title: Association between level of brachial-ankle pulse wave velocity and onset of activities of daily living impairment in community-dwelling older individuals.
abstract: OBJECTIVE
  The purpose of the present study was to clarify the longitudinal association between brachial-ankle pulse wave velocity (baPWV) and the onset of impairment in activities of daily living (ADL) among community-dwelling individuals.
  
  
  METHODS
  Deaths and the onsets of ADL impairment during 3 years were followed for 450 individuals without ADL impairment at entry who were aged 65 years or older (men : women 181:269; mean age 77 years). They were dichotomized on the median baPWV value at entry.
  
  
  RESULTS
  Within 3 years, 28 died and 60 had an onset of ADL impairment. The high baPWV group had a higher incidence of deaths (high baPWV group vs low baPWV group, 9.3% vs 3.1%) and ADL impairment (high baPWV group vs low baPWV group, 20.7% vs 9.3%). After adjustment for age, sex and systolic blood pressure, as compared with the low baPWV group, the high baPWV group had increased risk for mortality (adjusted odds ratio 3.22; 95% confidence interval 1.26-8.22) and the onset of ADL impairment (adjusted odds ratio 1.94; 95% confidence interval 1.03-3.63). When the onset of ADL impairment was grouped according to medical conditions that preceded/accompanied the onset of ADL impairment, elevated baPWV was associated with increased risk for the onset of ADL impairment after/accompanying fall/fracture.
  
  
  CONCLUSIONS
  The assessment of arterial stiffness by baPWV contributes to identifying functionally independent community-dwelling older individuals at risk for ADL impairment, in particular ADL impairment associated with fall/fracture, as well as for mortality. Geriatr Gerontol Int 2015; 15: 840-847.
authors.affiliation: Department of Public Health, Kochi Medical School, Nankoku, Japan.
authors.forename: Yumi
authors.initials: Y
authors.lastname: Kuroiwa
authors.affiliation: Department of Public Health, Kochi Medical School, Nankoku, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Miyano
authors.affiliation: Department of Internal Medicine, Saitama Memorial Hospital, Saitama, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Nishinaga
authors.affiliation: The Center to Promote Creativity in Medical Education, Kochi Medical School, Nankoku, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Takata
authors.affiliation: Department of Medicine and Geriatrics, Kochi Medical School, Nankoku, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Shimizu
authors.affiliation: Research Institute for Humanity and Nature, Kyoto, Japan.
authors.forename: Kiyohito
authors.initials: K
authors.lastname: Okumiya
authors.affiliation: The Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan.
authors.forename: Kozo
authors.initials: K
authors.lastname: Matsubayashi
authors.affiliation: Department of Medicine and Geriatrics, Kochi Medical School, Nankoku, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Ozawa
authors.affiliation: Department of Medicine and Geriatrics, Kochi Medical School, Nankoku, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kitaoka
authors.affiliation: Department of Medicine and Geriatrics, Kochi Medical School, Nankoku, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Doi
authors.affiliation: Department of Public Health, Kochi Medical School, Nankoku, Japan.
authors.forename: Nobufumi
authors.initials: N
authors.lastname: Yasuda
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D055109:Ankle Brachial Index / Q000379:methods*; D001783:Blood Flow Velocity / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D059289:Vascular Stiffness / Q000502:physiology*
keywords: activities of daily living impairment; arterial stiffness; brachial-ankle pulse wave velocity; fall; mortality