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Functional Trajectories of Persons with Cardiovascular Disease in Late Life.

ABSTRACT: OBJECTIVES:Physical function declines with aging and is accelerated for persons with cardiovascular disease (CVD). While CVD increases the risk of functional decline in late life, little is known about differences in trajectories of functional decline. To determine whether there is more than 1 trajectory of functional decline in Americans with cardiovascular disease (CVD) who are functionally independent. DESIGN:Secondary analysis of National Health and Aging Trends Study (NHATS). Latent class growth modeling was used to estimate trajectories of function over 4 years of follow-up. SETTING:Annual structured in-home interviews. PARTICIPANTS:Americans aged 65 and older with CVD who were functionally independent at baseline (N = 392). MEASUREMENTS:We compared trajectories of function in individuals with CVD with trajectories of those without and examined the association between risk factors (sex, age at baseline, education level, comorbidity) and trajectory group membership. Function was measured using the Short Physical Performance Battery. RESULTS:Three functional trajectories emerged: rapid functional decline (23.8%), gradual functional decline (44.2%), and stable function (32.0%). Similar trajectories were seen for those without CVD, with a smaller proportion in the rapid functional decline group (16.2%). Women, older participants, and those with less education and greater comorbidity were less likely to be in the stable function group than the rapid functional decline group. CONCLUSION:Although function declines in late life for independently functioning persons with CVD, some individuals remain stable, and others decline gradually or rapidly. Persons with CVD were more likely to experience rapid functional decline than those without, suggesting that CVD increases the risk of rapid functional decline. Risk factors predicted functional trajectory group membership, not just overall decline. J Am Geriatr Soc 67:37-42, 2019.

SUBMITTER: Keeney T

PROVIDER: S-EPMC6705121 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature

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Functional Trajectories of Persons with Cardiovascular Disease in Late Life.

Keeney Tamra T Fox Annie B AB Jette Diane U DU Jette Alan A

Journal of the American Geriatrics Society 20181121 1

<h4>Objectives</h4>Physical function declines with aging and is accelerated for persons with cardiovascular disease (CVD). While CVD increases the risk of functional decline in late life, little is known about differences in trajectories of functional decline. To determine whether there is more than 1 trajectory of functional decline in Americans with cardiovascular disease (CVD) who are functionally independent.<h4>Design</h4>Secondary analysis of National Health and Aging Trends Study (NHATS). ...[more]

PMID: 30460975

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Project description:ObjectivesPrevious studies have shown marital status differences in incidence and prevalence of cardiovascular disease and cardiovascular mortality. This study examines the consequences of partnership on biomarkers related to cardiovascular health of older men and women in Germany and England (C-reactive protein, HbA1c, systolic and diastolic blood pressure; and total cholesterol).MethodsData used is from older adults (60 +) from the German Survey of Health and Retirement Europe SHARE (n=955) and the English Longitudinal Study of Ageing ELSA (n=9707). Life course partnership is measured using the timing (age at first partnership), quantum (number of partnerships) and partnership trajectory. OLS for C-reactive protein, logistic regressions for systolic and diastolic blood pressure, and multinomial logistic regressions for cholesterol are used to investigate the associations between life course partnership characteristics and biomarkers, accounting for early age socioeconomic and health conditions.ResultsTiming of first partnership is associated with poor cardiovascular health in England, number of partnership transitions with poor health in Germany, and partnership trajectories are associated with cardiovascular health both in Germany and England. Men in trajectories with multiple marriages have higher CRP, and are more likely to have elevated systolic and diastolic BP. Trajectories containing single marital disruption for men and women are no longer associated with poor health after accounting for selection effects of childhood conditions. Respondents in widowed partnership trajectories have poorer cardiovascular health compared to those in intact committed relationships, whereas cohabitation trajectories do not differ in the associations with biomarkers from those in intact marriage.ConclusionThe results offer better understanding of the pathways through which family events and processes are linked to health and support the hypothesis that adversity related to partnerships over the life course accumulates and contributes to worse cardiovascular health in later life measured by objective health measures.

Dataset Information

Functional Trajectories of Persons with Cardiovascular Disease in Late Life.

Publications

Functional Trajectories of Persons with Cardiovascular Disease in Late Life.

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