What is the clinical evidence from this study?

Study design: Cohort. Population: Atrial fibrillation and systemic inflammation (n=2048). Intervention: Atrial fibrillation vs. No atrial fibrillation. Primary outcome: Annual change in chair stand test duration (β = 1.49, 95% CI 0.82 to 2.16, p=< 0.001).

What question did this study set out to answer?

This study aims to explore how atrial fibrillation and systemic inflammation affect muscle mass and strength over time in older adults.

June 24, 2026GeroScience0 citationsOpen Access

Association between atrial fibrillation and systemic inflammation with muscle mass and strength trajectories in old age

Q: What are the key findings of this study?

Atrial fibrillation was associated with a steeper annual increase in chair stand test duration (β = 1.49) over 12 years, a functional decline that was exacerbated by elevated baseline levels of GDF-15 and IL-6.

Q: What question did this study set out to answer?

This study aims to explore how atrial fibrillation and systemic inflammation affect muscle mass and strength over time in older adults.

DCDilek CelikUniversity of Padua AOAlice Margherita OrnagoStockholm University FTFederico TrioloStockholm University

Key Result

Atrial fibrillation was associated with a steeper annual increase in chair stand test duration (β = 1.49) over 12 years, a functional decline that was exacerbated by elevated baseline levels of GDF-15 and IL-6.

Key Points

This study aims to explore how atrial fibrillation and systemic inflammation affect muscle mass and strength over time in older adults.
Data from 2048 participants aged 60 years and older was analyzed over 12 years.
Muscle mass and strength were assessed using calf circumference, handgrip strength, and chair stand test.
Linear mixed models evaluated changes in muscle outcomes based on AF status and inflammatory markers.
Participants with atrial fibrillation showed a significant increase in chair stand test duration (β = 1.49; 95% CI: 0.82 to 2.16).
High GDF-15 levels were linked to greater declines in muscle mass (β = − 0.12; 95% CI: − 0.20 to − 0.05) and chair stand performance (β = 2.48; 95% CI: 1.66 to 3.30).
Participants with AF and elevated IL-6 also displayed accelerated reductions in calf circumference (β = − 0.12; 95% CI: − 0.19 to − 0.05) and chair stand performance (β = 2.20; 95% CI: 1.39 to 3.01).

Study Design

Type

Cohort (n=2,048)

Structured PICO

Does atrial fibrillation and systemic inflammation accelerate the decline of muscle mass and strength in older adults?

Population

2,048 community-dwelling adults aged 60 years and older, with and without atrial fibrillation, followed for 12 years to assess muscle mass and strength trajectories.

Exposure

Atrial fibrillation (AF) and elevated systemic inflammatory markers (IL-6, GDF-15)

Comparator

Absence of atrial fibrillation and lower levels of systemic inflammatory markers

Outcome

Longitudinal trajectories of muscle mass and strength (assessed using calf circumference, handgrip strength, and chair stand test) over 12 years

Atrial fibrillation is associated with a steeper decline in muscle mass and strength over time in older adults, which is exacerbated by elevated inflammatory biomarkers.

Main Result

Mean Difference: 1.49 (95% CI 0.82–2.16)

p-value: p=< 0.001

Limitations

Healthy participant bias due to the cohort being healthier and of higher socioeconomic status than the general population
Exclusion of 39% of the original cohort due to missing data
Use of calf circumference as an indirect measure of muscle mass, which may be influenced by adiposity or peripheral edema
Biomarker assessments and atrial fibrillation status were restricted to baseline values only, preventing evaluation of changes over time
Potential residual confounding from unmeasured factors such as subclinical cardiac conditions or nutritional status

Abstract

Abstract The long-term impact of atrial fibrillation (AF) and systemic inflammation on muscle health and, hence, functional decline remains unclear. This study investigates the link between AF and longitudinal trajectories of muscle mass and strength, considering the role played by systemic inflammation. Data were obtained from 2048 participants (≥ 60 years) in the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K), followed for 12 years. Muscle mass and strength were assessed using calf circumference, handgrip strength, and chair stand test. Inflammatory marker interleukin-6 (IL-6) and the stress-response mediator growth differentiation factor-15 (GDF-15) were measured at baseline. Linear mixed models examined the longitudinal changes in muscle outcomes according to AF status and the combination of AF status with inflammatory markers. Participants with AF experienced a steeper increase in the duration of the chair stand test (β = 1.49; 95% CI: 0.82 to 2.16). High levels of GDF-15 amplified declines in muscle mass (β = − 0.12; 95% CI: − 0.20 to − 0.05) and chair stand test performance (β = 2.48; 95% CI: 1.66 to 3.30) in individuals with AF. Participants with AF and high IL-6 levels also experienced an accelerated decline of calf circumference (β = − 0.12; 95% CI: − 0.19 to − 0.05) and chair stand test performance (β = 2.20; 95% CI: 1.39 to 3.01). AF is associated with a steeper decline in muscle mass and strength over time, exacerbated by elevated inflammatory biomarkers, underscoring the importance of systemic inflammation in AF-related functional decline.

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