TY - JOUR
T1 - A novel aging phenotype of slow gait, impaired executive function, and depressive symptoms
T2 - Relationship to blood pressure and other cardiovascular risks
AU - Hajjar, Ihab
AU - Yang, Frances
AU - Sorond, Farzaneh
AU - Jones, Richard N.
AU - Milberg, William
AU - Cupples, L. Adrienne
AU - Lipsitz, Lewis A.
N1 - Funding Information:
The Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly of Boston study (MOBILIZE Boston) is a prospective observational study conducted at the Institute for Aging Research at Hebrew SeniorLife in Boston, Massachusetts, and funded through a National Institute on Aging program project grant. It is designed to investigate risk factors for mobility and falls in an elderly cohort living within a 5-mile radius from the study center. The details on the design and recruitment are described elsewhere ( ). The Institutional Review Board at Hebrew SeniorLife approved this study and each participant provided written informed consent.
Funding Information:
I.H. was supported by grant 1 K23 AG030057 from the National Institute on Aging (NIA). F.Y. was supported by grant 5 R01 AG025308-02 National Institutes of Health (NIH)/NIA 5 R01 AG025308-02 Diversity Supplement, Harvard Medical School Psychiatry Livingston Fellowship and the National Alliance for Research on Schizophrenia and Depression Young Investigator Award . R.N.J. ’ s support to this project was assisted in part by NIH grants P01 AG004390 and P60 AG008812 W.M. was supported by the Medical Research Service VA Merit Review Award . L.A.C. was supported by P01 AG004390 from the NIA. L.A.L. holds the Irving and Edyth S. Usen Chair in Geriatric Medicine at Hebrew SeniorLife was also supported by grants AG004390, AG08812, AG025037, and AG005134 from the NIA.
PY - 2009/9
Y1 - 2009/9
N2 - Background. Our objectives were to investigate the existence of a group of nondemented elderly individuals who simultaneously have impairments in cognition, mobility, and mood, and to examine the association between being a member of this group and elevated blood pressure and other cardiovascular conditions. Methods. The Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly of Boston study is an ongoing prospective observational study of community-dwelling individuals. We analyzed the cross-sectional data collected at baseline (N = 580, mean age = 77.8 years, 64% women, 14% African American, mean Mini-Mental State Examination = 27.2). Using latent profile analysis, we investigated the existence of a group of elderly participants with impairments in executive function (Trail Making Test Part B [TMT-B]), gait speed (two 4-m walk tests), and depressive symptoms (Center for Epidemiological Studies-Depression scale [CES-D]). Results. We identified a group (n = 99 [17%]) with prolonged TMT-B, slow gait speed, and high CES-D scores. This group did not exist when we used a memory measure. Hypertension (p =.001), diabetes (p =.0002), congestive heart failure (p =.006), stroke (p =.005), and higher Framingham cardiovascular risk score (p =.0001) were associated with an increased likelihood of being a member in this group. This association with elevated systolic and pulse pressure, and stroke remained significant after multiple covariate adjustments. Conclusions. There exists a group of elderly individuals in whom poor executive function, slow gait speed, and depressive symptoms occur simultaneously. Memory measures did not identify such a grouping. Elevated blood pressure and other cardiovascular diseases are independently associated with being a member of this group. Assessing these domains is an important part of the evaluation of the elderly patients with high vascular risk.
AB - Background. Our objectives were to investigate the existence of a group of nondemented elderly individuals who simultaneously have impairments in cognition, mobility, and mood, and to examine the association between being a member of this group and elevated blood pressure and other cardiovascular conditions. Methods. The Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly of Boston study is an ongoing prospective observational study of community-dwelling individuals. We analyzed the cross-sectional data collected at baseline (N = 580, mean age = 77.8 years, 64% women, 14% African American, mean Mini-Mental State Examination = 27.2). Using latent profile analysis, we investigated the existence of a group of elderly participants with impairments in executive function (Trail Making Test Part B [TMT-B]), gait speed (two 4-m walk tests), and depressive symptoms (Center for Epidemiological Studies-Depression scale [CES-D]). Results. We identified a group (n = 99 [17%]) with prolonged TMT-B, slow gait speed, and high CES-D scores. This group did not exist when we used a memory measure. Hypertension (p =.001), diabetes (p =.0002), congestive heart failure (p =.006), stroke (p =.005), and higher Framingham cardiovascular risk score (p =.0001) were associated with an increased likelihood of being a member in this group. This association with elevated systolic and pulse pressure, and stroke remained significant after multiple covariate adjustments. Conclusions. There exists a group of elderly individuals in whom poor executive function, slow gait speed, and depressive symptoms occur simultaneously. Memory measures did not identify such a grouping. Elevated blood pressure and other cardiovascular diseases are independently associated with being a member of this group. Assessing these domains is an important part of the evaluation of the elderly patients with high vascular risk.
KW - Blood pressure
KW - Cognitive function
KW - Depression
KW - Executive function
KW - Gait speed
KW - Vascular disease
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U2 - 10.1093/gerona/glp075
DO - 10.1093/gerona/glp075
M3 - Article
C2 - 19535785
AN - SCOPUS:68949116786
SN - 1079-5006
VL - 64
SP - 994
EP - 1001
JO - Journals of Gerontology - Series A Biological Sciences and Medical Sciences
JF - Journals of Gerontology - Series A Biological Sciences and Medical Sciences
IS - 9
ER -