Abstract
We hypothesized that, in the absence of clinically recognized dementia, cognitive dysfunction measured by the clock draw test (CDT) is associated with greater functional impairment in men and women with peripheral artery disease (PAD). Participants were men and women aged 60 years and older with Mini-Mental Status Examination scores ≥ 24 with PAD (n = 335) and without PAD (n = 234). We evaluated the 6-minute walk test, 4-meter walking velocity at usual and fastest pace, the Short Physical Performance Battery (SPPB), and accelerometer-measured physical activity. CDTs were scored using the Shulman system as follows: Category 1 (worst): CDT score 0-2; Category 2: CDT score 3; Category 3 (best): CDT score 4-5. Results were adjusted for age, sex, race, education, ankle-brachial index (ABI), and comorbidities. In individuals with PAD, lower CDT scores were associated with slower 4-meter usual-paced walking velocity (Category 1: 0.78 meters/second; Category 2: 0.83 meters/second; Category 3: 0.86 meters/second; p-trend = 0.025) and lower physical activity (Category 1: 420 activity units; Category 2: 677 activity units; Category 3: 701 activity units; p-trend = 0.045). Poorer CDT scores were also associated with worse functional performance in individuals without PAD (usual and fast-paced walking velocity and SPPB, p-trend = 0.022, 0.043, and 0.031, respectively). In conclusion, cognitive impairment identified with CDT is independently associated with greater functional impairment in older, dementia-free individuals with and without PAD. Longitudinal studies are necessary to explore whether baseline CDT scores and changes in CDT scores over time can predict long-term decline in functional performance in individuals with and without PAD.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 173-181 |
| Number of pages | 9 |
| Journal | Vascular Medicine |
| Volume | 16 |
| Issue number | 3 |
| DOIs | |
| State | Published - Jun 2011 |
| Externally published | Yes |
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Keywords
- ankle-brachial index
- clock draw test
- cognitive impairment
- functional performance
- peripheral artery disease
- walking
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Poorer clock draw test scores are associated with greater functional impairment in peripheral artery disease : The Walking and Leg Circulation Study II. / Zimmermann, Laura J.; Ferrucci, Luigi; Kiang Liu, Liu; Lu Tian, Tian; Guralnik, Jack M.; Criqui, Michael H.; Yihua Liao, Liao; McDermott, Mary M.
In: Vascular Medicine, Vol. 16, No. 3, 06.2011, p. 173-181.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Poorer clock draw test scores are associated with greater functional impairment in peripheral artery disease
T2 - The Walking and Leg Circulation Study II
AU - Zimmermann, Laura J.
AU - Ferrucci, Luigi
AU - Kiang Liu, Liu
AU - Lu Tian, Tian
AU - Guralnik, Jack M.
AU - Criqui, Michael H.
AU - Yihua Liao, Liao
AU - McDermott, Mary M.
PY - 2011/6
Y1 - 2011/6
N2 - We hypothesized that, in the absence of clinically recognized dementia, cognitive dysfunction measured by the clock draw test (CDT) is associated with greater functional impairment in men and women with peripheral artery disease (PAD). Participants were men and women aged 60 years and older with Mini-Mental Status Examination scores ≥ 24 with PAD (n = 335) and without PAD (n = 234). We evaluated the 6-minute walk test, 4-meter walking velocity at usual and fastest pace, the Short Physical Performance Battery (SPPB), and accelerometer-measured physical activity. CDTs were scored using the Shulman system as follows: Category 1 (worst): CDT score 0-2; Category 2: CDT score 3; Category 3 (best): CDT score 4-5. Results were adjusted for age, sex, race, education, ankle-brachial index (ABI), and comorbidities. In individuals with PAD, lower CDT scores were associated with slower 4-meter usual-paced walking velocity (Category 1: 0.78 meters/second; Category 2: 0.83 meters/second; Category 3: 0.86 meters/second; p-trend = 0.025) and lower physical activity (Category 1: 420 activity units; Category 2: 677 activity units; Category 3: 701 activity units; p-trend = 0.045). Poorer CDT scores were also associated with worse functional performance in individuals without PAD (usual and fast-paced walking velocity and SPPB, p-trend = 0.022, 0.043, and 0.031, respectively). In conclusion, cognitive impairment identified with CDT is independently associated with greater functional impairment in older, dementia-free individuals with and without PAD. Longitudinal studies are necessary to explore whether baseline CDT scores and changes in CDT scores over time can predict long-term decline in functional performance in individuals with and without PAD.
AB - We hypothesized that, in the absence of clinically recognized dementia, cognitive dysfunction measured by the clock draw test (CDT) is associated with greater functional impairment in men and women with peripheral artery disease (PAD). Participants were men and women aged 60 years and older with Mini-Mental Status Examination scores ≥ 24 with PAD (n = 335) and without PAD (n = 234). We evaluated the 6-minute walk test, 4-meter walking velocity at usual and fastest pace, the Short Physical Performance Battery (SPPB), and accelerometer-measured physical activity. CDTs were scored using the Shulman system as follows: Category 1 (worst): CDT score 0-2; Category 2: CDT score 3; Category 3 (best): CDT score 4-5. Results were adjusted for age, sex, race, education, ankle-brachial index (ABI), and comorbidities. In individuals with PAD, lower CDT scores were associated with slower 4-meter usual-paced walking velocity (Category 1: 0.78 meters/second; Category 2: 0.83 meters/second; Category 3: 0.86 meters/second; p-trend = 0.025) and lower physical activity (Category 1: 420 activity units; Category 2: 677 activity units; Category 3: 701 activity units; p-trend = 0.045). Poorer CDT scores were also associated with worse functional performance in individuals without PAD (usual and fast-paced walking velocity and SPPB, p-trend = 0.022, 0.043, and 0.031, respectively). In conclusion, cognitive impairment identified with CDT is independently associated with greater functional impairment in older, dementia-free individuals with and without PAD. Longitudinal studies are necessary to explore whether baseline CDT scores and changes in CDT scores over time can predict long-term decline in functional performance in individuals with and without PAD.
KW - ankle-brachial index
KW - clock draw test
KW - cognitive impairment
KW - functional performance
KW - peripheral artery disease
KW - walking
UR - http://www.scopus.com/inward/record.url?scp=79959254860&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79959254860&partnerID=8YFLogxK
U2 - 10.1177/1358863X11407109
DO - 10.1177/1358863X11407109
M3 - Article
C2 - 21636676
AN - SCOPUS:79959254860
VL - 16
SP - 173
EP - 181
JO - Vascular Medicine
JF - Vascular Medicine
SN - 1358-863X
IS - 3
ER -