Heiland Emerald G, Qiu Chengxuan, Wang Rui, Santoni Giola, Liang Yajun, Fratiglioni Laura, Welmer Anna-Karin
Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden.
Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
J Am Geriatr Soc. 2017 Nov;65(11):2418-2424. doi: 10.1111/jgs.15158.
To explore the association between cardiovascular risk factor (CRF) burden and limitation in walking speed, balance, and chair stand and to verify whether these associations vary according to age and cognitive status.
Longitudinal population-based study.
Urban area of Stockholm, Sweden.
Individuals aged 60 and older who participated in the Swedish National Study on Aging and Care in Kungsholmen and were free of limitations in walking speed (n = 1,441), balance (n = 1,154), or chair stands (n = 1,496) at baseline (2001-04).
At baseline, data on demographic characteristics, CRFs, other lifestyle factors, C-reactive protein, and cognitive function were collected. CRF burden was measured using the Framingham general cardiovascular risk score (FRS). Limitations in walking speed (<0.8 m/s), balance (<5 seconds), and chair stand (inability to rise 5 times) were determined at 3-, 6-, and 9-year follow-up. Data were analyzed using Cox proportional hazards models stratified according to age (<78, ≥78).
During follow-up, 326 persons developed limitations in walking speed, 303 in balance, and 374 in chair stands. An association between the FRS and walking speed limitation was evident only in adults younger than 78 (for each 1-point increase in FRS: hazard ratio (HR) = 1.09, 95% confidence interval (CI) = 1.02-1.17) after controlling for potential confounders including cognitive function (correspondingly, in adults aged ≥78: HR = 0.98, 95% CI = 0.92-1.03). Also, higher FRS was significantly associated with faster decline in walking speed (P < .001).
A higher FRS is associated with greater risk of subsequent development of walking speed limitation in adults younger than 78, independent of cognitive function. Interventions targeting multiple CRFs in younger-old people may help in maintaining mobility function.
探讨心血管危险因素（CRF）负担与步行速度、平衡能力和从椅子上站起能力受限之间的关联，并验证这些关联是否因年龄和认知状态而异。
基于人群的纵向研究。
瑞典斯德哥尔摩市区。
年龄在60岁及以上、参加了瑞典 Kungsholmen 地区老龄化与护理全国研究且在基线时（2001 - 2004年）步行速度（n = 1441）、平衡能力（n = 1154）或从椅子上站起能力无受限的个体。
在基线时，收集了人口统计学特征、CRF、其他生活方式因素、C反应蛋白和认知功能的数据。使用弗雷明汉一般心血管风险评分（FRS）测量CRF负担。在3年、6年和9年随访时确定步行速度（<0.8米/秒）、平衡能力（<5秒）和从椅子上站起能力（无法站起5次）的受限情况。使用根据年龄（<78岁、≥78岁）分层的Cox比例风险模型分析数据。
在随访期间，326人出现步行速度受限，303人出现平衡能力受限，374人出现从椅子上站起能力受限。在控制包括认知功能在内的潜在混杂因素后，FRS与步行速度受限之间的关联仅在78岁以下的成年人中明显（FRS每增加1分：风险比（HR）= 1.09，95%置信区间（CI）= 1.02 - 1.17）（相应地，在78岁及以上的成年人中：HR = 0.98，95% CI = 0.92 - 1.03）。此外，较高的FRS与步行速度更快下降显著相关（P < 0.001）。
较高的FRS与78岁以下成年人随后出现步行速度受限的风险增加相关，与认知功能无关。针对年轻老年人的多种CRF进行干预可能有助于维持运动功能。
