Physical function as a predictor of cardiovascular disease risk in older adults

1. Higher physical function in community-dwelling older adults was associated with a decreased risk of cardiovascular disease.

Level of evidence assessment: 2 (good)

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 research gap regarding individual cardiovascular outcomes in older adults in community settings, such as level of physical activity. In this community-based prospective cohort study, 5570 participants aged 45-64 were asked to perform a brief physical examination with a wide variety of actions and were assessed for coronary heart disease, stroke, and heart failure. . After the physical examination, the patients were divided into low, intermediate and high groups based on their physical functional ability. Patients in the low- and middle-scoring categories were more likely to be older, female, black, or have a lower level of education. The results of this study show that the 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, in older people living in the community, a lower physical activity score is associated with a high risk of developing cardiovascular diseases such as coronary heart disease, stroke or heart failure. This was independent of pre-existing cardiovascular risk factors. However, several limitations should be discussed in this study. For example, while the physical activity test included various maneuvers and actions that were tested, a positive performance on this test may not be an accurate indication of true physical activity level. Additionally, the study population consisted of only white and black adults, so these findings cannot be generalized to other races or age groups. Nevertheless, these results demonstrate the importance of physical activity in reducing cardiovascular risk, independently of pre-existing “traditional” risk factors. As such, further research in this area, including randomized trials and experimental studies, could be useful in assessing the exact effectiveness of physical function in reducing cardiovascular risk.

Click to read the study in JAHA

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