| Abstract: | Background: Atherosclerotic peripheral arterial disease (PAD),common among older adults, is associated with poor low-extremityfunctioning. In considering functional status, varying domains exist,including activities of daily living, instrumental activities of daily liv-ing, low-extremity mobility, and leisure/social activities. However, lit-tle is known about how PAD is related to functional status beyondlow-extremity functioning.Methods: A total of 1887 participants aged>60 years from thepopulation-based National Health and Nutrition Examination Sur-vey 1999-2002 in the U.S. Activities of daily living (ADL), instrumental activities of daily living (IADL), leisure/social activities (LSA),low-extremity mobility (LEM), and general physical activities (GPA)were obtained by self-report. Peak leg force was obtained from anisokinetic dynamometer. Habitual gait speed was obtained from a 20-foot timed walk. PAD was defined as an ankle-brachial blood pres-sure index<0.9 in either leg.Results: After multi-variable adjustment, the odds ratios (ORs)for dependence in IADL, LSA, and LEM comparing subjects withPAD to those without were 1.57 (95% confidence interval [CI] 1.10-2.24), 1.58 (95% CI 1.06-2.35) and 2.27 (95% CI 1.64-3.15), respec-tively. Additional adjustment of peak leg force and/or habitual gaitspeed diminished the relations of PAD to dependence in IADL andLSA. PAD was associated with a 16.23 Newton decrease (p=0.006)in peak leg force and a 0.051 m/sec decrease (p=0.001) in habitualgait speed.Conclusion: PAD was associated with reduced peak leg force,habitual gait speed as well as dependence in IADL, LSA, and LEM.The association between PAD and dependence in IADL and LSAwas to a large extent mediated by leg force and gait speed. |
