den Ouden Marjolein E M, Schuurmans Marieke J, Mueller-Schotte Sigrid, Bots Michiel L, van der Schouw YvonneT
Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht, The Netherlands.
Faculty Chair Care for the Chronically Ill and Elderly, University of Applied Sciences Utrecht, Utrecht, The Netherlands; Department of Rehabilitation, Nursing Science and Sports, UMC Utrecht, Utrecht, The Netherlands.
Exp Gerontol. 2014 Oct;58:1-7. doi: 10.1016/j.exger.2014.06.002. Epub 2014 Jun 5.
Cardiovascular disease is an important cause of disability in activities of daily living (ADL) through its effect on physical functioning. However, it is unclear whether subclinical vascular abnormalities and rate of change in subclinical vascular abnormalities is also associated with an impaired physical ability and with ADL disability. In a longitudinal study, 490 middle-aged and older persons were included. Physical ability was measured using the Short Physical Performance Battery and ADL disability using a questionnaire on self-reported basic and instrumental ADL. Subclinical vascular abnormalities were measured by pulse wave velocity (PWV) and carotid intima media thickness (CIMT, in men only). Longitudinal associations between baseline markers of subclinical vascular abnormalities, their rate of change, and change in physical ability or ADL disability were assessed using generalized estimation equation models. After adjustment for confounders, higher baseline PWV, change in PWV, baseline CIMT (in men) and change in CIMT (in men) were associated with a higher rate of change in physical ability (regression coefficients 0.035, 95% CI [0.018; 0.052]; 0.047, 95% CI [0.024; 0.069]; 0.214, 95% CI [0.070; 0.358] and 0.148, 95% CI [0.019; 0.277], respectively). No relations were found for change in ADL disability. In subjects with incident cardiovascular disease, higher change in PWV was associated with a higher rate of change in ADL disability (regression coefficient 0.054, 95% CI [0.001; 0.106]). The present study showed that subclinical vascular abnormalities and rate of change were associated with higher rate of change in physical ability. The association between (change in) subclinical vascular abnormalities and ADL disability tended to be stronger in persons with incident and prevalent cardiovascular disease. These data may suggest that ADL decline is more a direct effect of experienced clinically manifest vascular events rather than the effect of progression of subclinical vascular abnormalities.
心血管疾病通过影响身体功能，是日常生活活动（ADL）中致残的重要原因。然而，尚不清楚亚临床血管异常及其变化率是否也与身体能力受损和ADL残疾有关。在一项纵向研究中，纳入了490名中老年人。使用简短身体性能量表测量身体能力，使用关于自我报告的基本和工具性ADL的问卷测量ADL残疾。通过脉搏波速度（PWV）和颈动脉内膜中层厚度（仅在男性中测量CIMT）来测量亚临床血管异常。使用广义估计方程模型评估亚临床血管异常的基线标志物、其变化率与身体能力或ADL残疾变化之间的纵向关联。在调整混杂因素后，较高的基线PWV、PWV变化、基线CIMT（男性）和CIMT变化（男性）与身体能力的较高变化率相关（回归系数分别为0.035，95%CI[0.018；0.052]；0.04
