, 74, 78, and 82, with mean estimated decline ranging from -0.08 to -0.10 U (95% confidence interval, -0.18 to -0.01; P<0.05 for all estimates) after multivariable adjustment. Grip strength, walk distance, and walk time similarly showed significantly greater declines at each 4-year age interval in participants with AF.
  
  
  CONCLUSIONS
  In community-based cohort older adults, incident AF was associated with increased risk of decline in physical performance. Further research is essential to identify mechanisms and preventive strategies for how AF may contribute toward declining physical performance in older adults.
authors.affiliation: From the Section of Cardiovascular Medicine, Boston University School of Medicine & National Heart, Lung and Blood Institute and Boston University's Framingham Heart Study, MA (J.W.M., E.J.B.); Department of Biostatistics, Boston University School of Public Health, MA (N.W., L.M.S.); Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, MD (M.E.G., C.L.P.); Division of General Internal Medicine, University of California, San Francisco (D.C.B.); Stony Brook University, NY (J.B.); Cardiovascular Research Center, Massachusetts General Hospital, Charlestown & Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston (P.T.E.); Program in Population and Medical Genetics, The Broad Institute of Harvard and MIT, Cambridge, MA (P.T.E.); Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, NC (S.K.); Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, University of California, San Francisco (G.M.M.); Department of Epidemiology, University of Pittsburgh, PA (A.N.); University of Tsukuba Faculty of Medicine, Tsukuba, Japan (H.S.); Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis (S.S.); and Geriatric Epidemiology Section, National Institute on Aging, Bethesda, MD (T.B.H.). jmagnani@bu.edu.
authors.forename: Jared W
authors.initials: JW
authors.lastname: Magnani
authors.affiliation: From the Section of Cardiovascular Medicine, Boston University School of Medicine & National Heart, Lung and Blood Institute and Boston University's Framingham Heart Study, MA (J.W.M., E.J.B.); Department of Biostatistics, Boston University School of Public Health, MA (N.W., L.M.S.); Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, MD (M.E.G., C.L.P.); Division of General Internal Medicine, University of California, San Francisco (D.C.B.); Stony Brook University, NY (J.B.); Cardiovascular Research Center, Massachusetts General Hospital, Charlestown & Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston (P.T.E.); Program in Population and Medical Genetics, The Broad Institute of Harvard and MIT, Cambridge, MA (P.T.E.); Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, NC (S.K.); Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, University of California, San Francisco (G.M.M.); Department of Epidemiology, University of Pittsburgh, PA (A.N.); University of Tsukuba Faculty of Medicine, Tsukuba, Japan (H.S.); Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis (S.S.); and Geriatric Epidemiology Section, National Institute on Aging, Bethesda, MD (T.B.H.).
authors.forename: Na
authors.initials: N
authors.lastname: Wang
authors.affiliation: From the Section of Cardiovascular Medicine, Boston University School of Medicine & National Heart, Lung and Blood Institute and Boston University's Framingham Heart Study, MA (J.W.M., E.J.B.); Department of Biostatistics, Boston University School of Public Health, MA (N.W., L.M.S.); Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, MD (M.E.G., C.L.P.); Division of General Internal Medicine, University of California, San Francisco (D.C.B.); Stony Brook University, NY (J.B.); Cardiovascular Research Center, Massachusetts General Hospital, Charlestown & Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston (P.T.E.); Program in Population and Medical Genetics, The Broad Institute of Harvard and MIT, Cambridge, MA (P.T.E.); Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, NC (S.K.); Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, University of California, San Francisco (G.M.M.); Department of Epidemiology, University of Pittsburgh, PA (A.N.); University of Tsukuba Faculty of Medicine, Tsukuba, Japan (H.S.); Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis (S.S.); and Geriatric Epidemiology Section, National Institute on Aging, Bethesda, MD (T.B.H.).
