Neuromuscular Attributes are Associated with Poor Mobility in Older Adults with Vascular Risk Conditions.
BACKGROUND
The mobility of older adults is limited by the compounding effects of vascular health conditions, or vascular risk burden. However, little is known about the role of neuromuscular attributes among those in which vascular risk burden contributes to mobility limitations.


OBJECTIVE
We investigated (1) the relationship between the absence/presence of type 2 diabetes, hypertension, and/or obesity and mobility measures and neuromuscular attributes, and (2) whether the association between vascular risk burden and mobility is mediated by lower limb neuromuscular attributes.


DESIGN
Cross-sectional analysis of baseline data from 430 older adults within the Boston RISE Study.


MEASUREMENTS
Measures of mobility were the Short Physical Performance Battery, habitual gait speed, and functional mobility as measured by the Late Life Function Instrument. We also evaluated lower limb neuromuscular attributes, namely leg strength, leg velocity, trunk extensor muscle endurance, knee and ankle range of motion, and sensory loss.


RESULTS
Participants self-reported the presence of None (n=93), One (n=179), Two (n=114), or Three (n=44) of the following conditions: diabetes, hypertension, and obesity. Multivariable regression models indicated that those with a greater vascular risk burden had worse performance on the Short Physical Performance Battery (p=0.01), slower gait speed (p=0.0003) and lower Basic and Advanced Late Life Function Instrument scores (p<0.003). These associations were independent of multiple covariates. Vascular risk burden was also found to be negatively associated with leg strength (p=0.0002) and knee flexion range of motion (p<0.0001) and an associated non-significant trend was observed with leg velocity (p=0.06). In addition, the association between vascular risk burden and mobility outcomes were found to be partially mediated by leg strength, leg velocity, and knee flexion range of motion.


CONCLUSIONS
Among older adults with vascular risk burden and mobility problems, neuromuscular impairments in attributes such as leg strength, leg velocity, and knee range of motion may need to be treatment priorities.
["Jor'dan|A J|AJ|", 'Jacob|M E|ME|', 'Leritz|E|E|', 'Bean|J F|JF|']
D000368:Aged D003430:Cross-Sectional Studies D003924:Diabetes Mellitus, Type 2 D006801:Humans D006973:Hypertension D007719:Knee Joint D007866:Leg D051346:Mobility Limitation D053580:Muscle Strength D009765:Obesity D016059:Range of Motion, Articular D012307:Risk Factors
neuromuscular attributes mobility Vascular risk cardiovascular disease