Abstract
Walking speed as one index of gait ability is an important component of physical fitness among older adults. Walking speed-arterial stiffness relationships have been studied, but whether poor walking speed is associated with higher segment-specific arterial stiffness in older adults is unclear. We thus aimed to examine the relationship between walking speed and segmental arterial stiffness among older community dwellers. This study was a cross-sectional study of 492 older Japanese community dwellers (age range, 65 to 96 years). Heart-brachial PWV (hbPWV), brachial-ankle PWV (baPWV), heart-ankle PWV (haPWV), and cardio-ankle vascular index (CAVI) were used as arterial stiffness indices. Walking speed, strength, flexibility, and cognitive function were also assessed. The participants were categorized into low (Slow), middle (Middle), and high (Fast) tertiles according to walking speed. The CAVI and baPWV were significantly lower in Fast than in Slow. Significant decreasing trends in CAVI and baPWV and a tendency toward decreasing trend in haPWV were observed from Slow to Fast, whereas hbPWV did not significantly differ among tertiles and no trend was evident. The results remained significant after normalizing CAVI and PWVs for multicollinearity of arterial stiffness indices and major confounding factors, such as age, gender, body mass index, blood pressure, cognitive function, and each physical fitness. Therefore, these findings suggest that poor walking speed is associated with higher segment-specific arterial stiffness of the central and lower limbs, but not of upper, in older adult community dwellers.
Highlights
Pulse wave velocity (PWV) and cardio-ankle vascular index (CAVI) are widely used as clinical indicators of arterial stiffness (Tanaka and Safar, 2005; Shirai et al, 2011)
We excluded 91 participants due to missing data associated with arterial stiffness and physical fitness (n = 14, 2.4%), refusal to cooperate (n = 5, 0.9%), pain (n = 4, 0.6%), dementia (n = 28, 4.8%), chronic diseases that affected walking (n = 2, 0.3%), features of peripheral arterial disease (n = 20, 3.4%), and technical errors associated with measuring arterial stiffness such as an undetectable pulse wave (n = 18, 3.1%)
Systolic blood pressure (BP) and mean BP (MBP) did not differ among the tertiles, diastolic BP and Anklebrachial index (ABI) were significantly higher and pulse pressure was significantly lower in Fast group than in Slow group
Summary
Pulse wave velocity (PWV) and cardio-ankle vascular index (CAVI) are widely used as clinical indicators of arterial stiffness (Tanaka and Safar, 2005; Shirai et al, 2011). Walking speed as one index of gait ability is an important component of physical fitness, especially among older adults (Barak et al, 2006), is generally considered to predict future cardiovascular diseases, disability, or mortality (Al Snih et al, 2002; Cesari et al, 2005, 2009; Rolland et al, 2006; Ostir et al, 2007; Mozaffarian et al, 2008; Dumurgier et al, 2009; Sattelmair et al, 2010), and is recognized as important for preventing frailty (Fried et al, 2001; Shimada et al, 2015). The study of Gonzales reported that lower gait performance is significantly associated with higher cfPWV (Gonzales, 2013) These findings indicate that walking speed is related to aortic arterial stiffness (cfPWV) in older adults and understanding such relationship could help partially to explain why gait ability can predict cardiovascular diseases and mortality
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