One-Year Change in Walking Performance and Subsequent Mobility Loss and Mortality Rates in Peripheral Artery Disease:...

Area of Science:

• Vascular Medicine
• Geriatrics
• Rehabilitation Medicine

Background:

• Peripheral artery disease (PAD) significantly impacts lower extremity function.
• The relationship between changes in functional performance and adverse outcomes in PAD patients remains understudied.
• Understanding these associations is crucial for risk stratification and management.

Purpose of the Study:

• To investigate the association between 1-year changes in functional performance measures and subsequent mobility loss in PAD patients.
• To examine the association between 1-year changes in functional performance measures and subsequent mortality in PAD patients.

Main Methods:

• A cohort of 612 individuals with PAD underwent assessments of the 6-minute walk test and 4-meter walking velocity (usual and fastest pace) at baseline and 1-year follow-up.
• Participants were stratified into tertiles based on their 1-year change in walking performance.
• Cox proportional hazards models were employed to analyze the association between performance changes and subsequent mobility loss and mortality, adjusting for confounders.

Main Results:

• A greater decline in the 6-minute walk test over one year was associated with a 2.35-fold increased risk of mobility loss (HR: 2.35, 95% CI: 1.47-3.74).
• Worsening usual-paced and fast-paced 4-meter walking velocity were linked to increased risks of mobility loss (HR: 2.21, 95% CI: 1.41-3.47 and HR: 1.81, 95% CI: 1.16-2.84, respectively).
• A decline in the 6-minute walk test (HR: 1.61, 95% CI: 1.07-2.43) and fast-paced 4-meter walking velocity (HR: 1.75, 95% CI: 1.16-2.64) were associated with higher mortality rates.

Conclusions:

• A substantial 1-year decline in the 6-minute walk test or 4-meter walking velocity identifies peripheral artery disease patients at elevated risk for mobility loss.
• These functional performance declines also predict increased mortality risk in the PAD population.
• Monitoring changes in walking performance can aid in identifying high-risk PAD individuals for proactive management strategies.