Relationship Between Midlife Cardiovascular Health and Late-Life Physical Performance: The ARIC Study.
OBJECTIVE
To examine the association between midlife cardiovascular health and physical performance 25 years later.


METHODS
Cohort study (Atherosclerosis Risk in Communities Study); multinomial logistic and logistic regression adjusted for demographic characteristics and clinical measures.


METHODS
Four U.S. communities: Forsyth County, North Carolina; Washington County, Maryland; Minneapolis, Minnesota; and Jackson, Mississippi.


METHODS
Individuals aged 54.2 ± 5.8 at baseline (N = 15,744; 55% female, 27% black).


METHODS
Cardiovascular health was measured at baseline using the American Heart Association's Life's Simple 7 (LS7) score (0-14) and LS7 component categories (poor, intermediate, ideal) for each risk factor. The Short Physical Performance Battery (SPPB) was used to quantify physical function as ordinal (0-12) and categorical (low (0-6), fair (7-9), good (10-12) outcomes.


RESULTS
Mean baseline LS7 score was 7.9 ± 2.4; 6,144 (39%) individuals returned 25 years later for the fifth ARIC examination, at which point the SPPB was administered. Of 5,916 individuals who completed the SPPB, 3,288 (50%) had good physical performance. Each 1-unit increase in LS7 score was associated with a 17% higher SPPB score (rate ratio (RR) = 1.17, 95% confidence interval (CI) = 1.15-1.19) and a 29% greater chance of having a late-life SPPB score of 10 or greater compared to SPPB score of less than 10 (RR = 1.29, 95% CI = 1.25-1.34). Ideal baseline glucose (RR = 2.53, 95% CI = 2.24-2.87), smoking (RR = 1.97, 95% CI = 1.81-2.15), blood pressure (RR = 1.70, 95% CI = 1.54-1.88), body mass index (RR = 1.51, 95% CI = 1.37-1.66), and physical activity (RR = 1.31, 95% CI = 1.20-1.43) had the strongest associations with late-life SPPB score, adjusting for other LS7 components.


CONCLUSIONS
Better cardiovascular health during midlife may lead better physical functioning in older age.
Dept. of Medicine, Division of Geriatrics, University of Mississippi Medical Center.
B Gwen
BG
Windham
School of Medicine, University of Mississippi Medical Center.
Kimystian L
KL
Harrison
Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center.
Seth T
ST
Lirette
University of Minnesota School of Public Health.
Pamela L
PL
Lutsey
University of Texas Health Science Center at Houston School of Public Health.
Lisa A
LA
Pompeii
University of Texas Health Science Center at Houston School of Public Health Austin Campus.
Kelley Pettee
KP
Gabriel
Johns Hopkins University.
Silvia
S
Koton
University of Minnesota School of Public Health.
Lyn M
LM
Steffen
Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center.
Michael E
ME
Griswold
Dept. of Medicine, Division of Geriatrics, University of Mississippi Medical Center.
Thomas H
TH
Mosley
D000367:Age Factors; D044383:Black People / Q000706:statistics & numerical data; D002318:Cardiovascular Diseases / Q000208:ethnology / Q000517:prevention & control*; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D044465:White People / Q000706:statistics & numerical data
cardiovascular; midlife; physical performance