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Relationship Between Midlife Cardiovascular Health and Late‐Life Physical Performance: The ARIC Study
Author(s) -
Windham B. Gwen,
Harrison Kimystian L.,
Lirette Seth T.,
Lutsey Pamela L.,
Pompeii Lisa A.,
Gabriel Kelley P.,
Koton Silvia,
Steffen Lyn M.,
Griswold Michael E.,
Mosley Thomas H.
Publication year - 2017
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.14732
Subject(s) - medicine , confidence interval , demography , relative risk , gerontology , cohort , logistic regression , odds ratio , cohort study , sociology
Objectives To examine the association between midlife cardiovascular health and physical performance 25 years later. Design Cohort study (Atherosclerosis Risk in Communities Study); multinomial logistic and logistic regression adjusted for demographic characteristics and clinical measures. Setting Four U.S. communities: Forsyth County, North Carolina; Washington County, Maryland; Minneapolis, Minnesota; and Jackson, Mississippi. Participants: Individuals aged 54.2 ± 5.8 at baseline (N = 15,744; 55% female, 27% black). Measurements Cardiovascular health was measured at baseline using the American Heart Association's Life's Simple 7 ( LS 7) score (0–14) and LS 7 component categories (poor, intermediate, ideal) for each risk factor. The Short Physical Performance Battery ( SPPB ) was used to quantify physical function as ordinal (0–12) and categorical (low (0–6), fair (7–9), good (10–12) outcomes. Results Mean baseline LS 7 score was 7.9 ± 2.4; 6,144 (39%) individuals returned 25 years later for the fifth ARIC examination, at which point the SPPB was administered. Of 5,916 individuals who completed the SPPB , 3,288 (50%) had good physical performance. Each 1‐unit increase in LS 7 score was associated with a 17% higher SPPB score (rate ratio ( RR ) = 1.17, 95% confidence interval ( CI ) = 1.15–1.19) and a 29% greater chance of having a late‐life SPPB score of 10 or greater compared to SPPB score of less than 10 ( RR = 1.29, 95% CI = 1.25–1.34). Ideal baseline glucose ( RR = 2.53, 95% CI = 2.24–2.87), smoking ( RR = 1.97, 95% CI = 1.81–2.15), blood pressure ( RR = 1.70, 95% CI = 1.54–1.88), body mass index ( RR = 1.51, 95% CI = 1.37–1.66), and physical activity ( RR = 1.31, 95% CI = 1.20–1.43) had the strongest associations with late‐life SPPB score, adjusting for other LS 7 components. Conclusion Better cardiovascular health during midlife may lead better physical functioning in older age.