Lesser Physical Function in Old Age Correlates with a Greater Cardiovascular Disease Risk
Better fitness in later life reduces mortality, and the study results here are just one of many examples that demonstrate this correlation, though specifically for cardiovascular disease in this case. While only correlations can be determined from most human data, animal studies make it quite clear that better fitness causes a reduced later life mortality. Maintaining better physical fitness is a good idea for many reasons, and it seems clear that health and longevity will benefit from doing so.
The Atherosclerosis Risk in Communities (ARIC) study, an ongoing community-based cohort enrolled 15,792 participants, ages 45-64 years from 1987-1989, to investigate the causes for atherosclerotic disease (plaque or fatty buildup in the arteries). Yearly and semi-yearly (beginning in 2012) check-ins included phone calls and in-person clinic exams. The present study evaluated health data from ARIC visit 5 (2011-2013; all participants were older than age 65) as a baseline, when the Short Physical Performance Battery (SPPB) test was first collected. The SPPB measured physical function to produce a score according to walking speed, speed of rising from a chair without using your hands, and standing balance.
Researchers analyzed health data for 5,570 adults, average age of 75 from 2011 to 2019. Using SPPB scores, the physical function of the participants was categorized into three groups: low, intermediate, and high, based on their test performance. Researchers examined the association of SPPB scores with future heart attack, stroke, and heart failure, as well as the composite of the three, adjusting for major cardiovascular disease risk factors, such as high blood pressure, smoking, high cholesterol, diabetes, and history of cardiovascular disease.
Among all participants, 13% had low, 30% had intermediate, and 57% had high physical function scores. During the 8 years of the study, there were 930 participants with one or more confirmed cardiovascular events: 386 diagnosed with heart attack, 251 who had a stroke, and 529 heart failure cases. Compared to adults with high physical function scores, those with low physical function scores were 47% more likely to experience at least one cardiovascular disease event, and those with intermediate physical function scores had a 25% higher risk of having at least one cardiovascular disease event. The association between physical function and cardiovascular disease remained after controlling for traditional cardiovascular disease risk factors such as age, high blood pressure, high cholesterol, and diabetes.
They designed the test to accommodate the least capable participants. That resulted in 57% of the study group scoring as "high physical function", a lot of instructive information could have been obtained if that 57% had been further stratified.
A huge problem with the entire US healthcare system is that almost everything is focused on the weakest 20% of the population.