Exercise Capacity, Heart Failure Risk, and Mortality in Older Adults: The Health ABC Study.
- Georgiopoulou VV Department of Medicine, Division of Cardiology, Emory University, Atlanta, Georgia. Electronic address: vgeorgi@emory.edu.
- Kalogeropoulos AP Department of Medicine, Division of Cardiology, Emory University, Atlanta, Georgia.
- Chowdhury R Department of Biostatistics, Harvard University, Boston, Massachusetts; Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia.
- Binongo JN Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia.
- Bibbins-Domingo K Department of Medicine and Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California.
- Rodondi N Department of General Internal Medicine, University of Bern, Bern, Switzerland.
- Simonsick EM Laboratory of Epidemiology, Demography, and Biometry, Intramural Research Program, National Institute on Aging, Baltimore, Maryland.
- Harris T Laboratory of Epidemiology, Demography, and Biometry, Intramural Research Program, National Institute on Aging, Baltimore, Maryland.
- Newman AB Departments of Medicine and Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania.
- Kritchevsky SB Division of Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest University, Winston Salem, North Carolina.
- Butler J Department of Medicine, Division of Cardiology, Stony Brook University, Stony Brook, New York.
- 2016-11-19
Published in:
- American journal of preventive medicine. - 2017
Aged
Aging
Female
Follow-Up Studies
Heart Failure
Humans
Incidence
Male
Prevalence
Prognosis
Proportional Hazards Models
Sex Factors
Walk Test
Walking
Walking Speed
English
INTRODUCTION
Data on the association between exercise capacity and risk for heart failure (HF) in older adults are limited.
METHODS
This study examined the association of exercise capacity, and its change over time, with 10-year mortality and incident HF in 2,935 participants of the Health, Aging, and Body Composition Study without HF at baseline (age, 73.6 [SD=2.9] years; 52.1% women; 41.4% black; 58.6% white). This cohort was initiated in 1997-1998 and exercise capacity was evaluated with a long-distance corridor walk test (LDCW) at baseline and Year 4. Outcomes were collected in 2007-2008 and initial analysis performed in 2014.
RESULTS
Ten-year incident HF for completers (n=2,245); non-completers (n=331); and those excluded from LDCW for safety reasons (n=359) was 11.4%, 19.2%, and 23.0%, respectively. The corresponding 10-year mortality was 27.9%, 41.1%, and 42.4%. In models accounting for competing mortality, the adjusted subhazard ratio for HF was 1.37 (95% CI=1.00, 1.88; p=0.049) in non-completers and 1.41 (95% CI=1.06, 1.89; p=0.020) in those excluded versus completers. Non-completers (adjusted hazard ratio, 1.49; 95% CI=1.21, 1.84; p<0.001) and those excluded (hazard ratio, 1.27; 95% CI=1.04, 1.55; p=0.016) had elevated mortality. In adjusted models, LDCW performance variables were associated mainly with mortality. Only 20-meter walking speed and resting heart rate retained prognostic value for HF. Longitudinal changes in LDCW did not predict subsequent incident HF or mortality.
CONCLUSIONS
Completing an LDCW is strongly associated with lower 10-year mortality and HF risk in older adults. Therefore, walking capacity may serve as an early risk marker.
Data on the association between exercise capacity and risk for heart failure (HF) in older adults are limited.
METHODS
This study examined the association of exercise capacity, and its change over time, with 10-year mortality and incident HF in 2,935 participants of the Health, Aging, and Body Composition Study without HF at baseline (age, 73.6 [SD=2.9] years; 52.1% women; 41.4% black; 58.6% white). This cohort was initiated in 1997-1998 and exercise capacity was evaluated with a long-distance corridor walk test (LDCW) at baseline and Year 4. Outcomes were collected in 2007-2008 and initial analysis performed in 2014.
RESULTS
Ten-year incident HF for completers (n=2,245); non-completers (n=331); and those excluded from LDCW for safety reasons (n=359) was 11.4%, 19.2%, and 23.0%, respectively. The corresponding 10-year mortality was 27.9%, 41.1%, and 42.4%. In models accounting for competing mortality, the adjusted subhazard ratio for HF was 1.37 (95% CI=1.00, 1.88; p=0.049) in non-completers and 1.41 (95% CI=1.06, 1.89; p=0.020) in those excluded versus completers. Non-completers (adjusted hazard ratio, 1.49; 95% CI=1.21, 1.84; p<0.001) and those excluded (hazard ratio, 1.27; 95% CI=1.04, 1.55; p=0.016) had elevated mortality. In adjusted models, LDCW performance variables were associated mainly with mortality. Only 20-meter walking speed and resting heart rate retained prognostic value for HF. Longitudinal changes in LDCW did not predict subsequent incident HF or mortality.
CONCLUSIONS
Completing an LDCW is strongly associated with lower 10-year mortality and HF risk in older adults. Therefore, walking capacity may serve as an early risk marker.
- Language
-
- English
- Open access status
- bronze
- Identifiers
-
- DOI 10.1016/j.amepre.2016.08.041
- PMID 27856115
- Persistent URL
- https://sonar.rero.ch/global/documents/185014
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