Lower Extremity Peripheral Artery Disease and Quality of Life among Older Individuals in the Community: The Atherosclerosis Risk in Communities (ARIC) Study

Peripheral arterial disease;Ankle-brachial index (ABI);Quality of life (QOL);Older population;Epidemiology

Wu, AozhouCoresh, Josef ;

Johns Hopkins University

关键词: Peripheral arterial disease;    Ankle-brachial index (ABI);    Quality of life (QOL);    Older population;    Epidemiology;   

Others  :  https://jscholarship.library.jhu.edu/bitstream/handle/1774.2/38098/WU-THESIS-2015.pdf?sequence=1&isAllowed=y

瑞士|英语

来源: JOHNS HOPKINS DSpace Repository

【 摘 要 】

Background: Lower extremity peripheral arterial disease (PAD), commonly identified by an ankle-brachial Index (ABI) <0.9, increases mortality risk and may impair quality of life (QOL). However, most studies assessing reduced QOL in the relation to PAD rely on small clinical studies, leaving uncertainty about the impact of PAD on QOL in the community. Methods: Using data of 5,115 ARIC visit 5 (2011-2013) participants aged 66-90 years, we assessed the associations of ABI with several QOL parameters, including physical and mental components in SF-12 as well as some other QOL parameters (leisure time exercise/activity/walking, depression, and hopeless feeling. We used linear/logistic regression models to adjust for demographic characteristics, cardiovascular disease (CVD) risk factors, history of CVD, and other comorbidities including lung disease and reduced kidney function.Results: There were 402 participants with low ABI < 0.90 and 426 participants with borderline low ABI (0.90-0.99). Overall, there were dose-response relationships between lower ABI and poor status of QOL parameters. With ABI 1.10-1.19 as a reference (n=1900), the associations of low ABI (< 0.90) and impaired QOL were much more evident in physical components (Physical Component Summary: -3.27 [95%CI: -5.60 to -0.93]), compared to mental components (Mental Component Summary: -0.07 [95%CI: -2.21 to 2.06]). Regarding each of eight domains in SF-12, low ABI was significantly associated with all four domains for physical components (Physical Functioning, Role Physical, Bodily Pain, and General Health) but only with one of four domains for mental components (vitality). Similarly low ABI was more consistently associated with the other physical QOL parameters than the other mental parameters. Interestingly, a poor status of several QOL parameters was also observed in borderline low ABI. Similar results for lower ABI and physical QOL parameters were observed in subgroups according to sex, race as well as history of CVD, diabetes, and reduced kidney function.Conclusions: Lower ABI was independently associated with poor status of QOL, especially on physical, with potential important implications on quality-maintained life in older individuals. Further studies are warranted to assess if the PAD-specific management can improve QOL among individuals with lower ABI.