Association Between Functional Limitations and Incident Cardiovascular Diseases and All-Cause Mortality Among the Middle-Aged and Older Adults in China: A Population-Based Prospective Cohort Study

Abstract

BackgroundThe prevalence of functional limitations is relatively high among the middle-aged and older adults. However, the contribution of functional limitations to subsequent incident cardiovascular diseases (CVD) and death is unclear. This study aims to examine the association between functional limitations and incident CVD and all-cause mortality among the middle-aged and older adults.MethodsThis is a nationally representative prospective cohort study. Participants were middle-aged and older Chinese adults from The China Health and Retirement Longitudinal Study. Functional limitations were measured using activities of daily living (ADL) scale and instrumental activities of daily living (IADL) scale. Incident CVD and death were recorded at followed-up from June 1, 2011, up until August 31, 2018. Cox proportional hazards model was used to assess the association between functional limitations and incident CVD and all-cause mortality.ResultsA total of 11,013 participants were included in this study. During the 7 years of follow-up, 1,914 incident CVD and 1,182 incident deaths were identified. Participants with functional limitations were associated with a 23% increased risk of incident CVD (HR, 1.23, 95% CI:1.08,1.39) after adjusting for age, gender, residential area, marital status, education, smoking, alcohol drinking, sleep duration, nap duration, depression symptoms, social participation, history of hypertension, diabetes, dyslipidemia, use of hypertension medications, diabetes medications, and lipid-lowering therapy. Moreover, participants with functional limitations were associated with a 63% increased risk of all-cause mortality (HR,1.63, 95%CI: 1.41,1.89) after adjusting for potential confounders.ConclusionsFunctional limitations were significantly associated with subsequent incident CVD and death among the middle-aged and older Chinese adults.

The bidirectional relationship between activities of daily living and frailty during short-and long-term follow-up period among the middle-aged and older population: findings from the Chinese nationwide cohort study

“…Special attention should be given to middle-aged and older person with ADL disability to prevent the incidence of their frailty. Besides, ADL disability is one independent risk factor for 7 years mortality in middle-aged and older adults in China ( 84 ), and ADL skills can facilitate successful aging ( 85 ). Frailty serves as a strong predictor for disability in ADL, while disability in ADL is also a strong predictor of frailty among middle-aged and older population.…”

Patient-reported predictors of post-discharge mortality after cardiac hospitalization

“…We and others have previously demonstrated that functional health literacy is independently predictive of mortality among adults hospitalized for cardiovascular events, presumably through an inability to manage the complex medication prescriptions and dietary requirements associated with cardiovascular disease. 17,47 Similarly, it has long been established that patient-reported exercise frequency is predictive of mortality among adults with increased risk for cardiovascular disease, though the precise amount of leisure time physical activity needed to confer a mortality benefit remains a source of ongoing investigation. 48 However, our cohort added to these data by using a wide range of validated measures of disease self-management, followed patients for an extended period of time, and adjusted for numerous demographic and clinical characteristics.…”

Long-Term Influence of Locus of Control and Quality of Life on Metabolic Profile in Elderly Subjects with Type 2 Diabetes

“…It is important to point out that study subjects had mean ADL and IADL scores indicative of preserved functional abilities. Elderly people with diabetes are at increased risk of frailty and disability [ 33 , 34 ], which in turns are associated to with adverse health outcomes, including mortality risk in older subjects [ 35 ]. In addition, a lower functional ability can translate into a greater tendency to rely on caregivers and therefore it may influence LOC domains.…”