Key result
High brachial-ankle pulse wave velocity was associated with an increased risk for the onset of ADL impairment compared to low baPWV.
Why the study?
Does high brachial-ankle pulse wave velocity predict mortality and the onset of ADL impairment in community-dwelling older individuals?
Cohort (n=450)
Does high brachial-ankle pulse wave velocity predict mortality and the onset of ADL impairment in community-dwelling older individuals?
Elevated brachial-ankle pulse wave velocity is a significant predictor of mortality and future ADL impairment, particularly related to falls or fractures, in community-dwelling older adults.
Answers are grounded in this paper and cite their sources.
Supports baPWV as potential ADL risk marker in older adults; hypothesis-generating and requires prospective validation before practice change.
AIM: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
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Kuroiwa et al. (2014) conducted a cohort in Community-dwelling older individuals (n=450). High brachial-ankle pulse wave velocity (baPWV) vs. Low brachial-ankle pulse wave velocity (baPWV) was evaluated on Onset of ADL impairment (OR 1.94, 95% CI 1.03-3.63). High brachial-ankle pulse wave velocity was associated with an increased risk for the onset of ADL impairment compared to low baPWV.
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