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Decline in Functional Performance Predicts Later Increased Mobility Loss and Mortality in Peripheral Arterial Disease
Open accessAbstract
Objectives We hypothesized that a greater 2-year decline in office-based functional performance measures would be associated with greater mobility loss and mortality in people with peripheral arterial disease (PAD).Background Associations of decline in functional performance with clinically important outcomes in patients with PAD are unknown.Methods A total of 440 men and women with PAD completed the 6-min walk test and measures of walking velocity at baseline and annually for 2 years. Participants were categorized into tertiles according to their functional decline between baseline and 2-year follow-up and were followed annually after the functional change assessment. Cox proportional hazard models were used to assess relations between the 2-year change in functional performance with later mortality and mobility loss, with adjustments for age, sex, race, ankle brachial index, comorbidities, and other confounders.Results A total of 102 participants (23.2%) died during a median follow-up of 44.5 months after functional change was assessed. Of 319 participants without baseline mobility disability, 60 (18.8%) developed mobility loss after functional change was assessed. Participants in the tertile with the greatest 6-min walk decline had the highest subsequent mobility loss (hazard ratio [HR]: 3.50; 95% confidence interval [CI]: 1.56 to 7.85; p = 0.002), all-cause mortality (HR: 2.16; 95% CI: 1.28 to 3.64; p = 0.004), and cardiovascular disease mortality (HR: 2.45; 95% CI: 1.08 to 5.54; p = 0.031), compared with those with the smallest 6-min walk decline. Greater declines in fastest-paced 4-m walking velocity were associated with higher mobility loss (p trend = 0.018), all-cause mortality (p trend = 0.01), and cardiovascular mortality (p trend = 0.004).Conclusions Participants with PAD with declining functional performance are at increased risk for later mobility loss and mortality.
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Metadata
- Authors
- McDermott, M. M., Liu, K., Ferrucci, L., Tian, L., Guralnik, J. M., Liao, Y., & Criqui, M. H.
- Affiliations
- Northwestern University (US)
- National Institute on Aging (US)
- University of California San Diego (US)
- Corresponding author
- McDermott, Mary M.
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2011-02
- Volume
- 57
- Issue
- 8
- Pages
- 962-970
- ISSN
- 0735-1097 (ISSN-L)
- PMC
- PMC3222682
- OpenAlex
- W2156171476
- Cited by
- 122
- References
- 22
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 11 · 2023: 10 · 2022: 14 · 2021: 13 · 2020: 5 · 2019: 10 · 2018: 6 · 2017: 7 · 2016: 5 · 2015: 7 · 2014: 8 · 2013: 9 · 2012: 6
- FWCI
- 8.44
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (R01HL071223, R01HL064739, R01HL076298, R01HL058099)
- Topics
- Health Sciences › Medicine › Surgery › Peripheral Artery Disease Management
- Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Keywords
- peripheral arterial disease, mobility loss, all-cause mortality, cardiovascular mortality, 6-minute walk test, walking speed, functional decline prediction, prognosis
- MeSH terms
- Age Factors, Aged, Cause of Death, Disability Evaluation, Exercise Test, Female, Follow-Up Studies, Humans, Male, Middle Aged, Predictive Value of Tests, Severity of Illness Index, Sex Factors, Time Factors, Cohort Studies, Survival Rate, Proportional Hazards Models, Walking, Exercise Tolerance, Disease Progression, Mobility Limitation, Ankle Brachial Index, Peripheral Arterial Disease
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