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Longitudinal Relationships of Subclinical Cardiovascular Disease with Physical Function in Older Adults

Watson, Nora Lynn (2009) Longitudinal Relationships of Subclinical Cardiovascular Disease with Physical Function in Older Adults. Master's Thesis, University of Pittsburgh. (Unpublished)

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Low ankle-arm index (AAI), a marker of peripheral arterial disease, predicts incident disability in older adults. Elevated pulse wave velocity (PWV), a measure of arterial stiffness, increases risk of cardiovascular events and mortality. However, the relationship between PWV and mobility has not been well characterized in older adults. To evaluate the potential local and systemic influences of vascular disease on physical function, we compared the associations of AAI and PWV with usual gait speed over eight years in the Health, Aging and Body Composition (Health ABC) Study. The study population consisted of 2,066 participants (mean age ± SD 73.6 ± 2.8 years, 48.1% men, 37.8% black) with valid PWV, AAI and gait speed data at baseline after exclusion of those with either revascularization or angioplasty of the leg arteries. Random coefficient models were used to evaluate the relationships of both subclinical vascular disease measures with gait speed decline over time. After adjustment for risk factors and comorbidities, each SD higher PWV was associated with a 0.008 m/s slower gait speed over the study period (SE 0.004, p = 0.03). Compared to high-normal AAI (greater than 1.3 - 1.4), low AAI and noncompressible arteries were each associated with slower gait speed over the study period: Beta (SE) = -0.10 (0.03), p less than 0.001 for AAI < 0.7, and Beta (SE) = -0.16 (0.04), p less than 0.001 for noncompressible arteries. The public health relevance of these findings is the potential contribution of subclinical vascular disease, particularly low AAI and noncompressible arteries, to poor physical function in aging.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Watson, Nora
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairYouk, Adaayouk@pitt.eduAYOUK
Committee MemberSutton-Tyrrell,
Committee MemberBoudreau, Robertboudreaur@edc.pitt.eduROB21
Date: 29 January 2009
Date Type: Completion
Defense Date: 9 December 2008
Approval Date: 29 January 2009
Submission Date: 3 December 2008
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Biostatistics
Degree: MS - Master of Science
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: physical function; aging; vascular disease
Other ID:, etd-12032008-163300
Date Deposited: 10 Nov 2011 20:07
Last Modified: 15 Nov 2016 13:52


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