New research uncovers risks that over 65’s may face if they have low physical function.
Among those who took part in a short physical function test, those over 65 with low physical function were assessed to have a greater risk in developing stroke and heart attack/failure.
The study used a Short Physical Performance Battery (SPPB), which is considered as a measure of physical function, including walking speed, leg strength and balance.
Study senior author Kunihiro Matsushita says: “While traditional cardiovascular disease risk factors such as high blood pressure smoking or diabetes are closely linked to cardiovascular disease, particularly in middle-aged people, we also know these factors may not be as predictive in older adults, so we need to identify nontraditional predictors for older adults.
“We found that physical function in older adults predicts future cardiovascular disease beyond traditional heart disease risk factors, regardless of whether an individual has a history of cardiovascular disease.”
The atherosclerosis Risk in Communities (ARIC) study, which is an ongoing community based cohort with 15,792 participants enrolled.
The participants were aged 45-64 between the years of 1987-1989.
The study focused on investigating the causes for atherosclerotic disease, which is plaque or fatty buildup in the arteries.
Beginning in 2012, participants were given yearly and semi-yearly check ins, which included phone calls and in-person clinic exams.
This present study evaluates the health data from the ARIC from between 2011-2013, with all participants over the age of 65.
When the data from the SPPB physical function test was first collected, this data from the ARIC was used as a baseline.
The SPPB measured physical function to produce a score according to walking speed, speed of rising from a chair without the use of hands and standing balance.
The research team analysed the health data of 5,570 adults, with the average of 75 between 2011 and 2019.
Using the SPPB scores, their physical function was categorised into three groups: low, intermediate and high.
They then examined the links between SPPB scores with the risk of future stroke or heart attack/failure, as well as a composite of those, adjusting for major cardiovascular disease risk factors.
The study found:
- Among all participants, 13 per cent had low, 30 per cent had intermediate and 57 per cent had high physical function scores.
- During the 8 years of the study, there were 930 participants with one or more confirmed cardiovascular events: 386 diagnosed with heart attack, 251 who had a stroke and 529 heart failure cases.
- Compared to adults with high physical function scores, those with low physical function scores were 47 per cent more likely to experience at least one cardiovascular disease event, and those with intermediate physical function scores had a 25 per cent higher risk of having at least one cardiovascular disease event.
- The association between physical function and cardiovascular disease remained after controlling for traditional cardiovascular disease risk factors such as age, high blood pressure, high cholesterol and diabetes.
- The physical function score improved the risk prediction of cardiovascular disease outcomes beyond traditional cardiovascular risk factors regardless of whether individuals had a history of cardiovascular disease or were healthy.
On the findings of the study, study lead author Xiao Hu says: “Our findings highlight the value of assessing the physical function level of older adults in clinical practice.
”In addition to heart health, older adults are at higher risk for falls and disability.
“The assessment of physical function may also inform the risk of these concerning conditions in older adults.”
Fear of falling and falls in elderly adults are both major health issues as they are associated with high injury rates, high medical care costs and making a significant impact on the quality of life.
Matsushita highlights the importance of this study, before pondering what is next for this research: “Our study adds additional evidence to past research, which has demonstrated the importance of maintaining physical function at an older age.
“The next questions are: what is the best way for older adults to maintain physical function, and whether interventions that improve physical function can reduce cardiovascular disease risk?”
The study did face some limitations.
The study sample only included white and black adults, with ARIC enrolment beginning in 1985, participants from diverse racial and ethnic backgrounds were limited.
Furthermore, the study did not account for those individuals whose lack of mobility could potentially prevent them from getting assessed at a research clinic.
Additional research is required to confirm the findings of this study in people from more diverse racial backgrounds and ethnic groups and for those with even less physical function.
