Declines in physical and cognitive function that generally accompany aging can lead to loss of independence in performing activities of daily living and frailty- eventually leading to disability and death. Substantial evidence indicates that chronic disease, such as cardiovascular disease (CVD), plays a key role in the development, and severity of age-associated declines and disability. This suggests that interventions designed to reduce vascular risk are also likely to have positive effects on age-associated declines. Recently, the American Heart Association released its strategic impact goals for 2020, which include aims to improve cardiovascular health and decrease mortality from CVD and stroke, and provide a construct for defining cardiovascular health. This construct named Life's Simple 7 is based on evidence that the combination of health factors (blood pressure, blood glucose and cholesterol concentrations) and health behaviors (smoking status, body mass index, diet quality, and physical activity) is associated with longevity, disease-free survival, quality of life, and lower health care costs. Investigations using nationally representative data have demonstrated that meeting a greater number of these health criteria was associated with a lower risk of total and CVD mortality. Yet, surprisingly, not much is known about whether adherence to this widely promoted CVD prevention strategy has a beneficial impact on age-related functional outcomes. Therefore, the overall goal of the project is to examine the relationships between adherence to ideal cardiovascular health metrics with mortality, frailty, changes in lower extremity function, mobility, muscle strength and cognition in [two] NIH-supported, [longitudinal studies] of aging, the InCHIANTI study [and the Baltimore Longitudinal Study of Aging]. We hypothesize that in [middle-aged] and older adults, a higher adherence to ideal cardiovascular health is associated with: (i) survival, (ii) being less frail, (iii) smaller declines in measures of lower extremity fuction, mobility and muscle strength, and (iii) smaller declines in measures of cognition over time. Results of the study will address a critical gap in knowledge, providing evidence for clinicians to utilize an existing and widely promoted CVD prevention strategy for delaying the onset and progression of aging-related declines.

Public Health Relevance

Cardiovascular disease (CVD) is implicated in the development and progression of aging-related functional declines and frailty. Recently, a construct was put forth to improve cardiovascular health and decrease CVD-related mortality and includes goals for several health factors and health behaviors to achieve ideal cardiovascular health. No studies have examined whether adherence to this widely promoted CVD prevention strategy has any beneficial impact on frailty and multiple age-related functional outcomes, and the establishment of these relationships could potentially guide the development of improved guidelines for the elderly to maintain physical and cognitive function.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Small Research Grants (R03)
Project #
1R03AG048377-01A1
Application #
8824076
Study Section
Aging Systems and Geriatrics Study Section (ASG)
Program Officer
Patmios, Georgeanne E
Project Start
2015-01-15
Project End
2016-12-31
Budget Start
2015-01-15
Budget End
2015-12-31
Support Year
1
Fiscal Year
2015
Total Cost
$81,000
Indirect Cost
$31,000
Name
Johns Hopkins University
Department
Public Health & Prev Medicine
Type
Schools of Public Health
DUNS #
001910777
City
Baltimore
State
MD
Country
United States
Zip Code
21205
Jin, Yichen; Tanaka, Toshiko; Ma, Yan et al. (2018) Cardiovascular Health Is Associated With Disability Among Older Community Dwelling Men and Women. J Aging Health :898264318778417
Jin, Yichen; Tanaka, Toshiko; Bandinelli, Stefania et al. (2017) Overall Cardiovascular Health Is Associated With All-Cause and Cardiovascular Disease Mortality Among Older Community-Dwelling Men and Women. J Aging Health 29:437-453
Jin, Yichen; Tanaka, Toshiko; Ma, Yan et al. (2017) Cardiovascular Health Is Associated With Physical Function Among Older Community Dwelling Men and Women. J Gerontol A Biol Sci Med Sci 72:1710-1716