Relationship Between Midlife Cardiovascular Health and Late-Life Physical Performance: The ARIC Study

B. Gwen Windham, Kimystian L. Harrison, Seth T. Lirette, Pamela L. Lutsey, Lisa A. Pompeii, Kelley P. Gabriel, Silvia Koton, Lyn M. Steffen, Michael E. Griswold, Thomas H. Mosley

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Objectives: To examine the association between midlife cardiovascular health and physical performance 25 years later. Design: Cohort study (Atherosclerosis Risk in Communities Study); multinomial logistic and logistic regression adjusted for demographic characteristics and clinical measures. Setting: Four U.S. communities: Forsyth County, North Carolina; Washington County, Maryland; Minneapolis, Minnesota; and Jackson, Mississippi. Participants: Individuals aged 54.2 ± 5.8 at baseline (N = 15,744; 55% female, 27% black). Measurements: Cardiovascular health was measured at baseline using the American Heart Association's Life's Simple 7 (LS7) score (0–14) and LS7 component categories (poor, intermediate, ideal) for each risk factor. The Short Physical Performance Battery (SPPB) was used to quantify physical function as ordinal (0–12) and categorical (low (0–6), fair (7–9), good (10–12) outcomes. Results: Mean baseline LS7 score was 7.9 ± 2.4; 6,144 (39%) individuals returned 25 years later for the fifth ARIC examination, at which point the SPPB was administered. Of 5,916 individuals who completed the SPPB, 3,288 (50%) had good physical performance. Each 1-unit increase in LS7 score was associated with a 17% higher SPPB score (rate ratio (RR) = 1.17, 95% confidence interval (CI) = 1.15–1.19) and a 29% greater chance of having a late-life SPPB score of 10 or greater compared to SPPB score of less than 10 (RR = 1.29, 95% CI = 1.25–1.34). Ideal baseline glucose (RR = 2.53, 95% CI = 2.24–2.87), smoking (RR = 1.97, 95% CI = 1.81–2.15), blood pressure (RR = 1.70, 95% CI = 1.54–1.88), body mass index (RR = 1.51, 95% CI = 1.37–1.66), and physical activity (RR = 1.31, 95% CI = 1.20–1.43) had the strongest associations with late-life SPPB score, adjusting for other LS7 components. Conclusion: Better cardiovascular health during midlife may lead better physical functioning in older age.

Original languageEnglish (US)
Pages (from-to)1012-1018
Number of pages7
JournalJournal of the American Geriatrics Society
Issue number5
StatePublished - May 2017

Bibliographical note

Funding Information:
The authors thank the staff and participants of the ARIC Study for their important contributions. Financial Disclosure: The ARIC Study is a collaborative study of National Heart, Lung and Blood Institute?Contracts HHSN268201100005C, HHSN268201100006C, HHSN268201100007C, HHSN268201100008C, HHSN268201100009C, HHSN268201100010C, HHSN268201100011C, and HHSN268201100012C. Miss Harrison was funded by the American Federation for Aging Research and the National Institute on Aging Medical Student Training in Aging Research program for part of this work. Conflict of Interest: Windham, Lutsey, Pompeii, Gabriel, Griswold, Mosley, Harrison, and Lirette have received grant funding related to this work. Author Contributions: All authors made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; critically revised the final draft; and provided final approval. Sponsor's Role: The sponsor played no role in the design, methods, subject recruitment, data collections, analysis, or preparation of the paper.


  • cardiovascular
  • midlife
  • physical performance

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