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

Kucharska‐Newton, Anna; Griswold, Michael; Howard, Yao, Zhihao; Foraker, Randi E.; Rose, Kathryn M.; Rosamond, Wayne D.; Wagenknecht, Lynne E.; Koton, Silvia; Pompeii, Lisa; Windham, B. Gwen

doi:10.1161/jaha.116.004144

Cited by 19 publications

(16 citation statements)

References 26 publications

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“…Furthermore, our sensitivity analysis showed an increased need of home care in the period shortly after discharge in patients who lived at home after MI which is in agreement with studies that have demonstrated an increased need for home care, a decline in physical function, and loss of independence after discharge with MI [ 7 , 8 , 33 ]. Indeed, limited evidence has suggested that the functional capacity already declines prior to admission with MI potentially reflecting underlying coronary artery disease or other comorbidities [ 34 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

Nursing home admission after myocardial infarction in the elderly: A nationwide cohort study

et al. 2018

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BackgroundData on nursing home admission after myocardial infarction (MI) in the elderly are scarce. We investigated nursing home admission within 6 months and 2 years after MI including predictors for nursing home admission in a nationwide cohort of elderly patients.MethodsUsing Danish nationwide registries, we identified all subjects 65 years or older residing at home who were discharged following first-time MI in the period 2008–2015. We determined sex- and age-stratified incidence rates per 1000 person years (IRs) and incidence rate ratios (IRRs) of nursing home admissions using Poisson regression models compared to the Danish population 65 years or older with no prior MI. Poisson regression models were also applied to identify predictors of nursing home admission.ResultsThe 26,539 patients who were discharged after MI had a median age of 76 (quartile 1-quartile 3: 70–83) years. The IRs of nursing home admission after MI increased with increasing age and for 80-84-year-old women IRs after 6 months and 2 years were 113.9 and 62.9, respectively, compared to 29.4 for women of the same age with no prior MI. The IRs for 80-84-year-old men after MI were 56.0 and 36.2, respectively, compared to 24.3 for men of the same age with no prior MI. In adjusted analyses the 6 months and 2 years IRRs for 80-84-year-old subjects were 2.56 (95% CI 2.11–3.10) and 1.41 (95% CI 1.22–1.65) for women and 1.74 (95% CI 1.34–2.25) and 1.05 (95% CI 0.88–1.26) for men, respectively. Predictors were advanced age, dementia, home care, Parkinson’s disease, cerebrovascular disease, living alone, depression, and arrhythmia.ConclusionIn elderly patients discharged following first-time MI, the risk of subsequent nursing home admission within 6 months was 2-fold higher compared to an age-stratified population with no prior MI. After 2 years this risk remained higher in women.

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Section: Discussionmentioning

confidence: 99%

Nursing home admission after myocardial infarction in the elderly: A nationwide cohort study

et al. 2018

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“…While our study, like others, highlights the relatively high prevalence of workforce non-participation among people with CVD and a stronger relationship in younger people is also consistent with the idea that CVD is the driving force, it should not be assumed that CVD is the cause without additional evidence. However, cohort studies in Europe and Canada provide evidence consistent with a casual explanation [ 8 – 11 , 13 , 40 , 41 ]. For example, one study from the Netherlands analysed various exit mechanisms from paid employment (such as, via unemployment benefits, via early retirement benefits etc.)…”

Section: Discussionmentioning

confidence: 96%

Cardiovascular disease subtypes, physical disability and workforce participation: A cross-sectional study of 163,562 middle-aged Australians

