Predictors of a decrease in the quality of life of patients with senile asthenia syndrome and paroxysmal atrial fibrillation
The aim of the research. To determine the predictors of a decrease in the quality of life of patients with the senile asthenia syndrome and paroxysmal atrial fibrillation. Material and methods. A total of 45 patients aged over 65 with paroxysmal atrial fibrillation (AF) and senile asthenia (SA) syndrome were selected and constituted the main group. A control group of 43 apparently healthy individuals was formed as well. The search for predictors of a decrease in the quality of life (QoL) in patients with SA syndrome and paroxysmal AF was carried out based on standardised laboratory and instrumental studies. Results. The QoL of patients with SA syndrome and paroxysmal AF is declined according to indicators relevant for apparently healthy individuals comparable in age and gender characteristics. In comparison to men, women have demonstrated a decrease of the QoL according to three of the four scales of physical health: PF, RP, GH, and on two scales of psychosocial health: RE and MH. In the age group of subject aged over 75, mainly the indicators of physical status -PF, RP and GH - were reduced. With GFR lowering to less than 60 ml/min, there is predominantly a decline in the physical aspect of the QoL as well as a decrease in vital activity. Deterioration in the QoL was determined on two scales of the physical aspect of health - PF and RP - against the background of HR higher than 80 bpm, while no changes in the psychosocial aspect were diagnosed. Conclusion. The quality of life of patients with the senile asthenia syndrome and paroxysmal AF has the worst values on absolutely all scales of the physical aspect of health, whereas the psychosocial sphere is less involved and only vital activity and role-based emotional functioning are reduced. Predictors of QoL deterioration in patients with the SA syndrome and paroxysmal AF are: the age of 75 or older, the female gender, a decrease in GFR down to 60 ml/min and an increase in the heart rate to over 80 bpm. Thus, rational nephroprotective therapy and heart rate control contribute to the improvement in the quality of life of patients with the SA syndrome and paroxysmal AF.