Warfarin Treatment and All-Cause Mortality in Community-Dwelling Older Adults with Atrial Fibrillation: A Retrospective Observational Study

ABSTRACT: Objective: To evaluate all-cause mortality in approximately three years of follow-up and related sociodemographic, behavioral and health factors in community-dwelling older adults in Pelotas, RS. Methods: This was a longitudinal observational study that included 1,451 older adults (≥ 60 years) who were interviewed in 2014. Information on mortality was collected from their households in 2016–2017 and confirmed with the Epidemiological Surveillance department of the city and by documents from family members. Associations between mortality and independent variables were assessed by crude and multiple Cox regression, with hazard ratio with respective 95% confidence intervals (95%CI). Results: Almost 10% (n = 145) of the participants died during an average of 2.5 years of follow-up, with a higher frequency of deaths among males (12.9%), ?80 years (25.2%), widowhood (15.0%), no education (13.8%) and who did not work (10.5%). Factors associated with higher mortality were: being a male (HR = 2.8; 95%CI 1.9 – 4.2), age ?80 years (HR = 3.9; 95%CI 2.4 – 6.2), widowhood (HR = 2.2; 95%CI 1.4 – 3.7), physical inactivity (HR = 2.3; 95%CI 1.1 – 4..6), current smoking (HR = 2.1; 95%CI 1.2 – 3.6), hospitalizations in the previous year (HR = 2.0; 95%CI 1.2 – 3.2), depressive symptoms (HR = 2.0; 95%CI 1.2 – 3,4) and dependence for two or more daily life activities (HR = 3.1; 95%CI 1,7 – 5.7). Conclusion: The identification of factors that increased the risk of early death makes it possible to improve public policies aimed at controlling the modifiable risk factors that can lead to aging with a better quality of life.

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The Avoidance of Activities due to Fear of Falling Contributes to Sedentary Behavior among Community-Dwelling Older Adults with Chronic Musculoskeletal Pain: A Multisite Observational Study

Pain Medicine ◽

10.1111/pme.12570 ◽

2014 ◽

Vol 15 (11) ◽

pp. 1861-1871 ◽

Cited By ~ 41

Author(s):

Brendon Stubbs ◽

Sandhi Patchay ◽

Andy Soundy ◽

Pat Schofield

Keyword(s):

Older Adults ◽

Observational Study ◽

Sedentary Behavior ◽

Musculoskeletal Pain ◽

Fear Of Falling ◽

Community Dwelling ◽

Chronic Musculoskeletal Pain ◽

Community Dwelling Older Adults

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Abstract 31: Higher Levels of Light Intensity Physical Activity and Lower Sedentary Time are Associated With a Lower Risk of All-cause Mortality in Older Adults: The Framingham Heart Study

Circulation ◽

10.1161/circ.141.suppl_1.31 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Joowon Lee ◽

Nicole L Spartano ◽

Ramachandran S Vasan ◽

Vanessa Xanthakis

Keyword(s):

Physical Activity ◽

Older Adults ◽

Light Intensity ◽

Mortality Risk ◽

Lower Risk ◽

Sedentary Time ◽

Cox Proportional Hazards ◽

Community Dwelling ◽

All Cause Mortality ◽

Community Dwelling Older Adults

Introduction: Habitual physical activity (PA) and less sedentary behavior have been associated with a lower risk of mortality in middle-aged adults. However, little is known about the associations of objectively-assessed PA of varying levels and sedentary time with mortality in community-dwelling older adults. Hypothesis: We hypothesized that higher overall PA and less sedentary time will be associated with a lower risk of all-cause mortality in older adults. Methods: We evaluated 1,262 Framingham Offspring Study participants (mean age 69 yrs, 54% women) with accelerometry-derived PA data (wear time ≥10 hours/day for at least 4 days using an Actical device) at their ninth examination (2011-2014). Multivariable Cox proportional hazards regression models were used to relate PA and sedentary time (separate model for each) with all-cause mortality adjusting for potential confounders. In sensitivity analysis to mitigate the potential impact of frailty on the associations evaluated, we excluded those with frailty at baseline. Results: Overall, 67 participants died during a median follow-up of 4.8 years (25 th -75 th percentiles: 4.3 - 5.3 [years]). Higher total PA, light intensity PA (LIPA), adherence to PA guidelines, and lower sedentary time were associated with a lower risk of all-cause mortality ( Table ). The results remained statistically significant even after excluding those with frailty. Higher LIPA and lower sedentary time were associated with a lower risk of all-cause mortality regardless of MVPA in both models including all participants and excluding those with frailty. Conclusions: In our investigation of a moderate-size sample of community-dwelling older adults, we confirmed that being physically active substantially lowered mortality risk. Additionally, our findings suggest that reducing sedentary time and increasing LIPA (regardless of MVPA) may be sufficient to reduce mortality risk in older adults. Additional studies of larger multi-ethnic samples of older adults are warranted to confirm our findings.

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