Association Between Pulse Wave Velocity and Frailty, Disability, and Mortality in Community-Dwelling Older Adults.

Background

Arterial stiffness leads to several adverse events in the older population, but there is a lack of data on its association with frailty, disability, and mortality in the same population.

Objectives

The purpose of this study was to evaluate the role of arterial stiffness in the loss of functional ability (frailty and disability) and mortality.

Methods

Data were taken from community-dwelling aged 65 years participants without diabetes in the Toledo Study of Healthy Ageing cohort. Pulse wave velocity (PWV), assessed through SphygmoCor, was recorded at baseline. Median follow-up time were 2.99 years for frailty (frailty phenotype [FP] and Frailty Trait Scale-5 [FTS5]) and disability (Katz Index) and 6.2 for mortality. Logistic regressions models were built for disability and frailty and Cox proportional hazards model for death, adjusted by age and sex, comorbidity, cardiovascular risk factors, asymmetric dimethylarginine levels, and polypharmacy.

Results

Overall, 978 (mean age 74.5 ± 5.6 years, 56.7% female) participants were included. Different cut-off points were shown for each outcome. PWV >11.5 m/s was cross-sectionally associated with frailty (FP: OR fully-adjusted model: 1.69, 95% CI: 1.45-1.97; FTS5: OR: 1.51, 95% CI: 1.22-1.87) and disability (OR: 1.51, 95% CI: 1.26-1.79); PWV >10 m/s with incident frailty by FP (OR: 1.36, 95% CI: 1.10-1.68) and FTS5 (OR: 1.40, 95% CI: 1.12-1.75), and PWV >11 m/s with death (HR: 1.28, 95% CI: 1.09-1.50). For incident (OR: 1.28, 95% CI: 1.06-1.55) and worsening disability (OR: 1.21, 95% CI: 1.02-1.45) the threshold was 12.5 m/s. Below these cut-off points, age was the best predictor of adverse outcomes.

Conclusions

Arterial stiffness predicts frailty, disability, and mortality in older people, with different cut-off points, ie,severity degrees, for each of the assessed outcomes.

Informations de copyright

© 2023 The Authors.

Déclaration de conflit d'intérêts

Financial support for this analysis was provided by Abbott. TSHA research was funded by grants from the Spanish 10.13039/501100010198Ministry of Economy, Industry and Competitiveness, cofinanced by the 10.13039/501100008530European Regional Development Funds (10.13039/501100004587Instituto de Salud Carlos III, PI20/00977) and the Centro de Investigación Biomédica en Red en Fragilidad y Envejecimiento Saludable (CB16/10/00464); the MITOFUN Project, Fundación Francisco Soria Melguizo (Section 2/2020); 10.13039/501100010767Innovative Medicines Initiative Joint Undertaking under grant agreement n◦115621, resources of which are composed of financial contribution from the European Union’ 10.13039/100011102Seventh Framework Programme (FP7/2007-2013) and EFPIA companies. Drs Rueda, Pereira, Sulo are employees of Abbott. Dr Rodríguez-Mañas has received funds as a speaker in Abbott-supported conferences. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.