Associations of baseline and longitudinal changes in basic activity of daily living with risk of cardiovascular disease among older adults in China

Background and aims: The purpose of this study was to examine the associations of basic activities of daily living (BADL) and its longitudinal changes with cardiovascular disease (CVD) risk among older population.

Methods and results: We conducted a prospective analysis of the Chinese Longitudinal Healthy Longevity Survey between 2008 and 2018 in 7051 participants aged 65 years or over. Cox proportional hazards models were performed to evaluate the associations of baseline and longitudinal changes in BADL with the incidence of CVD. A total of 1510 incident CVD cases were identified. The participants with BADL limitation at baseline had a 67 % increased risk of CVD compared with those without BADL limitation (multivariable-adjusted hazards ratio (HR): 1.67, 95 % confidence interval (CI): 1.35-2.07). Moreover, participants with persistent BADL limitation (HR: 2.25, 95 % CI: 1.73-2.93), BADL from limitation to non-limitation (HR: 1.80, 95 % CI: 1.27-2.54), and BADL from non-limitation to limitation (HR: 1.86, 95 % CI: 1.62-2.14) were each experienced a higher risk of CVD compared with those with persistent BADL non-limitation. Of all the items of BADL, limitation of bathing or multiple BADL limitations (≥2) was positively associated with the risk of stroke.

Conclusion: Longitudinally persistent BADL limitation was associated with a more than twofold risk of CVD in later life among the Chinese older adults. Similar but slightly weak association was also observed for temporary BADL limitation. Older adults with BADL limitation, especially those with bathing limitation or with multiple functional limitations, should be the target population for CVD prevention.