Abstract
BackgroundThe prevalence of functional limitations is relatively high among the middle-aged and older adults. However, the contribution of functional limitations to subsequent incident cardiovascular diseases (CVD) and death is unclear. This study aims to examine the association between functional limitations and incident CVD and all-cause mortality among the middle-aged and older adults.MethodsThis is a nationally representative prospective cohort study. Participants were middle-aged and older Chinese adults from The China Health and Retirement Longitudinal Study. Functional limitations were measured using activities of daily living (ADL) scale and instrumental activities of daily living (IADL) scale. Incident CVD and death were recorded at followed-up from June 1, 2011, up until August 31, 2018. Cox proportional hazards model was used to assess the association between functional limitations and incident CVD and all-cause mortality.ResultsA total of 11,013 participants were included in this study. During the 7 years of follow-up, 1,914 incident CVD and 1,182 incident deaths were identified. Participants with functional limitations were associated with a 23% increased risk of incident CVD (HR, 1.23, 95% CI:1.08,1.39) after adjusting for age, gender, residential area, marital status, education, smoking, alcohol drinking, sleep duration, nap duration, depression symptoms, social participation, history of hypertension, diabetes, dyslipidemia, use of hypertension medications, diabetes medications, and lipid-lowering therapy. Moreover, participants with functional limitations were associated with a 63% increased risk of all-cause mortality (HR,1.63, 95%CI: 1.41,1.89) after adjusting for potential confounders.ConclusionsFunctional limitations were significantly associated with subsequent incident CVD and death among the middle-aged and older Chinese adults.
Highlights
Functional ability is an important indicator that reflects the quality of life and health status
Participants with functional limitations were associated with a 23% increased risk of incident cardiovascular diseases (CVD) (HR, 1.23, 95% confidence interval (CI):1.08,1.39) after adjusting for age, gender, residential area, marital status, education, smoking, alcohol drinking, sleep duration, nap duration, depression symptoms, social participation, history of hypertension, diabetes, dyslipidemia, use of hypertension medications, diabetes medications, and lipid-lowering therapy
Participants with functional limitations were associated with a 63% increased risk of all-cause mortality (HR,1.63, 95%CI: 1.41,1.89) after adjusting for potential confounders
Summary
Functional ability is an important indicator that reflects the quality of life and health status. Previous studies found that incident CVD and its mortality were associated with unhealthy lifestyle behaviors [13,14,15], overweight and obesity [16], emotional problem [17], cardiorespiratory fitness [18] and insomnia or poor sleep [19]. In this regard, the progression of CVD may involve multiple risk factors acting together over a long-term period of time, suggesting that the underlying mechanisms of CVD, its risk factors and improved treatment remain a hot field of further research. This study aims to examine the association between functional limitations and incident CVD and all-cause mortality among the middle-aged and older adults
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