Abstract 1334: Living Alone Predicts Long-term Mortality in Older Women After Myocardial Infarction
Background: Research on long term survival after acute myocardial infarction (MI) in older women is scarce. Living with someone has shown a protective effect, but in cardiac populations reported mainly in men. The aim of this study was to determine whether 10-year survival in older women after MI is related to living arrangements.
Methods : We incluced all women aged 60 – 80 years suffering an MI during 1992–1997, and treated at one university hospital in Norway. In 1998, 145 (60% of those alive) completed a questionnaire package including socio-demographics, the Sense of Coherence Scale (SOC-29) and the World Health Organization Quality of Life Instrument Abbreviated (WHOQOL-BREF). Clinical information was based on self-reports and hospital medical records data. Patients were followed-up for 10 years (1998 –2008). End points were all-cause death, and adverse cardiac and cerebral events (MACCE); a composite of cardiac death, reinfarction and stroke.
Results: The all-cause mortality rate during 10 years of follow-up of all patients was 41%. Mean age was 72 years, and 41% were living alone. The majority of those living with someone lived with a spouse or partner (85%), whereas 12% lived with their children. In univariate analysis, women living alone had more than a twofold increased risk of all-cause death (HR 2.87, 95%CI 1.70 – 4.86, p<0.001) and MACCE (HR 2.12, 95%CI 1.22–3.66, p=0.007). After adjusting for age, time since MI, conventional predictors like creatinine and left ventricular ejection fraction, and a number of patient reported outcomes, living alone proved to be a robust, independent predictor of all-cause death (HR 6.24, 95%CI 2.68 –14.51, p<0.001) and MACCE (HR 6.07, 95%CI 2.69 –13.69, p<0.001). There was no significant difference between women living alone and women living with someone as to self-reported health, quality of life, and sense of coherence.
Conclusion : Living arrangements has prognostic importance for long-term outcome, and need to be taken into account when planning aftercare of older female MI patients.