Physical function as a predictor for cardiovascular disease risk in the elderly

1. A higher physical function among community-dwelling older adults was associated with a decreased risk of cardiovascular disease. 

Evidence Rating Level: 2 (Good)

Leading a sedentary lifestyle with minimal physical activity has been shown to be associated with an increased risk of cardiovascular disease. However, there is currently a gap with regards to research investigating individual cardiovascular outcomes amongst older adults in community settings, such as physical activity level. In this community-based prospective cohort study, 5570 participants between 45 and 64 years of age were asked to perform a short physical examination with a wide variety of actions and were assessed for coronary heart disease, stroke, and heart failure. After the physical examination, patients were divided into low, intermediate, and high groups based on their physical function ability. Patients in the low and intermediate scoring categories were more likely to be older in age, female, Black, or have a lower education level. The results of this study show that low and intermediate physical examination groups had an increased risk of cardiovascular disease compared to the high physical examination group (HR 2.41, 95%CI 1.99-2.91 and HR 1.58, 95%CI 1.36-1.84, respectively). In conclusion, amongst older adults living in the community, a lower physical activity score is associated with an elevated risk of developing cardiovascular disease outcomes such as coronary heart disease, stroke, or heart failure. This was independent of pre-existing cardiovascular risk factors. However, there are several limitations that should be discussed in this study. For instance, while the physical activity test had various maneuvers and actions that were tested, a positive performance on this examination may not be an accurate indication of true physical activity level. As well, the study population only consisted of white and black adults so these results cannot be generalizable to other races or age groups. Nevertheless, these findings do demonstrate the importance of physical activity in reducing cardiovascular risk regardless of pre-existing “traditional” risk factors. As such, further research into this area, including randomized trials and experimental studies could be valuable in assessing the exact efficacy of physical function in reducing cardiovascular risk. 

Click to read the study in JAHA

Image: PD

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