Wang Zhangyu, Cui Kaiwang, Song Ruixue, Li Xuerui, Qi Xiuying, Buchman Aron S, Bennett David A, Xu Weili
Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.
Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.
Front Med (Lausanne). 2022 Apr 26;9:856260. doi: 10.3389/fmed.2022.856260. eCollection 2022.
This study aimed to investigate the association of the cardiovascular risk burden assessed by the Framingham General Cardiovascular Risk Score (FGCRS) with the trajectories of motor function over time and to assess the mediating effects of cardiovascular diseases (CVDs) accumulation and cognitive decline in such association.
In Rush Memory and Aging Project, a total of 1,378 physical health participants (mean age: 79.3 ± 7.3 years) were followed up for up to 22 years. FGCRS at baseline was assessed and categorized into tertiles (lowest, middle, and highest). Global motor function (including dexterity, gait, and hand strength) was assessed annually with 10 motor tests. CVDs (including stroke, congestive heart failure, and other heart diseases) were ascertained at baseline and follow-ups, and the number of CVDs accumulation over time was assessed. Global cognitive function was tested annually by 19 tests. Data were analyzed using the linear mixed-effects models and mediation analysis.
At baseline, FGCRS ranged from 4 to 28 (mean score: 15.6 ± 3.7). Over the follow-up (median: 5.3 years; interquartile range: 2.9-9.0 years), in multi-adjusted mixed-effects models, the highest FGCRS was associated with faster decline in global motor function (β = -0.0038; 95% confidence interval [CI]: -0.0069 to -0.0008), dexterity (β = -0.0056; 95% CI: -0.0093 to -0.0020), gait (β = -0.0039; 95% CI: -0.0077 to -0.0001), and hand strength (β = -0.0053; 95% CI: -0.0098 to -0.0008) compared with the lowest tertile. In mediation analysis, CVDs accumulation and cognitive decline mediated 8.4% and 42.9% of the association between FGCRS and global motor function over time, respectively.
Higher cardiovascular risk burden is associated with a faster decline in motor function including dexterity, gait, and hand strength. CVDs accumulation and cognitive decline may partially mediate the association between cardiovascular risk burden and global motor function decline.
本研究旨在探讨弗雷明汉总体心血管风险评分（FGCRS）评估的心血管风险负担与运动功能随时间变化轨迹之间的关联，并评估心血管疾病（CVD）累积和认知衰退在这种关联中的中介作用。
在拉什记忆与衰老项目中，对1378名身体健康的参与者（平均年龄：79.3±7.3岁）进行了长达22年的随访。评估基线时的FGCRS并将其分为三分位数（最低、中间和最高）。每年通过10项运动测试评估整体运动功能（包括灵活性、步态和握力）。在基线和随访时确定CVD（包括中风、充血性心力衰竭和其他心脏病），并评估随时间累积的CVD数量。每年通过19项测试对整体认知功能进行测试。使用线性混合效应模型和中介分析对数据进行分析。
在基线时，FGCRS范围为4至28（平均得分：15.6±3.7）。在随访期间（中位数：5.3年；四分位间距：2.9 - 9.0年），在多因素调整的混合效应模型中，与最低三分位数相比，最高FGCRS与整体运动功能更快下降相关（β = -0.0038；95%置信区间[CI]：-0.0069至-0.0008）、灵活性（β = -0.0056；95% CI：-0.0093至-0.0020）、步态（β = -0.0039；95% CI：-0.0077至-0.0001）和握力（β = -0.0053；95% CI：-0.0098至-0.0008）。在中介分析中，CVD累积和认知衰退分别介导了FGCRS与整体运动功能随时间关联的8.4%和42.9%。
较高的心血管风险负担与包括灵活性、步态和握力在内的运动功能更快下降相关。CVD累积和认知衰退可能部分介导心血管风险负担与整体运动功能衰退之间的关联。
