Trajectories of the Framingham general cardiovascular risk profile in midlife and poor motor function later in life: The Whitehall II study

Alexis Elbaz,Martin J Shipley,Hermann Nabi,Eric J Brunner,Mika Kivimaki,Archana Singh-Manoux

doi:10.1016/j.ijcard.2013.12.051

Abstract

BackgroundVascular risk factors are associated with increased risk of cognitive impairment and dementia, but their association with motor function, another key feature of aging, has received little research attention. We examined the association between trajectories of the Framingham general cardiovascular disease risk score (FRS) over midlife and motor function later in life. MethodsA total of 5376 participants of the Whitehall II cohort study (29% women) who had up to four repeat measures of FRS between 1991–1993 (mean age=48.6years) and 2007–2009 (mean age=65.4years) and without history of stroke or coronary heart disease in 2007–2009 were included. Motor function was assessed in 2007–2009 through objective tests (walking speed, chair rises, balance, finger tapping, grip strength). We used age- and sex-adjusted linear mixed models. ResultsParticipants with poorer performances for walking speed, chair rises, and balance in 2007–2009 had higher FRS concurrently and also in 1991–1993, on average 16years earlier. These associations were robust to adjustment for cognition, socio-economic status, height, and BMI, and not explained by incident mobility limitation prior to motor assessment. No association was found with finger tapping and grip strength. ConclusionsCardiovascular risk early in midlife is associated with poor motor performances later in life. Vascular risk factors play an important and under-recognized role in motor function, independently of their impact on cognition, and suggest that better control of vascular risk factors in midlife may prevent physical impairment and disability in the elderly.

Highlights

In addition to being strong predictors of cardio- and cerebrovascular disease, vascular risk factors have been associated with aging phenotypes, including worse cognitive function [1] and dementia [2]
Higher Framingham cardiovascular risk was associated with worse motor function assessed through measures of walking speed, chair rises, and balance
This association was robust to adjustments for body mass index (BMI), height, Socioeconomic status (SES), and cognitive function; it was not explained by mobility limitations before motor assessment

Summary

Introduction

In addition to being strong predictors of cardio- and cerebrovascular disease, vascular risk factors have been associated with aging phenotypes, including worse cognitive function [1] and dementia [2]. For better prediction of cardiovascular disease (CVD) risk and a more complete assessment of vascular burden, several risk algorithms encompassing multiple risk factors have been developed [10] Scores derived from these algorithms predict the risk of CVD, stroke, dementia [11], and cognitive deficit [12,13], but to our knowledge their association with motor function has not been examined. Results: Participants with poorer performances for walking speed, chair rises, and balance in 2007–2009 had higher FRS concurrently and in 1991–1993, on average 16 years earlier. These associations were robust to adjustment for cognition, socio-economic status, height, and BMI, and not explained by incident mobility limitation prior to motor assessment. Vascular risk factors play an important and under-recognized role in motor function, independently of their impact on cognition, and suggest that better control of vascular risk factors in midlife may prevent physical impairment and disability in the elderly

Methods

Results

Conclusion