title: The Relationship of Cardiovascular Disease to Physical Functioning in Women Surviving to Age 80 and Above in the Women's Health Initiative.
abstract: BACKGROUND
  Cardiovascular disease (CVD) is highly prevalent at ages 80 and above. The association of physical functioning (PF), a key to an optimal aging trajectory, with CVD and specific CVD diagnosis in women who survive to age 80 and above has not been described previously and has important public health significance given our aging population.
  
  
  METHODS
  Women's Health Initiative participants aged 80 years or older at the time of self-reporting PF (RAND SF-36) were studied in relationship to CVD diagnosis, whether present at study baseline (1993-1998) or diagnosed during follow-up through 2012. Cross-sectional analyses utilized demographic, medical, lifestyle, and psycho-social questionnaire data from baseline or updated at the time of self-reported PF.
  
  
  RESULTS
  Among 27,145 older Women's Health Initiative participants, 22.0% (N = 5,959) had been diagnosed with CVD, specifically: 11.3% (N = 3,071) with coronary heart disease; 4.7% (N = 1,279), stroke; 5.2% (N = 1,397), venous thromboembolism; 2.7% (N = 737), peripheral arterial disease; and 2.7% (N = 725), congestive heart failure. PF scores (mean ± SE) were significantly (p < .0001) higher without CVD (60.0 ± 26.9), compared with any CVD (47.9 ± 27.3), and for each specific CVD diagnosis: coronary heart disease (48.8 ± 27.1); stroke (44.8 ± 27.9); venous thromboembolism (48.9 ± 27.4); peripheral arterial disease (41.9 ± 2.2); and congestive heart failure (38.8 ± 26.1). Regardless of CVD diagnosis, higher PF was associated with: younger age at the time of PF assessment; lower body mass index; higher recreational physical activity; better self-reported general health; fewer hip fractures after age 55; no history of arthritis; and no recent use of non-steroidal anti-inflammatory drugs.
  
  
  CONCLUSIONS
  Older women with any CVD, and particularly women with congestive heart failure or peripheral arterial disease, reported significantly lower PF compared to women with no CVD. Regardless of CVD diagnosis, higher PF was strongly associated with a more active lifestyle and lower body mass index, suggesting potential intervention targets for more optimal aging.
authors: Department of Medicine, Stanford Prevention Research Center and Department of Obstetrics & Gynecology, School of Medicine, Stanford University, California. stefanick@stanford.edu.
authors: Marcia L
authors: ML
authors: Stefanick
authors: Department of Family and Community Medicine, University of Nevada School of Medicine, Reno.
authors: Robert L
authors: RL
authors: Brunner
authors: Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors: X
authors: X
authors: Leng
authors: Division of Cardiovascular Medicine, Department of Medicine, College of Medicine, University of Florida, Gainesville.
authors: Marian C
authors: MC
authors: Limacher
authors: RAND Corporation, Santa Monica, California.
authors: Chloe E
authors: CE
authors: Bird
authors: Department of Health Promotion Sciences, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson.
authors: David O
authors: DO
authors: Garcia
authors: Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors: Patricia E
authors: PE
authors: Hogan
authors: Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo - SUNY, New York.
authors: Michael J
authors: MJ
authors: LaMonte
authors: Department of Epidemiology, School of Public Health, University of Pittsburgh, Pennsylvania.
authors: Rachel H
authors: RH
authors: Mackey
authors: Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis.
authors: Karen C
authors: KC
authors: Johnson
authors: Department of Family and Preventative Medicine, University of California San Diego, La Jolla, California.
authors: Andrea
authors: A
authors: LaCroix
authors: Department of Epidemiology, College of Public Health, University of Iowa.
authors: Jennifer G
authors: JG
authors: Robinson
authors: Division of Nutritional Sciences, Cornell University, Ithica, New York.
authors: Rebecca A
authors: RA
authors: Seguin
authors: Center for Research on Health Care, University of Pittsburgh, Pennsylvania.
authors: Hilary A
authors: HA
authors: Tindle
authors: Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York.
authors: Sylvia
authors: S
authors: Wassertheil-Smoller
mesh_terms: D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000503:physiopathology*; D004185:Disability Evaluation; D005260:Female; D015577:Geriatric Assessment; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D015995:Prevalence; D011788:Quality of Life; D017741:Survivors / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D016387:Women's Health
keywords: Cardiovascular; Physical function; Successful aging