authors.forename: Emelia J
authors.initials: EJ
authors.lastname: Benjamin
authors.affiliation: From the Section of Cardiovascular Medicine, Boston University School of Medicine & National Heart, Lung and Blood Institute and Boston University's Framingham Heart Study, MA (J.W.M., E.J.B.); Department of Biostatistics, Boston University School of Public Health, MA (N.W., L.M.S.); Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, MD (M.E.G., C.L.P.); Division of General Internal Medicine, University of California, San Francisco (D.C.B.); Stony Brook University, NY (J.B.); Cardiovascular Research Center, Massachusetts General Hospital, Charlestown & Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston (P.T.E.); Program in Population and Medical Genetics, The Broad Institute of Harvard and MIT, Cambridge, MA (P.T.E.); Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, NC (S.K.); Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, University of California, San Francisco (G.M.M.); Department of Epidemiology, University of Pittsburgh, PA (A.N.); University of Tsukuba Faculty of Medicine, Tsukuba, Japan (H.S.); Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis (S.S.); and Geriatric Epidemiology Section, National Institute on Aging, Bethesda, MD (T.B.H.).
authors.forename: Melissa E
authors.initials: ME
authors.lastname: Garcia
authors.affiliation: From the Section of Cardiovascular Medicine, Boston University School of Medicine & National Heart, Lung and Blood Institute and Boston University's Framingham Heart Study, MA (J.W.M., E.J.B.); Department of Biostatistics, Boston University School of Public Health, MA (N.W., L.M.S.); Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, MD (M.E.G., C.L.P.); Division of General Internal Medicine, University of California, San Francisco (D.C.B.); Stony Brook University, NY (J.B.); Cardiovascular Research Center, Massachusetts General Hospital, Charlestown & Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston (P.T.E.); Program in Population and Medical Genetics, The Broad Institute of Harvard and MIT, Cambridge, MA (P.T.E.); Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, NC (S.K.); Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, University of California, San Francisco (G.M.M.); Department of Epidemiology, University of Pittsburgh, PA (A.N.); University of Tsukuba Faculty of Medicine, Tsukuba, Japan (H.S.); Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis (S.S.); and Geriatric Epidemiology Section, National Institute on Aging, Bethesda, MD (T.B.H.).
authors.forename: Douglas C
authors.initials: DC
authors.lastname: Bauer
authors.affiliation: From the Section of Cardiovascular Medicine, Boston University School of Medicine & National Heart, Lung and Blood Institute and Boston University's Framingham Heart Study, MA (J.W.M., E.J.B.); Department of Biostatistics, Boston University School of Public Health, MA (N.W., L.M.S.); Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, MD (M.E.G., C.L.P.); Division of General Internal Medicine, University of California, San Francisco (D.C.B.); Stony Brook University, NY (J.B.); Cardiovascular Research Center, Massachusetts General Hospital, Charlestown & Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston (P.T.E.); Program in Population and Medical Genetics, The Broad Institute of Harvard and MIT, Cambridge, MA (P.T.E.); Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, NC (S.K.); Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, University of California, San Francisco (G.M.M.); Department of Epidemiology, University of Pittsburgh, PA (A.N.); University of Tsukuba Faculty of Medicine, Tsukuba, Japan (H.S.); Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis (S.S.); and Geriatric Epidemiology Section, National Institute on Aging, Bethesda, MD (T.B.H.).
authors.forename: Javed
authors.initials: J
authors.lastname: Butler
authors.affiliation: From the Section of Cardiovascular Medicine, Boston University School of Medicine & National Heart, Lung and Blood Institute and Boston University's Framingham Heart Study, MA (J.W.M., E.J.B.); Department of Biostatistics, Boston University School of Public Health, MA (N.W., L.M.S.); Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, MD (M.E.G., C.L.P.); Division of General Internal Medicine, University of California, San Francisco (D.C.B.); Stony Brook University, NY (J.B.); Cardiovascular Research Center, Massachusetts General Hospital, Charlestown & Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston (P.T.E.); Program in Population and Medical Genetics, The Broad Institute of Harvard and MIT, Cambridge, MA (P.T.E.); Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, NC (S.K.); Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, University of California, San Francisco (G.M.M.); Department of Epidemiology, University of Pittsburgh, PA (A.N.); University of Tsukuba Faculty of Medicine, Tsukuba, Japan (H.S.); Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis (S.S.); and Geriatric Epidemiology Section, National Institute on Aging, Bethesda, MD (T.B.H.).
