Cardiovascular Risk Burden and Future Risk of Walking Speed Limitation in Older Adults

Heiland, Emerald G.; Qiu, Chengxuan; Wang, Rui; Santoni, Giola; Liang, Yajun; Fratiglioni, Laura; Welmer, Anna-Karin

doi:10.1111/jgs.15158

Cited by 27 publications

(17 citation statements)

References 52 publications

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“…Heart disease, smoking, low BMI, and polypharmacy are all linked to poor health in older adults and were found to be associated with falls in previous studies . In addition, vascular risk factors (e.g., smoking) can increase risk of physical decline . Our results are in line with those of recent meta‐analyses that suggest that generic early prevention, such as physical activity, may help prevent injurious falls over the long term.…”

Section: Discussionsupporting

confidence: 90%

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Risk Factors for Injurious Falls in Older Adults: The Role of Sex and Length of Follow‐Up

Rizzuto

Fratiglioni

et al. 2018

J American Geriatrics Society

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OBJECTIVES To identify sex‐specific associations between risk factors and injurious falls over the short (<4 years) and long (4–10 years) term. DESIGN Longitudinal cohort study between 2001 and 2011. SETTING Swedish National Study on Aging and Care, Kungsholmen, Sweden. PARTICIPANTS Community‐dwelling adults aged 60 and older (N = 3,112). MEASUREMENTS An injurious fall was defined as a fall that required inpatient or outpatient care. Information was collected on participant and exposure characteristics using structured interviews, clinical examinations, and physical function tests at baseline. RESULTS The multivariate model showed that, in the short term, living alone (hazard ratio (HR)=1.83, 95% confidence interval (CI)=1.13–2.96), dependency in instrumental activities of daily living (IADLs) (HR=2.59, 95% CI=1.73–3.87), and previous falls (HR=1.71, 95% CI=1.08–2.72) were independently associated with injurious falls in women. Low systolic blood pressure (HR=1.96, 95% CI=1.04–3.71), impaired chair stands (HR=3.00, 95% CI=1.52–5.93), and previous falls (HR=2.81, 95% CI=1.32–5.97) were associated with injurious falls in men. Long‐term risk factors were underweight (HR=2.03, 95% CI=1.40–2.95), cognitive impairment (HR=1.49, 95% CI=1.08–2.06), fall‐risk increasing drugs (HR=1.67, 95% CI=1.27–2.20 for ≥2 drugs), and IADL dependency (HR=1.58, 95% CI=1.32–5.97) for women and smoking (HR=1.71, 95% CI=1.03–2.84), heart disease (HR=2.20, 95% CI=1.5–3.24), impaired balance (HR=1.68, 95% CI=1.08–2.62), and a previous fall (HR=3.61, 95% CI=1.98–6.61) for men. CONCLUSION Men and women have different fall risk profiles, and these differences should be considered when developing preventive strategies. Some risk factors were more strongly predictive of injurious falls over shorter than longer periods and vice versa, suggesting that it may be possible to identify older men and women at short‐ and long‐term risk of injurious falls. J Am Geriatr Soc 67:246–253, 2019.

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Section: Discussionsupporting

confidence: 90%

“…20,39,42,45 In addition, vascular risk factors (e.g., smoking) can increase risk of physical decline. 46,47 Our results are in line with those of recent meta-analyses that suggest that generic early prevention, such as physical activity, 48,49 may help prevent injurious falls over the long term.…”

Section: Discussionsupporting

confidence: 90%

Risk Factors for Injurious Falls in Older Adults: The Role of Sex and Length of Follow‐Up

Rizzuto

Fratiglioni

et al. 2018

J American Geriatrics Society

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“…This suggests knee OA symptoms did not largely account for the association between plasma phylloquinone and mobility limitation or disability. Low vitamin K status has also been associated with CVD and inflammation (1,9,16,17), which have also been linked to mobility disability (12,18). However, our models controlled for CVD and IL-6, so the association between plasma phylloquinone and mobility limitation and disability appears to be independent of these potential mediators as well.…”

Section: Discussionmentioning

confidence: 87%

Vitamin K Status and Mobility Limitation and Disability in Older Adults: The Health, Aging, and Body Composition Study

