Abstract
BackgroundMuscle pump dysfunction is an essential component of chronic venous disease (CVD) pathology. Aging reduces muscle strength which further weakens the venous return. However, the epidemiology of CVD and its relationship with the physical performance in older persons is poorly studied. We studied the prevalence of CVD in subjects aged over 70 years and its association primarily with the Short Physical Performance Battery (SPPB) and 10 m walk test.MethodsAn accurate clinical leg examination was performed and the Clinical-Etiological-Anatomical-Pathophysiological-classification (CEAP, clinical classification of chronic venous disorders, C1-C6) determined by dermatologists in 552 subjects aged between 70 and 93 years belonging to the Northern Finland Birth Cohort 1966 – Parents’ Study (NFBC-PS). Linear regression analyses were used to examine the association between CVD and functional tests and anthropometric measurements.ResultsThe prevalence of CVD (C1-C6) was 54.3%. C1 was diagnosed in 22.1% (n=84), C2 in 15.2% (n=45), C3 in 8.2% (n=45), C4 in 7.8% (43), C5 in 0.4% (n=2) and C6 in 0.5% (n=3). The prevalence and severity of CVD increased with increasing age (p<0.05). Males presented more with severe stages of CVD (C4-C6) (p<0.001). Subjects with CVD had significantly lower total SPPB scores and longer times in the 10 m walk test (p<0.001). The association between CVD severity and SPPB remained statistically significant in females after adjusting for age, body mass index (BMI) and number of children. The 10 m walk test times were associated with CVD when adjusted for sex and age but not after adjusting for BMI.ConclusionsIt is recommended that detailed skin examination of legs should be performed by physicians treating older subjects in order to improve early diagnosis of CVD. We highlight the importance of physical activity in older persons - lower limb activation of older persons with CVD may improve venous return and therefore prevent progression of CVD. We found an association between CVD and gait speed, however, there may exist bidirectional relationship.
Highlights
Muscle pump dysfunction is an essential component of chronic venous disease (CVD) pathology
Short Physical Performance Battery (SPPB) scores showed a significant association with Clinical-Etiological-Anatomical-Patho‐ physiological classification (CEAP) classification
The total score in SPPB was significantly lower in those with CVD when compared with those with a C0 classification (p
Summary
Muscle pump dysfunction is an essential component of chronic venous disease (CVD) pathology. Aging reduces muscle strength which further weakens the venous return. We studied the prevalence of CVD in subjects aged over 70 years and its association primarily with the Short Physical Performance Battery (SPPB) and 10 m walk test. The main etiology of CVD is chronic venous hypertension and venous reflux that develop after the calf-muscle pump dysfunction [9]. Muscle strength is reduced which weakens the venous return in valves [10]. Physical activity has other undisputed health benefits in older people: it improves a quality of life, reduces disability, mortality and prevents for chronic diseases [11, 12]. Regardless of multiple benefits of physical activity older adults are sedentary and have low level of physical activity, especially women and older age groups [11]
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