Title : Association of arterial stiffness and changes in intrinsic capacity through the locomotion domain in elderly people in primary care
Abstract:
Aging is one of the risk factors for cardiovascular diseases. In particular, excessive pulsatility is associated with microvascular lesions in high-flow organs, such as the brain and kidney, suggesting that small vessels are damaged. On the other hand, intrinsic capacity (IC) is a comprehensive measure of individual physiological reserve, and as individuals age, IC declines. Locomotion is considered one of the most affected domains in elderly people. This study aimed to investigate the association between arterial stiffness and changes in IC through the locomotion domain in elderly people in primary care. This is a cross-sectional study (approval number: 6,813,872) with a randomized sample of 95 elderly individuals (68.65 ± 6.44 years [67.00]; 72 women and 23 men) of both sexes registered in the Basic Health Units (UBS) of Belo Horizonte, MG, Brazil. Elderly individuals who were unable to travel to the UBS for any reason were excluded. Cardiovascular parameters were assessed using the Mobil-O-Graph device (IEM, Stolberg, Germany), which estimates central blood pressure non-invasively from the oscillometric pressure of the brachial artery. Three measurements were performed, and the mean was considered for the final analysis. The arterial stiffness index assessed was pulsatility (central pulse pressure/central diastolic blood pressure). Changes in IC in the locomotion domain were assessed using the 4-meter gait speed test (GS), in which participants were asked to walk at their usual speed over a marked distance of 4 meters, considering one meter for acceleration and one meter for deceleration. Two runs were performed, and the shortest time was considered (GS < 0.8 = decline). Data were analyzed using the Statistical Package for the Social Sciences (SPSS) 25.0 and JASP version 0.18.3.0 software. Continuous variables were expressed as mean ± standard deviation. Data normality was assessed using the Shapiro-Wilk test. Correlations were performed using Pearson's correlation coefficient, and the significance level was set at 5%. Multivariate analysis was performed for multivariate and IC. Pulsatility (0.44 ± 0.13 [0.41]) had a minimum value of 0.18 and a maximum of 0.80. Changes in IC, assessed using the locomotion domain, were associated with pulsatility (p = 0.025). An average increase of 7.26 in pulsatility is associated with a greater probability of changes in IC. It can be concluded that increased pulsatility is related to the involvement of important organs. The higher the pulsatility, the worse the outcomes for individuals. In clinical practice, simple tests can identify negative outcomes. Further research is needed with a larger number of participants.
