Arterial stiffness expressed as brachial–ankle pulse wave velocity and gait assessment independent of lower extremity strength: a cross-sectional study in the older men population

Abstract

BACKGROUND Older men are more vulnerable to fatal falls than women, and gait disturbances contribute to the risk of falls. Studies have assessed the association between arterial stiffness and gait dysfunction, but the results have been inconclusive. This study aimed to conduct a cross-sectional analysis to evaluate the association between brachial-ankle pulse wave velocity (baPWV) and gait assessment in older men.METHODS Data from the 2014-2015 Korea Institute of Sport Science Fitness Standards project were used for the analysis. The inclusion criteria were men aged > 65 years with gait assessment [the 30-s chair stand test (30s-CST), the timed up and go (TUG) test, the figure-of-8 walk (F8W) test, the 2-min step test (2MST), and the 6-min walk test (6MWT)] and baPWV measurement data. Generalized linear regression analysis was conducted with multiple confounding factor adjustments, including lower extremity isometric strength. RESULTSA total of 291 participants were included in the analysis. The mean age was 71.38 ± 4.40 years. The mean values were as follows: (1) 30s-CST, 17.48 ± 5.00; (2) TUG test, 6.01 ± 1.10 s; (3) F8W test, 25.65 ± 4.71 s; (4) 2MST, 102.40 ± 18.83 per 2 min; and(5) 6MWT, 500.02 ± 85.65 m. After multivariable adjustment, baPWV was associated with the 6MWT (β = −0.037, 95% CI: −0.072-−0.002), TUG test (β = 0, 95% CI: 0.000-0.001), and F8W test (β = 0.002, 95% CI: 0.000-0.004). baPWV was not associated with the 30s-CST and 2MST. CONCLUSIONSThe current study showed a statistically significant association between gait assessments and arterial stiffness, independent of lower extremity strength. However, this association was modest. Future prospective studies are needed to elucidate the complex relationship between arterial stiffness and gait dysfunction. G ait dysfunction is a common comorbidity in the older adult population. [1] The prevalence increases with age, from approximately 10% at the age of 60 years to 60% at the age of > 80 years. [1] This can lead to immobility, falls, and increased mortality. [2] In addition, gait performance is a predictor of survival, cognitive decline, and quality of life. [3] Owing to this importance, multiple methods to assess a diverse aspect of gait has been suggested. The 30-s chair stand test (30s-CST) has been shown to provide information about functional strength, balance deficit, mu-scle endurance, and fall risk. [4,5] The timed up and go (TUG) test is known to effectively assess dynamic balance, mobility, and fall risk. [6] The figure-of-8 walk (F8W) test is designed to represent the walking skill in everyday life. [7] The 2-min step test (2MST) reflects physical functional capacity. [8] The 6-min walk test (6MWT) is a common measure of walking fatigability. [9] In addition, both the 2MST and 6MWT reflect cardiorespiratory fitness. [10,11] Each test has proven reliability and validity in the older adult population. [7,8,[12][13][14] Although gait is a common activity in daily living, it is