Abstract 20555: Association of Diabetes and Baseline Ankle-Brachial Index With Functional Decline in Peripheral Arterial Disease
Introduction: Lower ankle brachial index (ABI) values are associated with greater decline in some measures of functioning among people with and without peripheral artery disease (PAD). Little is known about the association of diabetes with functional decline in PAD, or whether diabetes status modifies the association of ABI and functional decline.
Methods: Between 1998 and 2012, adults with ABI <0.9 were identified from non-invasive vascular laboratories and vascular surgery, cardiology, and general medical practices in the Chicago area. Participants were followed every 6-12 months for up to four years. At baseline and follow-up participants underwent the six-minute walk (6MW) test and were queried regarding mobility. Mobility loss was defined as becoming unable to walk up and down a flight of stairs or walk 1/4 mile without assistance among those without mobility impairment at baseline. Stopping during 6MW during follow-up was assessed among those who walked for 6 minutes continuously at baseline. Generalized estimating equations were used to compare average annual decline in 6MW. Analyses were adjusted for age, sex, race, comorbidities, and other confounders.
Results: 1130 adults were enrolled; 435 (38.5%) were women, and 290 (25.7%) were black. Mean follow-up was 2.8±1.4 years. Presence of diabetes was not associated with mobility loss or the need to stop during the 6MW. However, adults with diabetes experienced an additional decline of -21 ft/yr (p<0.01) in the 6MW compared to adults without diabetes. The table shows associations of ABI with functional decline. For every unit change in the baseline ABI adults without diabetes experienced a decline of -59.8 ft/yr in the 6MW (p=0.048). Baseline ABI was not associated with 6MW decline among adults with diabetes (p=0.96).
Conclusions: Presence of diabetes is associated with greater declines in the 6MW. The association of baseline ABI with functional decline is more consistent in non-diabetics vs diabetics.
Author Disclosures: T.S. Polonsky: None. Y. Liao: None. L. Tian: None. M.M. McDermott: None.
- © 2016 by American Heart Association, Inc.