Increased Cardiovascular Stiffness and Impaired Age-related Functional Status

Abstract

Our objective was to determine if increased cardiovascular (CV) stiffness is associated with disability in middle-aged and older adults at risk for congestive heart failure. CV stiffness (brachial pulse pressure/left ventricular stroke volume indexed to body surface area) and total disability (the summed assessment of activities of daily living, mobility, and instrumental activities of daily living) were measured in 445 individuals. A subset of 109 randomly selected individuals also underwent physical function testing. Total disability was associated with CV stiffness (p = .01), driven by an association with mobility (p = .005), but not activities of daily living (p = .13) or instrumental activities of daily living (p = .61). After accounting for age, these correlations remained significant for men (p = .04), but not for women. CV stiffness was also associated with increased 400-m walk time (p = .02). In middle-aged and elderly men at risk for congestive heart failure, CV stiffness is associated with decreased mobility and physical function, and increased overall disability.Key Words: Cardiovascular stiffness-Disability-Congestive heart failure. Decision Editor: Rafael de Cabo, PhDPhysical disability reduces quality of life, increases health care costs (due to increased need for support services), and is an independent predictor of mortality (1,2). Mobility and activities of daily living are necessary for maintaining basic independent functioning in middle-aged and older individuals (3). Therapy targeted to attenuate the factors that promote disability could improve quality of life and prognosis in older individuals. Such therapy could provide a mortality benefit, as it has been shown in the elderly individual that all levels of physical activity are associated with lower risk of incident acute myocardial infarction, stroke, and cardiovascular (CV) mortality (4). Previously, it has been shown that abnormally increased cardiac and aortic stiffness is independently associated with reduced peak exercise capacity in elderly individuals with and without left ventricular (LV) systolic dysfunction and congestive heart failure (CHF) (5-10). We hypothesized that similar to exercise capacity, increased CV stiffness would be associated with increased disability in middleaged and elderly individuals at risk for their first episode of symptomatic CHF. To test this hypothesis, we noninvasively assessed CV stiffness (using CV magnetic resonance or CMR) and disability. Additionally, in a randomly selected subgroup of individuals, we formally measured physical function.

Apolipoprotein E Genotype Linked to Spatial Gait Characteristics: Predictors of Cognitive Dual Task Gait Change

“…An explanation for this relationship is that changes in gait and cognition share a common underlying neuropathophysiology [ 7 ]. Indeed, medical conditions, particularly vascular risk, associated with an increased risk of dementia have been linked to motor decline in older adults [ 8 ], [ 9 ]. Furthermore, the presence of multiple chronic medical conditions and greater overall disease burden as measured by physiological changes appears to contribute to gait changes in older adults [ 10 ].…”

Trends in Incidence of Disability in Activities of Daily Living in Chinese Older Adults: 1993–2006

“…Late‐life functional disability has been associated with unhealthy lifestyles (e.g., smoking) and chronic health conditions and multimorbidity (e.g., diabetes mellitus, cardiovascular disease (CVD), dementia) . Therefore, changes in prevalence of these factors may affect time trends of late‐life ADL disability.…”

“…Late-life functional disability has been associated with unhealthy lifestyles (e.g., smoking) and chronic health conditions and multimorbidity (e.g., diabetes mellitus, cardiovascular disease (CVD), dementia). [7][8][9][10][11] Therefore, changes in prevalence of these factors may affect time trends of late-life ADL disability. It has been estimated that the decrease in cardiovascular risk has contributed to an approximately 22% reduction in disability in the United States.…”

Stress: the good, the bad and the ugly?

“…As there is a growing body of evidence about successful interventions in the elderly population -even in high age -questions remain about our biological understanding and the right interventions in a highly diverse population. Most research now is done in the field of cardiovascular disease [14,15] and nutrition [16,17] or both [18] linking basic mechanisms with disease and interventions [18,19]. That means also to define elderly people as a minority -such as sex and gender and ethnicity -in clinical research [20].…”