Social Isolation and Daily Steps Are Associated With Fatigue in Older Women With Cardiovascular Disease: A Secondary Analysis of the MindMoves Trial.

Abstract

Background/objective: Fatigue is a common cardiovascular disease (CVD) symptom in older women; however, contributing factors are unclear. This study examined the association of background characteristics, social isolation, movement behaviors, and serum biomarkers with fatigue in older women with CVD.

Methods: This cross-sectional study used baseline data from older women (≥65 years, N = 246) with CVD participating in the MindMoves trial. We examined background characteristics (age, race/ethnicity, education, marital status, body mass index, pain, and comorbidities), social isolation, movement behaviors (sedentary behavior, light physical activity, moderate-vigorous physical activity, daily step count, and cardiorespiratory fitness test), and serum biomarkers (brain-derived neurotrophic factor, vascular endothelial growth factor-A, and insulin-like growth factor-1). Fatigue was assessed using two items ("could not get going" or "felt everything was an effort") from the Center for Epidemiologic Studies-Depression scale. Two-sample t tests examined differences in background characteristics across subgroups with fatigue versus without, and logistic regression examined whether social isolation, movement behaviors, and serum biomarkers were associated with fatigue.

Results: Fatigue was present in 17% of participants. A unit increase in social isolation score was associated with greater odds of fatigue (adjusted odds ratio = 2.38; 95% confidence interval [1.41, 3.99]), while an increase in walking steps by 1,000 per day was associated with lower odds of fatigue (adjusted odds ratio = 0.74; 95% confidence interval [0.59, 0.93]) in the fully adjusted models. Other factors were not associated with fatigue.

Conclusion: Prospective studies are needed to investigate fatigue-related factors in diverse patients with CVD. Significance/Implication: Interventions involving walking and group exercise may mitigate fatigue in older women with CVD.