Open AccessLower Extremity Peripheral Artery Disease and Quality of Life Among Older Individuals in the Community
Author(s) -
Wu Aozhou,
Coresh Josef,
Selvin Elizabeth,
Tanaka Hirofumi,
Heiss Gerardo,
Hirsch Alan T.,
Jaar Bernard G.,
Matsushita Kunihiro
Publication year - 2017
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.116.004519
Subject(s) - medicine , confounding , quality of life (healthcare) , arterial disease , sf 36 , logistic regression , physical therapy , disease , vitality , mental health , intermittent claudication , ankle , peripheral , gerontology , vascular disease , health related quality of life , psychiatry , pathology , philosophy , nursing , theology
Background Evidence regarding the association of lower extremity peripheral arterial disease with quality of life ( QOL ) is mainly from selected clinical populations or relatively small clinical cohorts. Thus, we investigated this association in community‐derived populations. Methods and Results Using data of 5115 participants aged 66 to 90 years from visit 5 (2011‐2013) of the Atherosclerosis Risk in Communities Study, we quantified the associations of ankle‐brachial index ( ABI ) with several QOL parameters, including 12‐item Short‐Form Health Survey ( SF ‐12), after accounting for potential confounders using linear and logistic regression models. Peripheral arterial disease defined by an ABI <0.90 (n=402), was independently associated with a low SF ‐12 Physical Component Summary score (−3.26 [95% CI −5.60 to −0.92]), compared to the ABI reference 1.10 to 1.19 (n=1900) but not with the Mental Component Summary score (−0.07 [−2.21 to 2.06]). A low ABI was significantly associated with poorer status of all SF ‐12 physical domains (physical functioning, role‐physical, bodily pain, and general health) but only vitality out of 4 mental domains. Similarly, low ABI values were more consistently associated with other physically related QOL parameters (leisure‐time exercise/activity/walking) than mentally related parameters (significant depressive symptoms and hopeless feeling). Lower physical QOL was observed even in individuals with borderline low ABI (0.90 to 0.99; n=426). Conclusions Low ABI (even borderline) was independently associated with poor QOL , especially for physical components, in community‐dwelling older adults. QOL is a critical element for older adults, and thus, further studies are warranted to assess whether peripheral arterial disease‐specific management can improve QOL in older populations.