Abstract P158: Lower Extremity Peripheral Artery Disease and Quality of Life among Older Individuals in the Community: The Atherosclerosis Risk in Communities (ARIC) Study

Abstract

Background: Lower extremity peripheral arterial disease (PAD), commonly identified by an ankle-brachial Index (ABI) <0.9, increases mortality risk and may impair mobility as well as quality of life (QOL). However, most studies assessing reduced QOL in the relation to PAD rely on small data from vascular clinics, leaving uncertainty about the impact of PAD on QOL in the community. Method: Using 5,610 ARIC visit 5 (2011-2013) participants aged 66-90 years, we assessed the associations of ABI with several QOL parameters, including self-evaluated general health status, mental status (the Center for Epidemiologic Studies Depression [CES-D] score and hopeless feeling), social aspect (work interfered by pain and social activity interfered by health status), and physical ability (limited ability to climb stairs and need of walking assistance). Logistic regression models were applied to assess the association of ABI with each QOL parameter, adjusting for potential confounders including comorbidities such as history of heart failure, coronary heart disease, and stroke. Result: With ABI 1.1-1.2 as a reference, lower ABI was consistently associated with poor status of all QOL parameters tested (Table), with overall evident dose-response relationship. Interestingly, a poor status of various QOL parameters was observed even in borderline low ABI (0.9-1.0) and low normal (1.0-1.1). High ABI (>1.3), indicative of arterial stiffness, was only significantly associated with limited ability to climb stairs. Similar results for low ABI and QOL were observed in both genders and white and black participants. Conclusion: Low ABI was independently and consistently associated with poor status of wide range of QOL domains, with potential important implications on quality-maintained life in older individuals. Further studies are warranted to assess whether the association is due to PAD-related leg symptoms or weakness and/or reflects the impact of systemic atherosclerosis on QOL.