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Ankle-brachial index and physical function in older individuals: The Atherosclerosis Risk in Communities (ARIC) study.

TitleAnkle-brachial index and physical function in older individuals: The Atherosclerosis Risk in Communities (ARIC) study.
Publication TypeJournal Article
Year of Publication2017
AuthorsMatsushita K, Ballew SH, Sang Y, Kalbaugh C, Loehr LR, Hirsch AT, Tanaka H, Heiss G, B Windham G, Selvin E
Secondary AuthorsCoresh JJ
JournalAtherosclerosis
Volume257
Pagination208-215
Date Published2017 02
ISSN1879-1484
KeywordsAge Factors, Aged, Aged, 80 and over, Aging, Ankle Brachial Index, Chi-Square Distribution, Cross-Sectional Studies, Female, Gait, Geriatric Assessment, Humans, Linear Models, Lower Extremity, Male, Multivariate Analysis, Odds Ratio, Peripheral Arterial Disease, Postural Balance, Predictive Value of Tests, Risk Factors, United States, Walking
Abstract

BACKGROUND AND AIMS: Most prior studies investigating the association of lower extremity peripheral artery disease (PAD) with physical function were small or analyzed selected populations (e.g., patients at vascular clinics or persons with reduced function), leaving particular uncertainty regarding the association in the general community.

METHODS: Among 5262 ARIC participants (age 71-90 years during 2011-2013), we assessed the cross-sectional association of ankle-brachial index (ABI) with the Short Physical Performance Battery (SPPB) score (0-12), its individual components (chair stands, standing balance, and gait speed) (0-4 points each), and grip strength after accounting for potential confounders, including a history of coronary disease, stroke, or heart failure.

RESULTS: There were 411 participants (7.8%) with low ABI ≤0.90 and 469 (8.9%) participants with borderline low ABI 0.91-1.00. Both ABI ≤0.90 and 0.91-1.00 were independently associated with poor physical function (SPPB score ≤6) compared to ABI 1.11-1.20 (adjusted odds ratio 2.10 [95% CI 1.55-2.84] and 1.86 [1.38-2.51], respectively). The patterns were largely consistent across subgroups by clinical conditions (e.g., leg pain or other cardiovascular diseases), in every SPPB component, and for grip strength. ABI >1.3 (472 participants [9.0%]), indicative of non-compressible pedal arteries, was related to lower physical function as well but did not necessarily reach significance.

CONCLUSIONS: In community-dwelling older adults, low and borderline low ABI suggestive of PAD were independently associated with poorer systemic physical function compared to those with normal ABI. Clinical attention to PAD as a potential contributor to poor physical function is warranted in community-dwelling older adults.

DOI10.1016/j.atherosclerosis.2016.11.023
Alternate JournalAtherosclerosis
PubMed ID28012644
PubMed Central IDPMC5325783
Grant ListHHSN268201100012C / HL / NHLBI NIH HHS / United States
U01 HL096812 / HL / NHLBI NIH HHS / United States
HHSN268201100010C / HL / NHLBI NIH HHS / United States
HHSN268201100008C / HL / NHLBI NIH HHS / United States
U01 HL096917 / HL / NHLBI NIH HHS / United States
R01 DK089174 / DK / NIDDK NIH HHS / United States
HHSN268201100007C / HL / NHLBI NIH HHS / United States
R01 AG053938 / AG / NIA NIH HHS / United States
HHSN268201100011C / HL / NHLBI NIH HHS / United States
U01 HL096902 / HL / NHLBI NIH HHS / United States
HHSN268201100006C / HL / NHLBI NIH HHS / United States
K24 DK106414 / DK / NIDDK NIH HHS / United States
U01 HL096814 / HL / NHLBI NIH HHS / United States
HHSN268201100009C / HL / NHLBI NIH HHS / United States
R01 HL070825 / HL / NHLBI NIH HHS / United States
HHSN268201100005C / HL / NHLBI NIH HHS / United States
U01 HL096899 / HL / NHLBI NIH HHS / United States
T32 HL007055 / HL / NHLBI NIH HHS / United States