title: Association of cardio-ankle vascular index with physical fitness and cognitive symptoms in aging Finnish firefighters.
abstract: OBJECTIVE
  Monitoring cardiovascular risk factors is important in health promotion among firefighters. The assessment of arterial stiffness (AS) may help to detect early signs of atherosclerosis. The aim of this study was to analyze associations between aerobic fitness, cognitive symptoms and cardio-ankle vascular index (CAVI) as a measure for AS among Finnish firefighters.
  
  
  METHODS
  The data are one part of a large 13-year follow-up study of the health and physical and mental capacity of Finnish professional firefighters. The subjects in this substudy comprised 65 male firefighters of a mean age of 48.0 (42-58) years in 2009. Their maximal oxygen uptake was successfully measured in two cross-sectional studies in 1996 and 2009, and they responded to questionnaires at both sessions, and their CAVI was measured in 2009. CAVI was calculated from the pulse waveform signal and pulse wave velocity. The lifestyle habits and subjective cognitive stress-related symptoms were collected via a standardized questionnaire. Muscular fitness was measured by the routine test battery used for Finnish firefighters.
  
  
  RESULTS
  CAVI was related to age. About one-fifth of the firefighters had a CAVI of >8. Aerobic fitness was the main physiological factor correlating with increased CAVI. Interestingly, VO(2)max and the accelerated decrease in VO(2)max during a 13-year follow-up were associated with signs of impaired vascular function. The cognitive symptoms derived from the Profile of Mood States questionnaire (POMS) were mainly associated with stress and sleeping difficulties. No clear association with physical fitness was found in this population of fit firefighters.
  
  
  CONCLUSIONS
  Among firefighters, the decrease in aerobic fitness predicts increased arterial stiffness. The speed of the age-related decline in maximal oxygen consumption is as important as absolute level. Against expectations, the cognitive function did not correlate with vascular health parameters. The cognitive symptoms, however, were only mild.
authors.affiliation: Finnish Institute of Occupational Health, Topeliuksenkatu 41a A, 00250, Helsinki, Finland. harri.lindholm@ttl.fi
authors.forename: H
authors.initials: H
authors.lastname: Lindholm
authors.forename: A
authors.initials: A
authors.lastname: Punakallio
authors.forename: S
authors.initials: S
authors.lastname: Lusa
authors.forename: M
authors.initials: M
authors.lastname: Sainio
authors.forename: E
authors.initials: E
authors.lastname: Ponocny
authors.forename: R
authors.initials: R
authors.lastname: Winker
mesh_terms: D000328:Adult; D000375:Aging / Q000502:physiology; D000842:Ankle / Q000098:blood supply*; D055109:Ankle Brachial Index; D050197:Atherosclerosis / Q000175:diagnosis / Q000503:physiopathology*; D001783:Blood Flow Velocity; D003072:Cognition Disorders / Q000453:epidemiology*; D005387:Finland; D061388:Firefighters; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness / Q000502:physiology*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D059289:Vascular Stiffness / Q000502:physiology*