Leg symptom categories and rates of mobility decline in peripheral arterial disease
Open accessAbstract
OBJECTIVES: To determine whether asymptomatic lower extremity peripheral arterial disease (PAD) and leg symptoms other than intermittent claudication (IC) in PAD are associated with faster functional decline than in people with both PAD and IC. DESIGN: Prospective, observational study. SETTING: Chicago‐area medical center. PARTICIPANTS: Four hundred fifteen people with PAD followed annually for up to 7 years. MEASUREMENTS: At baseline, patients with PAD were categorized into symptom categories, including IC; leg pain on exertion and rest; participants who could walk through exertional leg pain (pain/carry on); and participants who never experienced exertional leg pain, even during the 6‐minute walk (always asymptomatic). Outcomes included mobility loss (becoming unable to walk one‐quarter of a mile or walk up and down one flight of stairs without assistance) and becoming unable to complete the 6‐minute walk without stopping. Analyses adjusted for age, sex, comorbidities, ankle brachial index, and other confounders. RESULTS: Always‐asymptomatic participants (hazard ratio (HR)=2.94, 95% confidence interval (CI)=1.39–6.19, P =.005) and those with leg pain on exertion and rest (HR=2.89, 95% CI=1.47–5.68, P =.002) had greater mobility loss than participants with IC. Participants with PAD with leg pain/carry on were less likely ( P =.047) to become unable to walk for 6 minutes continuously without stopping than participants with IC. CONCLUSION: The ABI identifies patients with asymptomatic PAD and those with atypical leg symptoms who are at risk for greater mobility decline than participants without PAD and participants with PAD with IC.
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Functional impairment is present even in patients with peripheral arterial disease who do not have exertional leg symptoms.
“Importantly, functional impairment is present even in patients who do not have exertional leg symptoms [132] .”
From Physical activity, cardiorespiratory fitness, and cardiovascular health: A clinical practice statement of the American Society for Preventive Cardiology Part II: Physical activity, cardiorespiratory fitness, minimum and goal intensities for exercise training, prescriptive methods, and special patient populations (2022) · cites this paper as [132]
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- Authors
- McDermott, M. M., Ferrucci, L., Liu, K., Guralnik, J. M., Tian, L., Liao, Y., & Criqui, M. H.
- Affiliations
- Northwestern University (US)
- Corresponding author
- McDermott, Mary M.
- Venue
- Journal of the American Geriatrics Society
- Publisher
- Wiley
- Published
- 2010-07
- Volume
- 58
- Issue
- 7
- Pages
- 1256-1262
- ISSN
- 0002-8614 (ISSN-L)
- 1532-5415
- PMC
- PMC3227868
- OpenAlex
- W1561146850
- Cited by
- 90
- References
- 29
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 13 · 2023: 7 · 2022: 10 · 2021: 9 · 2020: 4 · 2019: 9 · 2018: 6 · 2017: 5 · 2016: 5 · 2015: 2 · 2014: 3 · 2013: 4 · 2012: 1
- FWCI
- 2.02
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of the American Geriatrics Society (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (R01HL64739, R01HL071223, R01HL064739, R01HL076298, R01-HL58099, R01HL058099, R01HL083064)
- National Center for Research Resources (RR00048, M01RR000048)
- Topics
- Health Sciences › Medicine › Surgery › Peripheral Artery Disease Management
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Keywords
- peripheral arterial disease, intermittent claudication, leg symptoms, asymptomatic peripheral arterial disease, mobility decline, functional decline, ankle-brachial index, exertional leg pain, 6-minute walk test, lower extremity
- MeSH terms
- Aged, Aged, 80 and over, Female, Follow-Up Studies, Humans, Intermittent Claudication, Leg, Male, Pain, Prospective Studies, Time Factors, Case-Control Studies, Peripheral Vascular Diseases, Mobility Limitation, Ankle Brachial Index
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