Abstract 15730: Ankle-Brachial Index and Physical Function in Community-Based Older Adults: The Atherosclerosis Risk in Communities (ARIC) Study
Background: Lower extremity peripheral artery disease (PAD), commonly defined by an ankle-brachial index (ABI) <0.9, increases mortality risk and also reduces physical function. All prior studies of the impact of PAD on objectively measured physical function have been in restricted populations with known PAD or physical inactivity, leaving uncertainty regarding its impact in the community.
Methods: We studied 5,351 ARIC participants (age 71-90 years during 2011-2013) who underwent the assessment of ABI and the Short Physical Performance Battery (SPPB, 0-12 scale), a summary measure of physical function based on three domains (4-meter walk velocity, timed chair stands, and standing balance). Logistic regression models examined the association of ABI with poor physical function (SPPB score <6), adjusting for potential confounders including a history of other cardiovascular diseases.
Results: There were 463 participants (8.2%) with ABI <0.9 and 506 participants (9.0%) with ABI ≥1.3, a potential manifestation of PAD reflecting noncompressible pedal arteries. Both ABI <0.9 and ≥1.3 were significantly and independently associated with higher odds of having poor physical function compared to those with a normal ABI (1.1-1.2). The 469 participants (8.8%) with a “borderline” low ABI (0.9-1.0) also demonstrated significantly poor physical function. Low ABI was significantly associated with poor performance in every SPPB domain, whereas none were statistically significant for high ABI. The results were largely consistent among those without a history of stroke or heart failure.
Conclusion: In our population of community-dwelling older adults, ~25% had low, borderline low, or high ABI suggestive of PAD and demonstrated poorer physical function compared to those with normal ABI. Since physical function is a key element for independent living in older adults and several therapeutic options for PAD exist, our findings may have broad and important implications.
Author Disclosures: K. Matsushita: None. S. Ballew: None. Y. Sang: None. C. Kalbaugh: None. L. Loehr: None. A. Hirsch: None. H. Tanaka: None. G. Heiss: None. B. Windham: None. E. Selvin: None. J. Coresh: None.
- © 2014 by American Heart Association, Inc.