authors.forename: Patrick T
authors.initials: PT
authors.lastname: Ellinor
authors.affiliation: From the Section of Cardiovascular Medicine, Boston University School of Medicine & National Heart, Lung and Blood Institute and Boston University's Framingham Heart Study, MA (J.W.M., E.J.B.); Department of Biostatistics, Boston University School of Public Health, MA (N.W., L.M.S.); Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, MD (M.E.G., C.L.P.); Division of General Internal Medicine, University of California, San Francisco (D.C.B.); Stony Brook University, NY (J.B.); Cardiovascular Research Center, Massachusetts General Hospital, Charlestown & Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston (P.T.E.); Program in Population and Medical Genetics, The Broad Institute of Harvard and MIT, Cambridge, MA (P.T.E.); Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, NC (S.K.); Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, University of California, San Francisco (G.M.M.); Department of Epidemiology, University of Pittsburgh, PA (A.N.); University of Tsukuba Faculty of Medicine, Tsukuba, Japan (H.S.); Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis (S.S.); and Geriatric Epidemiology Section, National Institute on Aging, Bethesda, MD (T.B.H.).
authors.forename: Stephen
authors.initials: S
authors.lastname: Kritchevsky
authors.affiliation: From the Section of Cardiovascular Medicine, Boston University School of Medicine & National Heart, Lung and Blood Institute and Boston University's Framingham Heart Study, MA (J.W.M., E.J.B.); Department of Biostatistics, Boston University School of Public Health, MA (N.W., L.M.S.); Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, MD (M.E.G., C.L.P.); Division of General Internal Medicine, University of California, San Francisco (D.C.B.); Stony Brook University, NY (J.B.); Cardiovascular Research Center, Massachusetts General Hospital, Charlestown & Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston (P.T.E.); Program in Population and Medical Genetics, The Broad Institute of Harvard and MIT, Cambridge, MA (P.T.E.); Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, NC (S.K.); Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, University of California, San Francisco (G.M.M.); Department of Epidemiology, University of Pittsburgh, PA (A.N.); University of Tsukuba Faculty of Medicine, Tsukuba, Japan (H.S.); Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis (S.S.); and Geriatric Epidemiology Section, National Institute on Aging, Bethesda, MD (T.B.H.).
authors.forename: Gregory M
authors.initials: GM
authors.lastname: Marcus
authors.affiliation: From the Section of Cardiovascular Medicine, Boston University School of Medicine & National Heart, Lung and Blood Institute and Boston University's Framingham Heart Study, MA (J.W.M., E.J.B.); Department of Biostatistics, Boston University School of Public Health, MA (N.W., L.M.S.); Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, MD (M.E.G., C.L.P.); Division of General Internal Medicine, University of California, San Francisco (D.C.B.); Stony Brook University, NY (J.B.); Cardiovascular Research Center, Massachusetts General Hospital, Charlestown & Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston (P.T.E.); Program in Population and Medical Genetics, The Broad Institute of Harvard and MIT, Cambridge, MA (P.T.E.); Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, NC (S.K.); Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, University of California, San Francisco (G.M.M.); Department of Epidemiology, University of Pittsburgh, PA (A.N.); University of Tsukuba Faculty of Medicine, Tsukuba, Japan (H.S.); Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis (S.S.); and Geriatric Epidemiology Section, National Institute on Aging, Bethesda, MD (T.B.H.).
authors.forename: Anne
authors.initials: A
authors.lastname: Newman
authors.affiliation: From the Section of Cardiovascular Medicine, Boston University School of Medicine & National Heart, Lung and Blood Institute and Boston University's Framingham Heart Study, MA (J.W.M., E.J.B.); Department of Biostatistics, Boston University School of Public Health, MA (N.W., L.M.S.); Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, MD (M.E.G., C.L.P.); Division of General Internal Medicine, University of California, San Francisco (D.C.B.); Stony Brook University, NY (J.B.); Cardiovascular Research Center, Massachusetts General Hospital, Charlestown & Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston (P.T.E.); Program in Population and Medical Genetics, The Broad Institute of Harvard and MIT, Cambridge, MA (P.T.E.); Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, NC (S.K.); Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, University of California, San Francisco (G.M.M.); Department of Epidemiology, University of Pittsburgh, PA (A.N.); University of Tsukuba Faculty of Medicine, Tsukuba, Japan (H.S.); Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis (S.S.); and Geriatric Epidemiology Section, National Institute on Aging, Bethesda, MD (T.B.H.).
