Relation of pulse pressure to long-distance gait speed in community-dwelling older adults: findings from the LIFE-P study.

Abstract

BACKGROUND: Reduced gait speed is associated with falls, late-life disability, hospitalization/institutionalization and cardiovascular morbidity and mortality. Aging is also accompanied by a widening of pulse pressure (PP) that contributes to ventricular-vascular uncoupling. The purpose of this study was to test the hypothesis that PP is associated with long-distance gait speed in community-dwelling older adults in the Lifestyle Interventions and Independence for Elders Pilot (LIFE-P) study. METHODS: Brachial blood pressure and 400-meter gait speed (average speed maintained over a 400-meter walk at "usual" pace) were assessed in 424 older adults between the ages of 70-89 yrs at risk for mobility disability (mean age=77 yrs; 31% male). PP was calculated as systolic blood pressure (BP) - diastolic BP. RESULTS: Patients with a history of heart failure and stroke (n=42) were excluded leaving 382 participants for final analysis. When categorized into tertiles of PP, participants within the highest PP tertile had significantly slower gait speed than those within the lowest PP tertile (p<0.05). Following stepwise multiple regression, PP was significantly and inversely associated with 400-meter gait speed (p<0.05). Other significant predictors of gait speed included: handgrip strength, body weight, age and history of diabetes mellitus (p<0.05). Mean arterial pressure, systolic BP and diastolic BP were not predictors of gait speed. CONCLUSIONS: Pulse pressure is associated long-distance gait speed in community-dwelling older adults. Vascular senescence and altered ventricular-vascular coupling may be associated with the deterioration of mobility and physical function in older adults.