Association of peripheral artery disease with life-space mobility restriction and mortality in community-dwelling older adults.
Association of peripheral artery disease with life-space mobility restriction and mortality in community-dwelling older adults.
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DOI：
10.1016/j.jvs.2019.08.276
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发表时间：
2020-06
影响因子：
4.3
通讯作者：
Bowling CB
中科院分区：
文献类型：
--
作者：
Arya S;Khakharia A;Rothenberg KA;Johnson TM 2nd;Sawyer P;Kennedy RE;Brown CJ;Bowling CB
症状性外周动脉疾病(PAD)损害步行，但关于PAD对社区活动的影响的数据有限。生活空间流动性衡量老年人在从卧室(生活空间流动性得分：0)到城镇以外(生活空间流动性得分：120)的地理区域移动时所需的距离、频率和所需的帮助。我们评估了PAD与纵向生活空间运动轨迹的关联。参与者是阿拉巴马大学伯明翰分校(UAB)老龄化研究的一部分，这是一项对2001年至2009年跟踪调查的社区居住的老年人的纵向研究。我们的分析仅限于存活至少6个月的患者(N=981)。PAD是基于自我报告和医生/医院记录的核实。我们的主要结果是每六个月评估一次生活空间移动性评分。多水平变化模型(混合模型)被用来确定PAD和生活空间流动性轨迹之间的关联，平均随访时间为7.9年。参与者的平均年龄为75.7岁(SD 6.7)，其中50.5%为女性，50.4%为非裔美国人。PAD患病率为10.1%，57.1%的PAD患者死亡。在PAD和生活空间受限的参与者中，我们观察到最高的死亡率(73.1%)。在多变量调整的混合效应模型中，与没有PAD的参与者相比，有PAD的参与者的生活空间流动性每年下降更快，−为1.1(95%CI−1.9，−为0.24)。在5年的随访中，模型调整后的平均生活空间活动度(95%CI)在有PAD和无PAD的患者中分别为48.1(43.5，52.7)和52.4(50.9，53.8)，对应于在邻里水平上对独立生活空间活动的限制。生活空间流动性是一种新的、以患者为中心的社区流动性衡量标准，PAD与居住在社区的老年人的生活空间流动性显著下降有关。需要进一步的研究来从机制上证实这些发现，并确定更好地识别和治疗PAD是否会改变生活空间移动性的轨迹。在阿拉巴马大学伯明翰分校的老龄化研究分析中，PAD与生活空间流动性的显著下降有关。生活空间移动性可能是衡量垫移动性影响的重要工具。
Symptomatic peripheral arterial disease (PAD) impairs walking, but data on the impact of PAD on community mobility is limited. Life-space mobility measures the distance, frequency, and assistance needed as older adults move through geographic areas extending from their bedroom (life-space mobility score: 0) to beyond their town (life-space mobility score: 120). We evaluated the association of PAD with longitudinal life-space mobility trajectory. Participants were part of the University of Alabama at Birmingham (UAB) Study of Aging, a longitudinal study of community-dwelling older adults who were followed from 2001–2009. We limited our analysis to those who survived at least 6 months (N=981). PAD was based on self-report with verification by physician/hospital records. Our primary outcome was life-space mobility score assessed every six-months. A multilevel change model (mixed model) was used to determine the association between PAD and life-space mobility trajectory over a median 7.9 years of follow-up. Participants had a mean age of 75.7 (SD 6.7), 50.5% were female, and 50.4% were African American. PAD prevalence was 10.1%, and 57.1% of participants with PAD died. In participants with both PAD and life-space restriction, defined as life-space mobility score <60, we observed the highest mortality (73.1%). In a multivariable adjusted mixed effects model, participants with PAD had a more rapid decline in life-space mobility by −1.1 (95% CI −1.9, −0.24) points per year compared to those without PAD. At five-year follow-up, model adjusted mean life-space mobility (95% CI) was 48.1 (43.5, 52.7) and 52.4 (50.9, 53.8), among those with and without PAD, respectively, corresponding to a restriction in independent life-space mobility at the level of one’s neighborhood. Life-space mobility is a novel, patient-centered measure of community mobility, and PAD is associated with significant life-space mobility decline among community-dwelling older adults. Further study is needed to mechanistically confirm these findings and determine if better recognition and treatment of PAD alter the trajectory of life-space mobility. PAD was associated with significant life-space mobility decline in in this analysis of the University of Alabama at Birmingham Study-of-Aging. Life-space mobility may be an important tool for measuring the impact of PAD mobility.
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影响因子：
24
作者：
McDermott, Mary M.;Liu, Kiang;Criqui, Michael H.
通讯作者：
Criqui, Michael H.
影响因子：
4.3
作者：
Jain, Atul;Liu, Kiang;McDermott, Mary M.
通讯作者：
McDermott, Mary M.
DOI：
10.1111/j.1532-5415.2000.tb03907.x
发表时间：
2000-02-01
影响因子：
6.3
作者：
Covinsky, KE;Palmer, RM;Chren, MM
通讯作者：
Chren, MM
影响因子：
13.2
作者：
Jassal, S. Vanita;Karaboyas, Angelo;Tentori, Francesca
通讯作者：
Tentori, Francesca
影响因子：
4.3
作者：
McDermott, MM;Liu, KA;Greenland, P
通讯作者：
Greenland, P