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

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 5,262 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.

Impact of sarcopenia on glycemic control and atherosclerosis in Japanese patients with type 2 diabetes: Cross‐sectional study using outpatient clinical data

“…Sarcopenia was reported as a prognostic factor for overall survival in patients with PAD. 21 In addition, previous studies have reported a positive association between preclinical atherosclerosis and SMI, 22 handgrip and walking velocity, 10,23 a finding also observed in this study. As this study's design was cross-sectional, it was impossible to determine the directionality of the association between sarcopenia and preclinical atherosclerosis.…”

Detecting Peripheral Arterial Disease in Primary Care: A Population Based Study

“…9) ABI value between 0.90 and 1.30 was considered as normal, <0.9 as PAD, and >1.3 as noncompressible artery (NCA). 10,11) Our study was approved by the University Medical Faculty Ethics Committee (approval no., 2011-01-05).…”

Fatigability and functional performance among older adults with low-normal ankle-brachial index: Cross-sectional findings from the Baltimore Longitudinal Study of Aging

“…(16) The speed of 0.67 m/s was selected because it is sufficiently low demand to minimize participant exclusion at older ages and lower functional thresholds. In the current analyses, perceived fatigability was treated as a continuous variable (6–20) as well as a binary outcome with high perceived fatigability defined as an RPE of 10 or greater (16).…”

“…Lower limb peripheral arterial disease (PAD) has been associated with poor physical functioning,(4–6) as well as increased fatigue and reduced quality of life in middle and older aged adults (4,7). Although in 2010 PAD affected approximately 8–10 million adults in the US and over 200 million globally (8–10), the majority of individuals are often asymptomatic and unaware of their disease until the severity is high (11,12).…”