title: A novel aging phenotype of slow gait, impaired executive function, and depressive symptoms: relationship to blood pressure and other cardiovascular risks.
abstract: BACKGROUND
  Our objectives were to investigate the existence of a group of nondemented elderly individuals who simultaneously have impairments in cognition, mobility, and mood, and to examine the association between being a member of this group and elevated blood pressure and other cardiovascular conditions.
  
  
  METHODS
  The Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly of Boston study is an ongoing prospective observational study of community-dwelling individuals. We analyzed the cross-sectional data collected at baseline (N=580, mean age=77.8 years, 64% women, 14% African American, mean Mini-Mental State Examination=27.2). Using latent profile analysis, we investigated the existence of a group of elderly participants with impairments in executive function (Trail Making Test Part B [TMT-B]), gait speed (two 4-m walk tests), and depressive symptoms (Center for Epidemiological Studies-Depression scale [CES-D]).
  
  
  RESULTS
  We identified a group (n=99 [17%]) with prolonged TMT-B, slow gait speed, and high CES-D scores. This group did not exist when we used a memory measure. Hypertension (p=.001), diabetes (p=.0002), congestive heart failure (p=.006), stroke (p=.005), and higher Framingham cardiovascular risk score (p=.0001) were associated with an increased likelihood of being a member in this group. This association with elevated systolic and pulse pressure, and stroke remained significant after multiple covariate adjustments.
  
  
  CONCLUSIONS
  There exists a group of elderly individuals in whom poor executive function, slow gait speed, and depressive symptoms occur simultaneously. Memory measures did not identify such a grouping. Elevated blood pressure and other cardiovascular diseases are independently associated with being a member of this group. Assessing these domains is an important part of the evaluation of the elderly patients with high vascular risk.
authors.affiliation: Department of Medicine, Division of Gerontology, Beth Israel Deaconess Medical Center, Harvard Medical School, and Department of Psychiatry, Brigham and Women's Children Hospital, 1200 Center Street, Boston, MA, USA. ihabhajjar@hrca.harvard.edu
authors.forename: Ihab
authors.initials: I
authors.lastname: Hajjar
authors.forename: Frances
authors.initials: F
authors.lastname: Yang
authors.forename: Farzaneh
authors.initials: F
authors.lastname: Sorond
authors.forename: Richard N
authors.initials: RN
authors.lastname: Jones
authors.forename: William
authors.initials: W
authors.lastname: Milberg
authors.forename: L Adrienne
authors.initials: LA
authors.lastname: Cupples
authors.forename: Lewis A
authors.initials: LA
authors.lastname: Lipsitz
mesh_terms: D000368:Aged; D000375:Aging / Q000502:physiology / Q000523:psychology; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000209:etiology*; D003071:Cognition / Q000502:physiology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D010641:Phenotype; D012307:Risk Factors