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Cardiovascular Health, as per Life's Essential 8, and Impaired Lower-Extremity Function in Older Adults
David Gómez-Ángel1, Mercedes Sotos-Prieto1,2,3,4, David Martínez-Gómez1,2,4
1Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain.
Insights
Maintaining good cardiovascular health (CVH) is linked to better lower-extremity function in older adults. Improving the American Heart Association's Life's Essential 8 (LE8) score can reduce the risk of impaired lower-extremity function (ILEF).
Area of Science:
- Gerontology
- Cardiovascular Health
- Biomedical Science
Background:
- Cardiovascular health (CVH) is crucial for overall well-being, but its impact on lower-extremity function in older adults is not well understood.
- Impaired lower-extremity function (ILEF) is a significant factor in disability, reduced quality of life, and mortality among the elderly.
Purpose of the Study:
- To investigate the cross-sectional and prospective associations between cardiovascular health and lower-extremity function in individuals aged 65 and older.
- To determine if higher cardiovascular health scores predict a lower prevalence and incidence of impaired lower-extremity function over time.
Main Methods:
- Utilized data from 2,487 participants in the Seniors-ENRICA-2 cohort (age ≥65 years).
- Assessed CVH using the American Heart Association's Life's Essential 8 (LE8) score and lower-extremity function via the Short Physical Performance Battery (SPPB) at baseline and follow-ups (2.4 and 5.2 years).
- Employed logistic regression analysis, adjusting for key confounding factors.
Main Results:
- A 10-point increase in the LE8 score was associated with a lower prevalence of ILEF at baseline (OR 0.75) and a reduced risk of incident ILEF over 2.4 years (OR 0.77) and 5.2 years (OR 0.76).
- Key contributors to this association included physical activity, glucose levels, body mass index, and nicotine exposure.
- Higher CVH, as indicated by the LE8 score, was significantly linked to better lower-extremity function in older adults.
Conclusions:
- A higher cardiovascular health score is associated with both lower prevalence and incidence of impaired lower-extremity function in older adults.
- Comprehensive assessment of CVH provides valuable insights into the progression of lower-extremity function and identifies potential targets for early intervention.
- Promoting cardiovascular health is a promising strategy for maintaining mobility and function in aging populations.
Abstract:
Cardiovascular health (CVH) is a broad construct that encompasses multiple behavioral and biological factors. A decline in CVH has been associated with various adverse health outcomes, but its role in impaired lower-extremity function (ILEF), a major contributor to disability, diminished quality of life and mortality in older adults, is unknown. Therefore, we examined the cross-sectional and prospective association between CVH and lower-extremity function. Using data from 2,487 individuals aged ≥65y from the Seniors-ENRICA-2 cohort, we estimated CVH at baseline using the American Heart Association's Life's Essential 8 (LE8) score (range 0 to 100, with higher values indicating better CVH). We assessed ILEF at baseline and at 2.4-year and 5.2-year follow-ups using the Short Physical Performance Battery (SPPB). Statistical analyses were conducted with logistic regression with adjustment for the main confounders. ILEF was present in 26.8% of participants at baseline (666 events). The cumulative incidence over 2.4 and 5.2 years was 24.8% (278 events) and 22.5% (157 events), respectively. A 10-point higher LE8 score at baseline was associated with lower prevalence of ILEF (SPPB ≤9) at baseline (odds ratio [OR] 0.75, 95% confidence interval [CI]: 0.69-0.80), and lower risk of incident ILEF over 2.4 years (OR 0.77, 95% CI: 0.68-0.87) and 5.2 years (OR 0.76, 95% CI: 0.65-0.89). Physical activity, glucose levels, body mass index and nicotine exposure stood out as major contributors to the lower risk of incident ILEF associated with a higher LE8 score. A higher LE8 score was associated with both a lower prevalence and incidence of ILEF in older adults. Comprehensive evaluation of CVH offers insight into older adults' lower-extremity function and how it may progress over time, identifying opportunities for early intervention.
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