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

• Autores: Emerald G. Heiland, Chengxuan Qiu, Rui Wang, Giola Santoni, Yajun Liang, Laura Fratiglioni, Anna Karin Welmer
• Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 65, Nº. 11, 2017, págs. 2418-2424
• Idioma: inglés
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• Resumen

  • Objectives To explore the association between cardiovascular risk factor (CRF) burden and limitation in walking speed, balance, and chair stand and to verify whether these associations vary according to age and cognitive status.

    Design Longitudinal population-based study.

    Setting Urban area of Stockholm, Sweden.

    Participants Individuals aged 60 and older who participated in the Swedish National Study on Aging and Care in Kungsholmen and were free of limitations in walking speed (n = 1,441), balance (n = 1,154), or chair stands (n = 1,496) at baseline (2001–04).

    Measurements At baseline, data on demographic characteristics, CRFs, other lifestyle factors, C-reactive protein, and cognitive function were collected. CRF burden was measured using the Framingham general cardiovascular risk score (FRS). Limitations in walking speed (<0.8 m/s), balance (<5 seconds), and chair stand (inability to rise 5 times) were determined at 3-, 6-, and 9-year follow-up. Data were analyzed using Cox proportional hazards models stratified according to age (<78, ≥78).

    Results During follow-up, 326 persons developed limitations in walking speed, 303 in balance, and 374 in chair stands. An association between the FRS and walking speed limitation was evident only in adults younger than 78 (for each 1-point increase in FRS: hazard ratio (HR) = 1.09, 95% confidence interval (CI) = 1.02–1.17) after controlling for potential confounders including cognitive function (correspondingly, in adults aged ≥78: HR = 0.98, 95% CI = 0.92–1.03). Also, higher FRS was significantly associated with faster decline in walking speed (P < .001).

    Conclusion 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.