et al. 2021

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Background Workforce participation is reduced among people with cardiovascular disease (CVD). However, detailed quantitative evidence on this is limited. We examined the relationship of CVD to workforce participation in older working-age people, by CVD subtype, within population subgroups and considering the role of physical disability. Methods Questionnaire data (2006–2009) for participants aged 45–64 years (n = 163,562) from the population-based 45 and Up Study (n = 267,153) were linked to hospitalisation data through the Centre for Health Record Linkage. Prior CVD was from self-report or hospitalisation. Modified Poisson regression estimated adjusted prevalence ratios (PRs) for non-participation in the workforce in people with versus without CVD, adjusting for sociodemographic factors. Results There were 19,161 participants with CVD and 144,401 without. Compared to people without CVD, workforce non-participation was greater for those with CVD (40.0% vs 23.5%, PR = 1.36, 95%CI = 1.33–1.39). The outcome varied by CVD subtype: myocardial infarction (PR = 1.46, 95%CI = 1.36–1.55); cerebrovascular disease (PR = 1.92, 95%CI = 1.80–2.06); heart failure (PR = 1.83, 95%CI = 1.68–1.98) and peripheral vascular disease (PR = 1.76, 95%CI = 1.65–1.88). Workforce non-participation in those with CVD versus those without was at least 21% higher in all population subgroups examined, with PRs ranging from 1.75 (95%CI = 1.65–1.85) in people aged 50–55 years to 1.21 (95%CI = 1.19–1.24) among those aged 60–64. Compared to people with neither CVD nor physical functioning limitations, those with physical functional limitations were around three times as likely to be out of the workforce regardless of CVD diagnosis; participants with CVD but without physical functional limitations were 13% more likely to be out of the workforce (PR = 1.13, 95%CI = 1.07–1.20). Conclusions While many people with CVD participate in the workforce, participation is substantially lower, especially for people with cerebrovascular disease, than for people without CVD, highlighting priority areas for research and support, particularly for people experiencing physical functioning limitations.

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“…Lastly, plasma concentrations of long-chain SMs may not be independent of the physiological systems that contribute to physical function decline. For example, plasma concentrations of SMs are influenced by chronic inflammatory disease, cardiovascular disease, diabetes, and lack of exercise, all of which can be associated with physical functional decline 22,[40][41][42][43][44] .…”

Section: Discussionmentioning

confidence: 99%

“…Self-reported disability was examined as a secondary outcome in a cross-sectional analysis only, which is based on self-reported functional status assessed as a summation of the 4 questions from a modified Rosow-Breslau questionnaire administrated in 2016–2017 over the phone, 5 years after the ARIC visit 5 22 , 23 . The 4 questions were: (1) Are you able to do your usual activities, such as work around the house or recreation?…”

Section: Methodsmentioning

confidence: 99%

Sphingolipids and physical function in the Atherosclerosis Risk in Communities (ARIC) study

Alam

et al. 2021

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Long-chain sphingomyelins (SMs) may play an important role in the stability of myelin sheath underlying physical function. The objective of this study was to examine the cross-sectional and longitudinal associations of long-chain SMs [SM (41:1), SM (41:2), SM (43:1)] and ceramides [Cer (41:1) and Cer (43:1)] with physical function in the Atherosclerosis Risk in Communities (ARIC) study. Plasma concentrations of SM (41:1), SM (41:2), SM (43:1), Cer (41:1) and Cer (43:1) were measured in 389 ARIC participants in 2011–13. Physical function was assessed by grip strength, Short Physical Performance Battery (SPPB), 4-m walking speed at both 2011–13 and 2016–17, and the modified Rosow-Breslau questionnaire in 2016–2017. Multivariable linear and logistic regression analyses were performed, controlling for demographic and clinical confounders. In cross-sectional analyses, plasma concentrations of SM 41:1 were positively associated with SPPB score (β-coefficients [95% confidence internal]: 0.33 [0.02, 0.63] per 1 standard deviation [SD] increase in log-transformed concentration, p value 0.04), 4-m walking speed (0.042 m/s [0.01, 0.07], p value 0.003), and negatively with self-reported disability (odds ratio = 0.73 [0.65, 0.82], p value < 0.0001). Plasma concentrations of the five metabolites examined were not significantly associated with longitudinal changes in physical function or incidence of poor mobility. In older adults, plasma concentrations of long-chain SM 41:1 were cross-sectionally positively associated with physical function.

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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

Cited by 19 publications

References 26 publications

Nursing home admission after myocardial infarction in the elderly: A nationwide cohort study

Nursing home admission after myocardial infarction in the elderly: A nationwide cohort study

Cardiovascular disease subtypes, physical disability and workforce participation: A cross-sectional study of 163,562 middle-aged Australians

Sphingolipids and physical function in the Atherosclerosis Risk in Communities (ARIC) study

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