Abstract P408: Cardiovascular Health And Recovery From Mobility Limitation in Middle Aged African Americans: The Jackson Heart Study

Abstract

Despite a well-established literature demonstrating that African Americans shoulder a high burden of mobility limitation, little is known about factors associated with recovery. Although poor cardiovascular health is a risk factor for mobility limitation, its role in recovery is less clear. The present study investigated demographic and cardiovascular factors associated with recovery from incident mobility limitation within one year in the Jackson Heart Study, a cohort study of African Americans in Jackson, MS. Participants underwent three in-person interviews and exams from 2000-2013, and mobility limitations were assessed by self-reported limitations in walking half a mile or climbing stairs during annual phone calls. The outcome of interest, recovery from mobility limitation, was defined as no mobility limitation the following year. Candidate predictor variables were assessed in logistic regression models and included sociodemographic factors, behaviors, cardiovascular health measures, and chronic conditions. Multiple imputation using chained equations was used to address missing data. Among 5,276 participants [mean (SD) age = 55.4 (12.9) years], 1,759 (33%) had an incident mobility limitation over 12 years of follow-up, and 953 (54%) reported recovery from mobility limitation by one year later. Young women were more likely to recover from mobility limitation than young men. However, with increasing age, women were less likely to recovery from mobility limitation compared with men (p-value for age and gender interaction = 0.03). In adjusted models, being married was associated with a greater likelihood of recovering (OR: 1.26; 95% CI: 1.02, 1.55), whereas a history of heart failure and current statin use were associated with a lower likelihood of recovering (OR = 0.57; 95% CI: 0.34, 0.98 and 0.77; 95% CI: 0.61, 0.98, respectively). In conclusion, the majority of incident mobility limitations in this population of middle-aged African Americans was transient. Being married may support recovery from limitations by providing a form of structural social support. Cardiovascular health status appears to be an important factor in recovery.