Shea

Kritchevsky

Loeser

et al. 2019

The Journals of Gerontology: Series A

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Abstract Background Vitamin K has been implicated in chronic diseases associated with increased risk for mobility disability, such as osteoarthritis and cardiovascular disease. However, the association between vitamin K status and mobility disability is unknown. Therefore, we examined the association between vitamin K status and incident mobility disability in the Health, Aging, and Body Composition Study. Methods Plasma phylloquinone (vitamin K1) was categorized as <0.5, 0.5–<1.0 and ≥1.0 nmol/L (n = 1,323, 48% male). Plasma ucMGP, which increases when vitamin K status is low, was measured in 716 participants and categorized into tertiles. Mobility limitation and disability, defined as two consecutive semiannual reports of having any or a lot of difficulty walking a one-fourth mile or climbing 10 steps without resting, were assessed over a median 6–10 years of follow-up. Multivariate Cox proportional hazard models were used to evaluate the association between vitamin K status and incident mobility limitation and disability. Results Participants with plasma phylloquinone less than 0.5 nmol/L were more likely to develop mobility limitation and disability compared to those with at least 1.0 nmol/L (adjusted HR (95% CI) mobility limitation: 1.27 (1.05–1.53); disability: 1.34 (1.01–1.76)). After further adjustment for knee pain, the associations were partially attenuated (HR (95% CI) mobility limitation: 1.20 (0.99–1.45); disability: 1.26 (0.96–1.67)). Plasma ucMGP was not associated with incident mobility limitation, but was nonlinearly associated with incident mobility disability (HR (95% CI), compared to tertile 1: tertile 2 = 1.64 (1.19–2.27), tertile 3 = 1.17 (0.83–1.66), fully adjusted). Conclusion Our results suggest vitamin K may be involved in the disablement process in older age. Future studies are needed to confirm our findings and clarify the underlying mechanism.

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“…Note that the mean cholesterol in our sample was in the normal range, and a higher cholesterol, therefore, was not reflecting abnormal cholesterol levels, but levels that are at the higher end of the normal range for this assay. A Swedish longitudinal study, also with 9years follow up, reported that several cardiovascular risk factors, especially when they coexisted, appeared to increase the risk of walking speed limitation in older adults, particularly those younger than 78 years of age (Heiland et al 2017). The NMAPS cohort mean age was younger than 78 years (~72 ± 8.4 years) and had all the common cardiovascular risks factors measured, which were included in the univariate analysis, but only cholesterol and insulin remained significant.…”

Section: Discussionmentioning

confidence: 99%

Sex-specific muscle and metabolic biomarkers associated with gait speed and cognitive transitions in older adults: a 9-year follow-up

et al. 2020

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Physical frailty and cognitive frailty share biological mechanisms, but sex-specific biomarkers associated with transitions in gait speed and cognition during ageing are poorly understood.Gait speed, cognition (3MSE), body composition (DXA) and serological biomarkers were assessed annually over 9 years in 216 males (72.7 + 8.07 years) and 384 females (71.1 + 8.44 years). In females, maintaining normal gait speed was associated with lower percent body fat (IRR 0.793, p = 0.001, 95%CI 0.691-0.910) and lower lactate dehydrogenase (LDH) (IRR 0.623, p = 0.00, 95%CI 0.514-0.752), and in males, the association was with higher cholesterol (IRR 1.394, p = 0.001, 95%CI 1.154-1.684). Abnormal to normal gait speed transitions were associated with higher insulin in females (IRR 1.325, p = 0.022, 95%CI 1.041-1.685) and lower creatinine in males (IRR 0.520, p = 0.01, 95%CI 0.310-0.870). Normal to slow gait speed transitions in males were associated with IGF-1 (IRR 1.74, p = 0.022, 95%CI 1.08-2.79) and leptin in females (IRR 1.39, p = 0.043, 95%CI 1.01-1.91.) Maintaining normal cognition was associated with lower LDH in females (IRR 0.276, p = 0.013, 95%CI 0.099-0.765) and higher appendicular skeletal muscle mass in males (IRR 1.52, p = 0.02, 95%CI 1.076-2.135). Improved cognition was associated with higher leptin (IRR 7.5, p = 0.03, 95%CI 1.282-44.34) and lower triglyceride (IRR 0.299, p = 0.017, 95%CI 0.110-0.809) in males. Education was protective against cognitive decline in females (IRR 0.84, p = 0.037, 0.732-0.982). Sexspecific biomarkers of muscle (LDH, Creatinine, IGF-1, APSM) and metabolism (%fat, insulin,cholesterol, leptin, tryglycerides) were associated with gait speed and cognitive transitions. These data suggest that modifiable biomarkers of muscle and metabolism could be targeted for interventions.

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Cardiovascular Risk Burden and Future Risk of Walking Speed Limitation in Older Adults

Abstract: A higher FRS is associated with greater risk of subsequent development of walking speed limitation in adults younger than 78, independent of cognitive function. Interventions targeting multiple CRFs in younger-old people may help in maintaining mobility function.

Cited by 27 publications

References 52 publications

Risk Factors for Injurious Falls in Older Adults: The Role of Sex and Length of Follow‐Up

Risk Factors for Injurious Falls in Older Adults: The Role of Sex and Length of Follow‐Up

Vitamin K Status and Mobility Limitation and Disability in Older Adults: The Health, Aging, and Body Composition Study

Sex-specific muscle and metabolic biomarkers associated with gait speed and cognitive transitions in older adults: a 9-year follow-up

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