Relationship Between Midlife Cardiovascular Health and Late-Life Physical Performance: The ARIC Study

ObjectivesTo examine the association between midlife cardiovascular health and physical performance 25years later. DesignCohort study (Atherosclerosis Risk in Communities Study); multinomial logistic and logistic regression adjusted for demographic characteristics and clinical measures. SettingFour U.S. communities: Forsyth County, North Carolina; Washington County, Maryland; Minneapolis, Minnesota; and Jackson, Mississippi. Participants: Individuals aged 54.25.8 at baseline (N=15,744; 55% female, 27% black). MeasurementsCardiovascular 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. ResultsMean baseline LS7 score was 7.9 +/- 2.4; 6,144 (39%) individuals returned 25years 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. ConclusionBetter cardiovascular health during midlife may lead better physical functioning in older age.