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March 15, 2026Frontiers in Public Health0 citationsOpen Access

Determinants of quality of life in older adults with atrial fibrillation: a structural equation modeling analysis

CQChunyan QiaoYXYi XuRJRu Jiang

Key Result

Higher average monthly household income, greater treatment adherence, and higher social support scores significantly improved quality of life among older adults with atrial fibrillation.

Key Points

  • This study aims to identify factors influencing quality of life in older adults with atrial fibrillation and explore their relationships using structural equation modeling.
  • Convenience sample of 252 older adults with atrial fibrillation hospitalized between August 2023 and August 2024.
  • Data collected using AFEQT, SDS, SAS, and SSRS questionnaires.
  • Participants categorized into high-quality and low-quality groups based on AFEQT scores.
  • Independent determinants identified through univariate analysis and multivariate logistic regression.
  • Constructed a structural equation model to assess interrelationships among variables.
  • Age, monthly income, AF type, treatment adherence, psychological scores, and presence of chronic conditions identified as key determinants.
  • Direct effects and total effect coefficients of age (0.316), AF type (0.188), and psychological scores were significant.
  • Social support and economic factors exerted combined effects on quality of life.

Study Design

Type

Observational (n=252)

Multicenter

No

Structured PICO

P
Population
252 older adults (>60 years) with atrial fibrillation admitted to the hospital between August 2023 and August 2024.
O
Outcome
Quality of life measured by the Atrial Fibrillation Effect on Quality-of-Life (AFEQT) questionnairepatient reported

Quality of life in older adults with atrial fibrillation is significantly influenced by a complex interplay of age, economic status, social support, and psychological well-being.

Main Result

Absolute Event Rate: 62.7% vs 37.3%

p-value: p=<0.001

Limitations

  • Single-center study limits generalizability.
  • Sample size may not capture sex differences in quality of life.
  • Sample may have had limited power to detect sex-specific effects
  • Did not include a specific, objective measure of physical performance (e.g., SPPB)

Abstract

Objective This study aimed to examine the determinants that influence quality of life among older adults diagnosed with atrial fibrillation (AF) and to explore the direct and indirect pathways between these factors using structural equation modeling (SEM). Methods A convenience sample of 252 older adults with AF who were admitted to the hospital between August 2023 and August 2024 was included. Data were collected using the Atrial Fibrillation Effect on Quality-of-Life (AFEQT) questionnaire, Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), and Social Support Rating Scale (SSRS). Patients were categorized into high-quality ( n = 158) and low-quality ( n = 94) groups according to theira AFEQT scores. Independent determinants were identified through univariate analysis and multivariate logistic regression, followed by the construction of an SEM model to assess interrelationships among variables. Results Age, monthly income, AF type, New York Heart Association functional classification, treatment adherence, SDS score, SSRS score, and presence of comorbid chronic conditions were identified as independent determinants of quality of life ( p 0.05). SEM demonstrated that age, monthly income, AF type, SDS score, and SSRS score exerted both direct effects (path coefficients of 0.200, −0.131, 0.134, 0.160, and −0.207, respectively) and indirect effects through mediating variables, resulting in total effect coefficients of 0.316, −0.168, 0.188, 0.225, and −0.347, respectively. Conclusion Quality of life among older adults with AF was influenced by multiple interrelated factors. Social support, psychological status, and economic circumstances exerted significant combined effects through both direct and indirect pathways. The development of individualized, evidence-based nursing interventions that address these determinants may contribute to improved quality of life and overall health outcomes in this population.

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Cite This Study

Qiao et al. (2026) conducted an observational in Atrial fibrillation (n=252). Higher average monthly household income, greater treatment adherence, and higher social support scores significantly improved quality of life among older adults with atrial fibrillation.

synapsesocial.com/papers/69b64c33b42794e3e660d8bfhttps://doi.org/10.3389/fpubh.2026.1753021
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