authors.forename: Caroline L
authors.initials: CL
authors.lastname: Phillips
authors.affiliation: From the Section of Cardiovascular Medicine, Boston University School of Medicine & National Heart, Lung and Blood Institute and Boston University's Framingham Heart Study, MA (J.W.M., E.J.B.); Department of Biostatistics, Boston University School of Public Health, MA (N.W., L.M.S.); Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, MD (M.E.G., C.L.P.); Division of General Internal Medicine, University of California, San Francisco (D.C.B.); Stony Brook University, NY (J.B.); Cardiovascular Research Center, Massachusetts General Hospital, Charlestown & Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston (P.T.E.); Program in Population and Medical Genetics, The Broad Institute of Harvard and MIT, Cambridge, MA (P.T.E.); Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, NC (S.K.); Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, University of California, San Francisco (G.M.M.); Department of Epidemiology, University of Pittsburgh, PA (A.N.); University of Tsukuba Faculty of Medicine, Tsukuba, Japan (H.S.); Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis (S.S.); and Geriatric Epidemiology Section, National Institute on Aging, Bethesda, MD (T.B.H.).
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sasai
authors.affiliation: From the Section of Cardiovascular Medicine, Boston University School of Medicine & National Heart, Lung and Blood Institute and Boston University's Framingham Heart Study, MA (J.W.M., E.J.B.); Department of Biostatistics, Boston University School of Public Health, MA (N.W., L.M.S.); Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, MD (M.E.G., C.L.P.); Division of General Internal Medicine, University of California, San Francisco (D.C.B.); Stony Brook University, NY (J.B.); Cardiovascular Research Center, Massachusetts General Hospital, Charlestown & Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston (P.T.E.); Program in Population and Medical Genetics, The Broad Institute of Harvard and MIT, Cambridge, MA (P.T.E.); Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, NC (S.K.); Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, University of California, San Francisco (G.M.M.); Department of Epidemiology, University of Pittsburgh, PA (A.N.); University of Tsukuba Faculty of Medicine, Tsukuba, Japan (H.S.); Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis (S.S.); and Geriatric Epidemiology Section, National Institute on Aging, Bethesda, MD (T.B.H.).
authors.forename: Suzanne
authors.initials: S
authors.lastname: Satterfield
authors.affiliation: From the Section of Cardiovascular Medicine, Boston University School of Medicine & National Heart, Lung and Blood Institute and Boston University's Framingham Heart Study, MA (J.W.M., E.J.B.); Department of Biostatistics, Boston University School of Public Health, MA (N.W., L.M.S.); Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, MD (M.E.G., C.L.P.); Division of General Internal Medicine, University of California, San Francisco (D.C.B.); Stony Brook University, NY (J.B.); Cardiovascular Research Center, Massachusetts General Hospital, Charlestown & Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston (P.T.E.); Program in Population and Medical Genetics, The Broad Institute of Harvard and MIT, Cambridge, MA (P.T.E.); Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, NC (S.K.); Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, University of California, San Francisco (G.M.M.); Department of Epidemiology, University of Pittsburgh, PA (A.N.); University of Tsukuba Faculty of Medicine, Tsukuba, Japan (H.S.); Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis (S.S.); and Geriatric Epidemiology Section, National Institute on Aging, Bethesda, MD (T.B.H.).
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Sullivan
authors.affiliation: From the Section of Cardiovascular Medicine, Boston University School of Medicine & National Heart, Lung and Blood Institute and Boston University's Framingham Heart Study, MA (J.W.M., E.J.B.); Department of Biostatistics, Boston University School of Public Health, MA (N.W., L.M.S.); Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, MD (M.E.G., C.L.P.); Division of General Internal Medicine, University of California, San Francisco (D.C.B.); Stony Brook University, NY (J.B.); Cardiovascular Research Center, Massachusetts General Hospital, Charlestown & Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston (P.T.E.); Program in Population and Medical Genetics, The Broad Institute of Harvard and MIT, Cambridge, MA (P.T.E.); Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, NC (S.K.); Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, University of California, San Francisco (G.M.M.); Department of Epidemiology, University of Pittsburgh, PA (A.N.); University of Tsukuba Faculty of Medicine, Tsukuba, Japan (H.S.); Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis (S.S.); and Geriatric Epidemiology Section, National Institute on Aging, Bethesda, MD (T.B.H.).
authors.forename: Tamara B
authors.initials: TB
authors.lastname: Harris
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000503:physiopathology* / Q000534:rehabilitation; D001823:Body Composition; D004185:Disability Evaluation; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology
keywords: aging; atrial fibrillation; epidemiology; medicare; physical exercise