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Do subclinical vascular abnormalities precede impaired physical ability and ADL disability?
Marjolein E M den Ouden1, Marieke J Schuurmans2, Sigrid Mueller-Schotte3
1Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht, The Netherlands.
Subclinical vascular abnormalities, like pulse wave velocity and carotid intima media thickness, are linked to declining physical ability in older adults. Changes in these markers also predict worsening physical function, but not necessarily daily living disability.
Area of Science:
- Gerontology and Cardiovascular Health
- Vascular Biology and Aging
- Physical Function and Disability Studies
Background:
- Cardiovascular disease significantly impacts daily activities and physical functioning.
- The role of subclinical vascular abnormalities and their progression in physical ability decline remains unclear.
- Understanding these links is crucial for developing targeted interventions in aging populations.
Purpose of the Study:
- To investigate the association between subclinical vascular abnormalities and physical ability.
- To determine if the rate of change in vascular markers predicts changes in physical ability and ADL disability.
- To explore these relationships in a longitudinal cohort of middle-aged and older adults.
Main Methods:
- Longitudinal study including 490 middle-aged and older individuals.
- Physical ability assessed using the Short Physical Performance Battery.
- Subclinical vascular abnormalities measured by pulse wave velocity (PWV) and carotid intima media thickness (CIMT); ADL disability assessed via self-report questionnaires.
- Generalized estimation equation models used to analyze longitudinal associations.
Main Results:
- Higher baseline PWV, PWV change, baseline CIMT (in men), and CIMT change (in men) were associated with a greater decline in physical ability.
- No significant association was found between vascular abnormalities and overall change in ADL disability.
- In individuals with incident cardiovascular disease, increased PWV change correlated with a higher rate of ADL disability decline.
Conclusions:
- Subclinical vascular abnormalities and their progression are associated with reduced physical ability over time.
- The link between vascular changes and ADL disability is more pronounced in individuals with existing or newly diagnosed cardiovascular disease.
- ADL decline may be more directly caused by clinical cardiovascular events than by the progression of subclinical vascular disease.
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