Long-term function in an older cohort--the cardiovascular health study all stars study.
OBJECTIVE
To evaluate shared and unique risk factors for maintaining physical and cognitive function into the ninth decade and beyond.


METHODS
Longitudinal cohort study.


METHODS
Four U.S. communities.


METHODS
One thousand six hundred seventy-seven participants in the Cardiovascular Health Study All Stars Study, assessed in 2005/06. Median age was 85 (range 77-102), 66.5% were women, and 16.6% were black.


METHODS
Intact function was defined as no difficulty with any activities of daily living and a score of 80 or higher on the Modified Mini-Mental State Examination. Baseline characteristics assessed in 1992/93 included demographics, behavioral health factors, chronic disease history, subclinical disease markers, cardiovascular risk factors, and inflammatory markers. Multinomial logistic regression was used to compare risk for physical disability, cognitive impairment,and combined impairments with no functional impairment.


RESULTS
Of the 1,677 participants evaluated in both domains, 891 (53%) were functionally intact. Continuous measures of function, including the Digit Symbol Substitution Test and gait speed, showed that all groups, including the most functional, had declined over time. The functional group had less decline but also tended to have higher starting values. Functional individuals had a higher baseline health profile than those with either or cognitive impairment or both impairments combined. Women and individuals with greater weight had higher rates of physical impairment but not cognitive impairment. Risk factors common to both types of impairment included cardiovascular disease and hypertension.


CONCLUSIONS
Intact function was found in only approximately half of these older adults in the ninth decade and beyond. High baseline function and low vascular disease risk characterized functional aging.
Newman
Anne B
AB
Department ofEpidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA. newmana@edc.pitt.edu
Arnold
Alice M
AM
Sachs
Michael C
MC
Ives
Diane G
DG
Cushman
Mary
M
Strotmeyer
Elsa S
ES
Ding
Jingzhong
J
Kritchevsky
Stephen B
SB
Chaves
Paulo H M
PH
Fried
Linda P
LP
Robbins
John
J
D000203:Activities of Daily Living / Q000145:classification*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000453:epidemiology; D001288:Attention; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D002908:Chronic Disease / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D005684:Gait; D015577:Geriatric Assessment / Q000706:statistics & numerical data; D018737:Hand Strength; D006306:Health Surveys; D006801:Humans; D008297:Male; D008570:Memory, Short-Term; D008609:Mental Status Schedule / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D011594:Psychometrics; D012307:Risk Factors; D014481:United States