Association between level of brachial-ankle pulse wave velocity and onset of activities of daily living impairment in community-dwelling older individuals.

Abstract

The purpose of the present study was to clarify the longitudinal association between brachial-ankle pulse wave velocity (baPWV) and the onset of impairment in activities of daily living (ADL) among community-dwelling individuals. Deaths and the onsets of ADL impairment during 3 years were followed for 450 individuals without ADL impairment at entry who were aged 65 years or older (men : women 181:269; mean age 77 years). They were dichotomized on the median baPWV value at entry. Within 3 years, 28 died and 60 had an onset of ADL impairment. The high baPWV group had a higher incidence of deaths (high baPWV group vs low baPWV group, 9.3% vs 3.1%) and ADL impairment (high baPWV group vs low baPWV group, 20.7% vs 9.3%). After adjustment for age, sex and systolic blood pressure, as compared with the low baPWV group, the high baPWV group had increased risk for mortality (adjusted odds ratio 3.22; 95% confidence interval 1.26-8.22) and the onset of ADL impairment (adjusted odds ratio 1.94; 95% confidence interval 1.03-3.63). When the onset of ADL impairment was grouped according to medical conditions that preceded/accompanied the onset of ADL impairment, elevated baPWV was associated with increased risk for the onset of ADL impairment after/accompanying fall/fracture. The assessment of arterial stiffness by baPWV contributes to identifying functionally independent community-dwelling older individuals at risk for ADL impairment, in particular ADL impairment associated with fall/fracture, as well as for mortality. Geriatr Gerontol Int 2015; 15: 840-847.