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Among people over 65 who were assessed using a brief physical function test, having lower physical function was independently associated with a higher risk of developing a heart attack, heart failure and stroke, according to new published research. today in the Journal of the American Heart. Association.
The Short Physical Performance Battery (SPPB) used in this study is considered a measure of physical function, including walking speed, leg strength, and balance. This study examined physical function, which is different from physical fitness.
“While traditional risk factors for cardiovascular disease, such as high blood pressure, high cholesterol, smoking or diabetes, are closely related to cardiovascular disease, particularly 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 the study’s senior author, Kunihiro Matsushita, M.D., Ph.D., associate professor in the department of epidemiology at the School of Medicine. of Johns Hopkins Bloomberg 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 beyond traditional heart disease risk factors, regardless of whether an individual has a history of cardiovascular disease."
The Atherosclerosis Risk in Communities (ARIC) study, an ongoing community-based cohort, enrolled 15,792 participants, ages 45 to 64, between 1987 and 1989, to investigate the causes of atherosclerotic disease (plaque or fatty buildup in the arteries). Annual and semiannual check-ups (starting in 2012) included telephone calls and in-person clinical examinations.
The present study evaluated health data from ARIC visit 5 (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 according to walking speed, speed of getting up from a chair without using hands, and standing balance.
Researchers analyzed health data from 5,570 adults (58% women; 78% white adults; 22% black adults), with an average age of 75 years from 2011 to 2019. Using SPPB scores, participants’ physical function was measured. classified into three groups: low, intermediate and high, based on their performance on the test.
The researchers examined the association of SPPB scores with future heart attacks, strokes and heart failure, as well as the combination of the three, adjusting for major cardiovascular disease risk factors such as high blood pressure, smoking, high cholesterol, diabetes and history of cardiovascular diseases.
The study found:
- Among all participants, 13% had low, 30% intermediate, and 57% high physical function scores.
- During the 8 years of the study, there were 930 participants with one or more confirmed cardiovascular events: 386 diagnosed with heart attack, 251 who suffered a stroke, and 529 cases of heart failure.
- Compared with 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. of having at least one cardiovascular disease event.
- 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 improved risk prediction of cardiovascular disease outcomes beyond traditional cardiovascular risk factors, regardless of whether people had a history of cardiovascular disease or were healthy.
“Our findings highlight the value of assessing the level of physical function of older adults in clinical practice,” said the study’s lead author, Xiao Hu, MHS, research data coordinator in the department of epidemiology at the School of Health. Public Johns Hopkins Bloomberg. ”In addition to heart health, older adults are at increased risk of falls and disability. “Assessment of physical function may also inform the risk of these concerning conditions in older adults.”
Falls and fear of falls in older adults are important health problems and are associated with high injury rates, high healthcare costs, and a significant impact on quality of life. A 2022 American Heart Association scientific statement, Prevention and Management of Falls in Adults with Cardiovascular Disease , recommends adjustments in medication, reevaluation of treatment plans, consideration of non-drug treatment options, and appropriate management of fall disorders. heart rate to reduce the risks of falls among older adults.
“Our study adds additional evidence to previous research, which has shown the importance of maintaining physical function into older age,” Matsushita said. "The next questions are: What is the best way for older adults 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 among people of diverse racial and ethnic backgrounds was more limited). The study also did not take into account people whose lack of mobility might prevent them from being evaluated in a research clinic. Additional research will be required to confirm the findings in people from more diverse racial and ethnic groups and people who have even lower physical function.
Co-authors are Yejin Mok, Ph.D.; Ning Ding, M.D., 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.
