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Cardiovascular Disease and Patterns of Change in Functional Status Over 15 Years: Findings From the Atherosclerosis Risk in Communities (ARIC) Study.

TitleCardiovascular Disease and Patterns of Change in Functional Status Over 15 Years: Findings From the Atherosclerosis Risk in Communities (ARIC) Study.
Publication TypeJournal Article
Year of Publication2017
AuthorsKucharska-Newton AMaria, Griswold M, Yao ZHoward, Foraker R, Rose K, Rosamond WD, Wagenknecht L, Koton S, Pompeii L
Secondary AuthorsB Windham G
JournalJ Am Heart Assoc
Volume6
Issue3
Date Published2017 Mar 01
ISSN2047-9980
KeywordsActivities of Daily Living, Atherosclerosis, Cardiovascular Diseases, Female, Follow-Up Studies, Forecasting, Health Status, Humans, Incidence, Male, Middle Aged, Population Surveillance, Retrospective Studies, Risk Assessment, Risk Factors, Self Report, United States
Abstract

BACKGROUND: Cardiovascular disease (CVD) is the leading cause of premature disability, yet few prospective studies have examined functional status (FS) among persons with CVD. Our aim was to examine patterns of change in FS prior to and after hospitalization for nonfatal myocardial infarction, stroke, and heart failure among members of the Atherosclerosis Risk in Communities (ARIC) study cohort.

METHODS AND RESULTS: FS was assessed using a modified Rosow-Breslau questionnaire administered during routine annual telephone interviews conducted from 1993 through 2007 among 15 277 ARIC study participants. An FS score was constructed as a summary measure of responses to questions about participants' ability to perform selected tasks of daily living (eg, walking half a mile, climbing stairs). Incidence of CVD was assessed through ARIC surveillance of hospitalized events. Rate of change in FS over time prior to and following a CVD event was examined using generalized estimating equations. A decline in FS was observed on average 2 years prior to a myocardial infarction hospitalization and on average 3 years prior to a stroke or heart failure hospitalization. FS post-myocardial infarction declined relative to pre-event levels but improved to close to pre-myocardial infarction levels within 3 years. Decline in FS following incident heart failure and stroke remained over time. Observed patterns of change in FS did not differ appreciably by race or sex.

CONCLUSIONS: This study documents that a decline in FS precedes incidence of CVD-related hospitalization by at least 2 years, providing a strong argument for routine preventative assessment of FS among older adults.

DOI10.1161/JAHA.116.004144
Alternate JournalJ Am Heart Assoc
PubMed ID28249844
PubMed Central IDPMC5523991
Grant ListU01 HL096812 / HL / NHLBI NIH HHS / United States
U01 HL096814 / HL / NHLBI NIH HHS / United States
U01 HL096899 / HL / NHLBI NIH HHS / United States
U01 HL096917 / HL / NHLBI NIH HHS / United States