According to a new study published today in the Journal of the American Heart Associationan open access peer-reviewed journal of the American Heart Association.
The Short Physical Performance Battery (SPPB) used in this study is considered a measure of physical function, which includes walking speed, leg strength, and balance. This study looked at physical function, which is different from fitness.
“While traditional risk factors for cardiovascular disease such as high blood pressure, high cholesterol, smoking or diabetes are strongly linked to cardiovascular disease, especially in middle-aged people, we also know that these factors may not be as predictive in older adults, so we need to identify non-traditional predictors for older adults,” said study lead author Kunihiro Matsushita, MD, Ph.D., associate professor in the Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health and the Division of Cardiology at the Johns Hopkins School of Medicine in Baltimore.”We found that physical function in older adults predicts future cardiovascular disease in beyond traditional risk factors for heart disease, whether or not an individual has a history of cardiovascular disease.”
The Atherosclerosis Risk in Communities (ARIC) study, an ongoing community cohort, recruited 15,792 participants, ages 45 to 64 from 1987 to 1989, to investigate the causes of atherosclerotic disease (plaque or fat accumulation in The arteries). Annual and semi-annual check-ups (from 2012) included phone calls and in-person clinical examinations.
The present study assessed health data from the ARIC 5 visit (2011-2013; all participants were over 65 years old) as baseline, when the SPPB physical function test was first collected. The SPPB measured physical function to produce a score based on speed of walking, speed of rising from a chair without using hands, and balance while standing.
Researchers analyzed health data from 5,570 adults (58% female; 78% white adults; 22% black adults), with an average age of 75 from 2011 to 2019. Using the scores SPPB, participants’ physical function was categorized into three groups: low, intermediate and high, based on their test performance.
Researchers looked at the association of SPPB scores with future heart attacks, strokes, and heart failure, as well as the composite of the three, adjusting for major cardiovascular disease risk factors, such as high blood pressure. , smoking, high cholesterol, diabetes and history of cardiovascular disease. sickness.
The study found:
- Among all participants, 13% had low physical function scores, 30% intermediate scores and 57% high scores.
- Over the 8 years of the study, there were 930 participants with one or more confirmed cardiovascular events: 386 diagnosed with a heart attack, 251 who had a stroke, and 529 with heart failure.
- Compared to adults with high physical function scores, those with low physical function scores were 47% more likely to experience at least one cardiovascular disease event, and those with intermediate physical function scores had a 25% higher risk to have at least one event of cardiovascular disease.
- The association between physical function and cardiovascular disease remained after controlling for traditional cardiovascular disease risk factors such as age, high blood pressure, high cholesterol, and diabetes.
- The physical function score has improved risk prediction of cardiovascular disease outcomes beyond traditional cardiovascular risk factors, whether individuals have a history of cardiovascular disease or are healthy.
“Our results highlight the value of assessing the level of physical function of older adults in clinical practice,” said study lead author Xiao Hu, MHS, research data coordinator at the Department of epidemiology from the Johns Hopkins Bloomberg School of Public Health. “In addition to heart health, older adults are at higher risk for falls and disability. Assessing physical function can also inform the risk of these conditions of concern in older adults.”
Falls and fear of falling in older adults are major health problems, and they are associated with high injury rates, high medical care costs, and a significant impact on quality of life. A 2022 scientific statement from the American Heart Association, Preventing and Managing Falls in Adults with Cardiovascular Disease, advises adjusting medications, re-evaluating treatment plans, considering non-drug treatment options, and properly manage heart rhythm disturbances to reduce the risk of falls in the elderly.
“Our study adds further evidence to previous research, which demonstrated the importance of maintaining physical function in old age,” Matsushita said. “The next questions are: what is the best way for older people to maintain physical function, and whether interventions that improve physical function can reduce the risk of cardiovascular disease?”
The study had several limitations. The study population included only white and black adults, but did not include people from other racial or ethnic groups (ARIC began enrollment in 1985, when participation of people from diverse racial and ethnic backgrounds was more limited ). The study also did not consider people whose lack of mobility might prevent them from being evaluated at a research clinic. Further research will be needed to confirm the results in people from more diverse racial and ethnic groups and people who have even less physical function.
Co-authors are Yejin Mok, Ph.D.; Ning Ding, MD, Sc.M. ; Kevin J. Sullivan, Ph.D.; Pamela L. Lutsey, Ph.D., MPH; Jennifer A. Schrack, Ph.D.; and Priya Palta, Ph.D.
The National Institutes of Health funded the study.