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Sarcopenia in Peripheral Arterial Disease: Prevalence and Effect on Functional Status

  • Odessa Addison
    Correspondence
    Corresponding author Odessa Addison, DPT, PhD, Department of Veterans Affairs and Veterans Affairs Medical Center Baltimore, Geriatric Research, Education and Clinical Center (GRECC), 10 N Greene St, Baltimore, MD 21201.
    Affiliations
    Veterans Affairs Medical Center Baltimore, Geriatric Research Education and Clinical Center (GRECC), Baltimore, MD

    Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD
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  • Steven J. Prior
    Affiliations
    Veterans Affairs Medical Center Baltimore, Geriatric Research Education and Clinical Center (GRECC), Baltimore, MD

    Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD
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  • Rishi Kundi
    Affiliations
    Division of Vascular Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD

    Department of Surgery, Veterans Affairs Medical Center, Baltimore, MD
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  • Monica C. Serra
    Affiliations
    Veterans Affairs Medical Center Baltimore, Geriatric Research Education and Clinical Center (GRECC), Baltimore, MD

    Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD
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  • Leslie I. Katzel
    Affiliations
    Veterans Affairs Medical Center Baltimore, Geriatric Research Education and Clinical Center (GRECC), Baltimore, MD

    Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD
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  • Andrew W. Gardner
    Affiliations
    Department of Physical Medicine and Rehabilitation, Penn State College of Medicine, Hershey, PA
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  • Alice S. Ryan
    Affiliations
    Veterans Affairs Medical Center Baltimore, Geriatric Research Education and Clinical Center (GRECC), Baltimore, MD

    Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD
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Published:November 11, 2017DOI:https://doi.org/10.1016/j.apmr.2017.10.017

      Abstract

      Objectives

      (1) To determine the prevalence of sarcopenia in older men with peripheral arterial disease (PAD); (2) to compare a subgroup of the group with age-, race-, sex-, and body mass index (BMI)–matched non-PAD control counterparts, and (3) to compare the functional status of those with PAD with and without sarcopenia.

      Design

      Cohort study.

      Setting

      Medical center.

      Participants

      Sedentary community-dwelling men (N=108; age, >50y) with a confirmed diagnosis of PAD (44% blacks; BMI, 27.8±0.4kg/m2; ankle-brachial index, .62±.01).

      Interventions

      Not applicable.

      Main Outcome Measures

      Dual-energy x-ray absorptiometry scans were used to assess appendicular lean mass and determine the prevalence of sarcopenia by/height2. Treadmill tests were used to determine claudication onset time, peak walking time, and claudication recovery time. 6-Minute walk distance was also measured.

      Results

      Sarcopenia prevalence in our PAD cohort was 25%. The PAD subgroup (n=42) matched with control counterparts in terms of race, sex, age, and BMI had higher prevalence rates than did their non-PAD counterparts (23.8% vs 2.4%; P<.05). Individuals with sarcopenia (n=28) had a shorter 6-minute walk distance (326±18.8m vs 380±9.7m; P<.05) and higher claudication recovery time (592±98s vs 395±29s; P<.05) than did individuals with PAD but without sarcopenia (n=80). There was no difference in claudication onset time or peak walking time between the PAD groups.

      Conclusions

      Men with PAD demonstrate a high prevalence of sarcopenia. Those with sarcopenia and PAD demonstrate decreased mobility function.

      Keywords

      List of abbreviations:

      6MWD (6-minute walk distance), ABI (ankle-brachial index), ALM (appendicular lean mass), ALM/ht2 (appendicular lean mass/height2), BMI (body mass index), CRT (claudication recovery time), PAD (peripheral arterial disease), WIQ (Walking impairment questionnaire)
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