Incident physical disability in people with lower extremity peripheral arterial disease

The role of cardiovascular disease

Jennifer S. Brach, Cam Solomon, Barbara L. Naydeck, Kim Sutton-Tyrrell, Paul L. Enright, Nancy Swords Jenny, Paulo M. Chaves, Anne B. Newman

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: 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. DESIGN: Observational cohort study. SETTING: Forsyth County, North Carolina; Sacramento County, California; Washington County, Maryland; and Allegheny County, Pennsylvania. PARTICIPANTS: Four thousand seven hundred five older adults, 58% women and 17.6% black, participating in the Cardiovascular Health Study. MEASUREMENTS: 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. RESULTS: 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. CONCLUSION: 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.

Original languageEnglish (US)
Pages (from-to)1037-1044
Number of pages8
JournalJournal of the American Geriatrics Society
Volume56
Issue number6
DOIs
StatePublished - Jun 2008

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Peripheral Arterial Disease
Disabled Persons
Activities of Daily Living
Lower Extremity
Cardiovascular Diseases
Ankle
Arm
Diabetes Mellitus
Mobility Limitation
Risk Reduction Behavior

Keywords

  • Cardiovascular disease
  • Disability
  • Peripheral arterial disease

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Incident physical disability in people with lower extremity peripheral arterial disease : The role of cardiovascular disease. / Brach, Jennifer S.; Solomon, Cam; Naydeck, Barbara L.; Sutton-Tyrrell, Kim; Enright, Paul L.; Jenny, Nancy Swords; Chaves, Paulo M.; Newman, Anne B.

In: Journal of the American Geriatrics Society, Vol. 56, No. 6, 06.2008, p. 1037-1044.

Research output: Contribution to journalArticle

Brach, JS, Solomon, C, Naydeck, BL, Sutton-Tyrrell, K, Enright, PL, Jenny, NS, Chaves, PM & Newman, AB 2008, 'Incident physical disability in people with lower extremity peripheral arterial disease: The role of cardiovascular disease', Journal of the American Geriatrics Society, vol. 56, no. 6, pp. 1037-1044. https://doi.org/10.1111/j.1532-5415.2008.01719.x
Brach, Jennifer S. ; Solomon, Cam ; Naydeck, Barbara L. ; Sutton-Tyrrell, Kim ; Enright, Paul L. ; Jenny, Nancy Swords ; Chaves, Paulo M. ; Newman, Anne B. / Incident physical disability in people with lower extremity peripheral arterial disease : The role of cardiovascular disease. In: Journal of the American Geriatrics Society. 2008 ; Vol. 56, No. 6. pp. 1037-1044.
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abstract = "OBJECTIVES: 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. DESIGN: Observational cohort study. SETTING: Forsyth County, North Carolina; Sacramento County, California; Washington County, Maryland; and Allegheny County, Pennsylvania. PARTICIPANTS: Four thousand seven hundred five older adults, 58{\%} women and 17.6{\%} black, participating in the Cardiovascular Health Study. MEASUREMENTS: 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. RESULTS: 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. CONCLUSION: 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.",
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T2 - The role of cardiovascular disease

AU - Brach, Jennifer S.

AU - Solomon, Cam

AU - Naydeck, Barbara L.

AU - Sutton-Tyrrell, Kim

AU - Enright, Paul L.

AU - Jenny, Nancy Swords

AU - Chaves, Paulo M.

AU - Newman, Anne B.

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