Higher
blood pressure associated with decline in walking ability in older
persons according to study by the Rush Alzheimer’s Disease Center
(Chicago) July 31,
2006 – Decline in lower limb function is common in older people,
and worsening gait is associated with increased risk of dementia and
death. However, factors contributing to gait difficulties in older
persons are not well understood. A study by researchers at Rush
University Medical Center suggests that higher blood pressure may be
one factor associated with a decline in walking ability in later
life. The research, by Dr. Raj Shah and colleagues at the Rush
Alzheimer’s Disease Center, is published in the August 2006 issue of
the Journal of Gerontology: Medical Sciences, the scientific journal
of The Gerontological Society of America.
Researchers
recruited 888 older Catholic clergy without dementia or Parkinson’s
disease who are participating in the Religious Orders Study. At
baseline, blood pressure was measured, the presence of vascular
diseases and diabetes was recorded, cognitive function was assessed,
and medications were inspected.
At baseline and
subsequent annual visits, gait and balance were assessed using
performance-based tasks, such as the time and number of steps taken
to walk 8 feet, the time to sit up and down five times, the number
of steps off the line during an 8-foot heel-to-toe walk, and a
comparison of ability to stand with eyes open and eyes closed.
Participants completed a mean of nearly eight annual
evaluations with a high rate of follow-up. Controlling for
age, education, and gender, the study found a 10mmHg
increment in systolic blood pressure was associated with
greater decline in lower limb function. On average, lower
limb function declined 28.7% faster in persons with a
systolic blood pressure of 160 mmHg than in persons with a
normal systolic blood pressure of 120 mmHg.
“After memory loss,
the biggest concern of older individuals is loss of mobility,” said
Dr. Raj Shah, medical director of the Rush Alzheimer’s Disease
Center’s Memory Clinic. “If high blood pressure is impacting gait,
it is a risk factor that possibly can be controlled in order to help
people stay active as they age.”
The study wasn’t
able to determine why blood pressure is impacting gait. However,
Shah notes it may partially be related to stroke. The study found
that diabetes, vascular diseases, or cognition did not change the
association of blood pressure and lower limb function. Although
baseline clinical stroke had no effect on higher blood pressure
being associated with lower limb function, when researchers took out
individuals that developed stroke during the study, the relationship
between blood pressure and mobility wasn’t as strong.
Further studies
examining lifelong blood pressure measures will be necessary to
fully explore why there is a link between blood pressure and lower
limb function. In addition, Shah hopes clinical trials will study if
the treatment of blood pressure improves walking abilities.
“Gait difficulties
are very common in older adults. We hope our research will lead to
better treatment options and to preventive measures that will help
older adults maintain active, independent lives,” said Shah.
The investigators
are part of the institution’s Rush Alzheimer’s Disease Center,
headed by Dr. David Bennett. The AD Center is one of 30 across the
U.S. supported by the National Institute on Aging (NIA) at the
National Institutes of Health to study and care for Alzheimer’s
patients.
The Rush
researchers are extremely grateful for the remarkable dedication and
altruism of the volunteers participating in the Religious Orders
Study, a longitudinal, clinical-pathologic study of older persons
without dementia The research was supported by grants from the
National Institute on Aging, which leads the Federal effort to
support and conduct basic, clinical, and social and behavioral
studies on aging and on Alzheimer’s disease.
# # #
The Gerontological
Society of America (GSA), founded in 1945, is the oldest and largest
national multidisciplinary scientific organization devoted to the
advancement of gerontological research. Its membership includes some
5,000+ researchers, educators, practitioners, and other
professionals in the field of aging. The Society's principal
missions are to promote research and education in aging and to
encourage the dissemination of research results to other scientists,
decision makers, and practitioners.
Rush University
Medical Center is an academic medical center that encompasses the
600 staffed-bed hospital (including Rush Children’s Hospital), the
Johnston R. Bowman Health Center and Rush University. Rush
University, with more than 1,270 students, is home to one of the
first medical schools in the Midwest, and one of the nation’s
top-ranked nursing colleges. Rush University also offers graduate
programs in allied health and the basic sciences. Rush is noted for
bringing together clinical care and research to address major health
problems, including arthritis and orthopedic disorders, cancer,
heart disease, mental illness, neurological disorders and diseases
associated with aging.
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