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Incident physical disability in people with lower extremity peripheral arterial disease: the role of cardiovascular disease.
Tuesday,2012-11-06 12:09 America/Los_Angeles — eenright
| Title | Incident physical disability in people with lower extremity peripheral arterial disease: the role of cardiovascular disease. |
| Publication Type | Journal Article |
| Year of Publication | 2008 |
| Authors | Brach, JS, Solomon, C, Naydeck, BL, Sutton-Tyrrell, K, Enright, PL, Jenny, NSwords, Chaves, PM, Newman, AB |
| Corporate/Institutional Authors | Cardiovascular Health Study Research Group, |
| Journal | J Am Geriatr Soc |
| Volume | 56 |
| Issue | 6 |
| Pagination | 1037-44 |
| Date Published | 2008 Jun |
| ISSN | 1532-5415 |
| Keywords | Activities of Daily Living, Aged, Cardiovascular Diseases, Cohort Studies, Comorbidity, Disability Evaluation, Female, Gait, Geriatric Assessment, Humans, Lower Extremity, Male, Mobility Limitation, Peripheral Vascular Diseases, Proportional Hazards Models, Risk Assessment, Risk Factors, United States |
| Abstract | <p><b>OBJECTIVES: </b>To evaluate the risk of incident physical disability and the decline in gait speed over a 6-year follow-up associated with a low ankle-arm index (AAI) in older adults.</p><p><b>DESIGN: </b>Observational cohort study.</p><p><b>SETTING: </b>Forsyth County, North Carolina; Sacramento County, California; Washington County, Maryland; and Allegheny County, Pennsylvania.</p><p><b>PARTICIPANTS: </b>Four thousand seven hundred five older adults, 58% women and 17.6% black, participating in the Cardiovascular Health Study.</p><p><b>MEASUREMENTS: </b>AAI was measured in 1992/93 (baseline). Self-reported mobility, activity of daily living (ADL), and instrumental activity of daily living (IADL) disability and gait speed were recorded at baseline and at 1-year intervals over 6 years of follow-up. Mobility disability was defined as any difficulty walking half a mile and ADL and IADL disability was defined as any difficulty with 11 specific ADL and IADL tasks. Individuals with mobility, ADL, or IADL disability at baseline were excluded from the respective incident disability analyses.</p><p><b>RESULTS: </b>Lower baseline AAI values were associated with increased risk of mobility disability and ADL/IADL disability. Clinical cardiovascular disease (CVD), diabetes mellitus, and interim CVD events partially explained these associations for mobility disability and clinical CVD and diabetes mellitus partially explained these associations for ADL and IADL disability. Individuals with an AAI less than 0.9 had on average a mean decrease in gait speed of 0.02 m/s per year, or a decline of 0.12 m/s over the 6-year follow-up. Prevalent CVD partly explained this decrease but interim CVD events did not further attenuate it.</p><p><b>CONCLUSION: </b>Low AAI serves as marker of future disability risk. Reduction of disability risk in patients with a low AAI should consider cardiovascular comorbidity and the prevention of additional disabling CVD events.</p> |
| DOI | 10.1111/j.1532-5415.2008.01719.x |
| Alternate Journal | J Am Geriatr Soc |
| PubMed ID | 18384579 |
| PubMed Central ID | PMC4509641 |
| Grant List | P30 AG024827 / AG / NIA NIH HHS / United States N01-HC-85085 / HC / NHLBI NIH HHS / United States N01-HC-85081 / HC / NHLBI NIH HHS / United States N01 HC015103 / HC / NHLBI NIH HHS / United States 1 P30 AG024827-01 / AG / NIA NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States N01-HC-85082 / HC / NHLBI NIH HHS / United States N01 HC-55222 / HC / NHLBI NIH HHS / United States K23 AG026766 / AG / NIA NIH HHS / United States T32 AG000181 / AG / NIA NIH HHS / United States N01HC75150 / HL / NHLBI NIH HHS / United States N01-HC-85079 / HC / NHLBI NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States N01 HC045133 / HC / NHLBI NIH HHS / United States N01 HC035129 / HC / NHLBI NIH HHS / United States N01-HC-85084 / HC / NHLBI NIH HHS / United States TG32 AG00181 / AG / NIA NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States N01-HC-85083 / HC / NHLBI NIH HHS / United States N01-HC-75150 / HC / NHLBI NIH HHS / United States N01-HC-85080 / HC / NHLBI NIH HHS / United States |