Exercise, Ethnicity, and Quality of Life in Older Adults with Persistent Nonvalvular Atrial Fibrillation: A Multicenter Cross-Sectional Study

PURPOSE: This study assessed quality of life and its determinants, including age and ethnicity, among elderly patients with persistent nonvalvular atrial fibrillation (NVAF) in Xinjiang, aiming to provide clinical evidence for targeted interventions. PATIENTS AND METHODS: A multicenter cross-sectional study enrolled 123 patients (≥65 years old) with persistent NVAF. QoL was evaluated using the EQ-5D-5L scale. Ordered logistic regression identified predictors of five EQ-5D-5L dimensions of QoL. RESULTS: The median EQ-5D-5L utility score was 0.654. Ordered logistic regression analysis revealed that age≥75 years was significantly associated with poorer QoL in the domains of mobility (OR=6.30, 95% CI: 2.49-15.94), self-care (OR=10.73, 95% CI: 3.87-29.70), daily activities (OR=9.23, 95% CI: 1.82-46.94), and pain/discomfort (OR=3.51, 95% CI: 1.40-8.79). Ethnic minority status was a protective factor for self-care (OR=0.25, 95% CI: 0.08-0.81), pain/discomfort (OR=0.30, 95% CI: 0.12-0.71), and anxiety/depression (OR=0.13, 95% CI: 0.05-0.35). Regular exercise (≥90 minutes/week) reduced the risks of self-care (OR=0.15, 95% CI: 0.03-0.87) and daily activities (OR=0.10, 95% CI: 0.01-0.81). Female sex was protective for pain/discomfort (OR=0.31, 95% CI: 0.13-0.73) and anxiety/depression (OR=0.17, 95% CI: 0.06-0.45). Conversely, regular medication use was unexpectedly associated with increased anxiety/depression risk (OR=9.47, 95% CI: 1.46-61.46). CONCLUSION: Age, ethnicity, and physical activity impact QoL in elderly NVAF patients. These findings support the need for age-specific and culturally tailored interventions, including structured exercise programs and personalized care strategies.