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

Kunihiro Matsushita, Shoshana H. Ballew, Yingying Sang, Corey Kalbaugh, Laura R. Loehr, Alan T. Hirsch, Hirofumi Tanaka, Gerardo Heiss, B. Gwen Windham, Elizabeth Selvin, Josef Coresh

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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 5262 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.

LanguageEnglish (US)
Pages208-215
Number of pages8
JournalAtherosclerosis
Volume257
DOIs
StatePublished - Feb 1 2017

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Ankle Brachial Index
Atherosclerosis
Peripheral Arterial Disease
Independent Living
Hand Strength
Uncertainty
Coronary Disease
Blood Vessels
Foot
Lower Extremity
Leg
Cardiovascular Diseases
Heart Failure
Arteries
Stroke
Odds Ratio
Pain

Keywords

  • Aging
  • Peripheral artery disease
  • Physical function

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Matsushita, K., Ballew, S. H., Sang, Y., Kalbaugh, C., Loehr, L. R., Hirsch, A. T., ... Coresh, J. (2017). Ankle-brachial index and physical function in older individuals: The Atherosclerosis Risk in Communities (ARIC) study. Atherosclerosis, 257, 208-215. DOI: 10.1016/j.atherosclerosis.2016.11.023

Ankle-brachial index and physical function in older individuals : The Atherosclerosis Risk in Communities (ARIC) study. / Matsushita, Kunihiro; Ballew, Shoshana H.; Sang, Yingying; Kalbaugh, Corey; Loehr, Laura R.; Hirsch, Alan T.; Tanaka, Hirofumi; Heiss, Gerardo; Windham, B. Gwen; Selvin, Elizabeth; Coresh, Josef.

In: Atherosclerosis, Vol. 257, 01.02.2017, p. 208-215.

Research output: Contribution to journalArticle

Matsushita, K, Ballew, SH, Sang, Y, Kalbaugh, C, Loehr, LR, Hirsch, AT, Tanaka, H, Heiss, G, Windham, BG, Selvin, E & Coresh, J 2017, 'Ankle-brachial index and physical function in older individuals: The Atherosclerosis Risk in Communities (ARIC) study' Atherosclerosis, vol 257, pp. 208-215. DOI: 10.1016/j.atherosclerosis.2016.11.023
Matsushita K, Ballew SH, Sang Y, Kalbaugh C, Loehr LR, Hirsch AT et al. Ankle-brachial index and physical function in older individuals: The Atherosclerosis Risk in Communities (ARIC) study. Atherosclerosis. 2017 Feb 1;257:208-215. Available from, DOI: 10.1016/j.atherosclerosis.2016.11.023
Matsushita, Kunihiro ; Ballew, Shoshana H. ; Sang, Yingying ; Kalbaugh, Corey ; Loehr, Laura R. ; Hirsch, Alan T. ; Tanaka, Hirofumi ; Heiss, Gerardo ; Windham, B. Gwen ; Selvin, Elizabeth ; Coresh, Josef. / Ankle-brachial index and physical function in older individuals : The Atherosclerosis Risk in Communities (ARIC) study. In: Atherosclerosis. 2017 ; Vol. 257. pp. 208-215
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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 5262 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.",
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AU - Matsushita,Kunihiro

AU - Ballew,Shoshana H.

AU - Sang,Yingying

AU - Kalbaugh,Corey

AU - Loehr,Laura R.

AU - Hirsch,Alan T.

AU - Tanaka,Hirofumi

AU - Heiss,Gerardo

AU - Windham,B. Gwen

AU - Selvin,Elizabeth

AU - Coresh,Josef

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N2 - 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 5262 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.

AB - 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 5262 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.

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KW - Peripheral artery disease

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