Fatigue After Myocardial Infarction in Older Adults

University Of North Carolina Greensboro, Greensboro NC

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Abstract

DESCRIPTION (provided by applicant): Coronary heart disease is the leading cause of death and disability in the United States, and the prevalence of those with myocardial infarction (Ml) is greater than those with congestive heart failure, angina, or stroke. The majority of MIs occur in those ages 65 and older. Within 6 years after Ml, 35% of women and 18% of men have another Ml. The difference in Ml recurrence rates between women and men may be related to less physical activity in older women compared to older men. One frequently reported barrier to participation in physical activity is fatigue. Little work, however, has been done on fatigue after Ml. Previous studies suggest comorbidities, anemia, cytokines, sleep, cardiac function, depression, and social support as correlates of fatigue. Medication may also be an important correlate of fatigue after Ml. Use of beta adrenergic antagonists (beta-blockers) after Ml is an American Heart Association class I recommendation. A major side effect of beta-blockers is fatigue, but while the effects of medication on fatigue have been explored in other patient populations, no published studies of fatigue after Ml have examined the effects of specific medications, such as beta-blockers. A study that included all of these correlates would provide a more comprehensive view of fatigue after Ml. Therefore, the purpose of this proposed study is to describe subjective fatigue that persists after Ml in older adults and comprehensively examine the factors related to such fatigue. Specific aims are to: (a) describe fatigue in older women and men 6 to 8 months after Ml; (b) examine the relationships of 11 variables -- age, sex, comorbidities, beta-blockers, cardiac function (heart rate, BMP), biological factors (anemia, IL-6), sleep, depression, and social support - to fatigue in older adults after Ml; and (c) explore the extent to which the association between fatigue and 10 variables - age, comorbidities, beta-blockers, cardiac function (heart rate, BNP), biological factors (anemia, IL-6), sleep, depression, and social support - differ in women and men. A secondary aim is to explore the association between fatigue and physical activity in older adults after Ml. A convenience sample of 98 women (n=49) and men (n=49) ages 65 and older will be recruited. Data will be analyzed using descriptive statistics, t-tests, and multiple regressions. Understanding fatigue and correlates of fatigue after Ml in older adults is an essential step in meeting the long term goal of my program of research: developing interventions to control symptoms, such as fatigue, thereby enhancing physical activity in older adults after Ml and thus, improving outcomes after Ml.