Abstract
Purpose This study was undertaken to determine the natural history of physical function in older men limited by intermittent claudication. Methods Forty-three men limited by intermittent claudication (mean age, 69 ± 7 years) were recruited and followed up for 18 months. At baseline the patients reported a history of intermittent claudication for 6.1 ± 6.1 years, and were able to walk for 1.9 ± 1.6 blocks before experiencing claudication pain. Measurements during the 18-month study included ankle-brachial index (ABI), calf blood flow, 6-minute walk performance, monitored and self-reported physical activity, self-reported stability while walking, and summary performance score of physical function determined from a 4-m walk test, a chair stand test, and a tandem stand test. Results Pain-free walking distance during the 6-minute walk test decreased by 22% ( P < .05) from baseline (185 ± 96 m) to follow-up (144 ± 93 m), and the total 6-minute walk distance decreased by 9% ( P < .05), from 368 ± 106 m to 334 ± 90 m. Furthermore, monitored physical activity decreased by 31% ( P < .05), from 159 ± 151 kcal/d to 110 ± 137 kcal/d; self-reported physical activity declined by 27% ( P < .05), from 1.5 ± 1.0 units to 1.1 ± 0.8 units; tandem stance time declined by 14% ( P < .05), from 9.46 ± 1.83 seconds to 8.12 ± 2.10 seconds; summary performance score of physical function decreased by 12% ( P < .05), from 6.8 ± 2.4 units to 6.0 ± 2.4 units; and the percentage of patients reporting ambulatory unsteadiness and stumbling increased from 28% to 43% ( P < .05). Calf blood flow measured at rest declined by 18% ( P < .05), from 3.72 ± 1.81 (mL/100 mL −1/min −1) to 3.04 ± 1.43 mL/100 mL −1/min −1, whereas ABI did not change ( P > .05). Conclusion Older men limited by intermittent claudication experienced decline in ambulatory function, physical activity, physical function, stability, and calf blood flow over 18 months of follow-up, despite no change in ABI.
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