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Cardiovascular Risk Factors and the Risk of Disability in Older Adults: Variation by Age and Functional Status.
Karolinska Institutet.ORCID iD: 0000-0001-7175-0093
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2019 (English)In: Journal of the American Medical Directors Association, ISSN 1525-8610, E-ISSN 1538-9375, Vol. 20, no 2, p. 208-212.e3, article id S1525-8610(18)30285-8Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: We aimed to quantify the increased risk of disability associated with cardiovascular risk factors among older adults, and to verify whether this risk may vary by age and functional status.

DESIGN: Longitudinal population-based cohort study.

SETTING: Urban area of Stockholm, Sweden.

PARTICIPANTS: Community-dwelling and institutionalized adults ≥60 years in the Swedish National study on Aging and Care in Kungsholmen free of cardiovascular diseases and disability (n = 1756) at baseline (2001-2004).

MEASURES: Incident disability in activities of daily living (ADL) was ascertained over 9 years. Cardiovascular risk factors (physical inactivity, alcohol consumption, smoking, high blood pressure, diabetes, high body mass index, high levels of total cholesterol, and high C-reactive protein) and walking speed were assessed at baseline. Data were analyzed using Cox proportional hazards models, stratifying by younger-old (age 60-72 years) and older-old (≥78 years).

RESULTS: During the follow-up, 23 and 148 persons developed ADL-disability among the younger- and older-old, respectively. In the younger-old, the adjusted hazard ratio (HR) of developing ADL-disability was 4.10 (95% confidence interval [CI] 1.22-13.76) for physical inactivity and 5.61 (95% CI 1.17-26.82) for diabetes. In the older-old, physical inactivity was associated with incident ADL-disability (HR 1.99, 95% CI 1.36-2.93), and there was a significant interaction between physical inactivity and walking speed limitation (<0.8 m/s), showing a 6-fold higher risk of ADL-disability in those who were both physically inactive and had walking speed limitation than being active with no limitation, accounting for a population-attributable risk of 42.7%.

CONCLUSIONS/IMPLICATIONS: Interventions targeting cardiovascular risk factors may be more important for the younger-old in decreasing the risk of disability, whereas improving physical function and maintaining physical activity may be more beneficial for the older-old.

Place, publisher, year, edition, pages
2019. Vol. 20, no 2, p. 208-212.e3, article id S1525-8610(18)30285-8
Keywords [en]
Cardiovascular disease, cohort study, disablement process, physical function, risk factors
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Medical and Health Sciences
Identifiers
URN: urn:nbn:se:gih:diva-5894DOI: 10.1016/j.jamda.2018.05.013PubMedID: 30006016OAI: oai:DiVA.org:gih-5894DiVA, id: diva2:1366541
Available from: 2019-10-29 Created: 2019-10-29 Last updated: 2019-11-11Bibliographically approved

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Heiland, Emerald G

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