The role of comorbidity in the assessment of intermittent claudication in older adults.
The prevalence of intermittent claudication (IC) in older adults by questionnaire is less than 5% while the prevalence of peripheral arterial disease (PAD) by non-invasive testing is 2-4-fold higher. Comorbid conditions may result in under-reporting intermittent claudication (IC) as assessed by the Rose Questionnaire. We examined characteristics of those who report leg pain in relationship to other comorbid conditions and disability in 5888 participants of the Cardiovascular Health Study (CHS). Older adults with exertional leg pain, not meeting criteria for IC, had a higher prevalence of PAD on non-invasive testing with the ankle-arm index than those without pain, as well as a higher prevalence of arthritis. The pattern of responses suggested that pain for both conditions was reported together. The Rose Questionnaire for IC is specific for PAD, but a negative questionnaire does not indicate a lack of symptoms, rather the presence of PAD along with other conditions that can cause pain.
Department of Medicine, Division of Geriatric Medicine, University of Pittsburgh School of Medicine, Keystone Blds., Suite 300, 3529 First Avenue, Pittsburgh, PA 15213-3313, USA. anewman@pitt.edu
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Newman
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Naydeck
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Sutton-Tyrrell
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Polak
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Kuller
D000368:Aged; D000787:Angina Pectoris / Q000453:epidemiology; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000453:epidemiology; D002561:Cerebrovascular Disorders / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000175:diagnosis / Q000453:epidemiology*; D007866:Leg / Q000098:blood supply; D008297:Male; D015995:Prevalence; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires