Prospective associations of cardiovascular disease with physical performance and disability

A longitudinal cohort study in the Osteoarthritis Initiative
  • Nicola Veronese
  • Brendon Stubbs
  • Sarah E Jackson
  • Ai Koyanagi
  • Vania Noventa
  • Francesco Bolzetta
  • Alberto Cester
  • Pinar Soysal
  • Stefania Maggi
  • Guillermo F. López-Sánchez
  • Mike Loosemore
  • Jacopo Demurtas
  • Lee SmithEmail author
original article



Literature regarding cardiovascular disease (CVD) and incident physical performance limitations and disability in older people is equivocal.


This study aimed to investigate whether CVD is longitudinally associated with incident physical performance limitations and disability in a large population-based sample.


This was an 8‑year prospective study using data collected as part of the Osteoarthritis Initiative. Participants were community-dwelling adults with knee osteoarthritis or at high risk for this condition. Diagnosed CVD was self-reported. Physical performance was assessed with measures of chair stand time and gait speed, whereas disability was assessed with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Longitudinal associations between CVD and changes in physical performance tests (chair stand time and gait speed) and disability score were analyzed using generalized linear models with repeated measurements.


The analyzed sample comprised 4796 adults (mean age 61.2 years, 58.5% female), of whom 313 people (6.5%) reported CVD at baseline. During 8 years of follow-up, after adjustment for 11 potential confounders measured at baseline, those with CVD experienced a worse profile in chair stand time over the 8‑year follow-up period than those without CVD (p = 0.006).


In a cohort of middle-aged and older adults with knee osteoarthritis or at high risk for this condition those with CVD experienced a worse profile in chair stand time over the 8‑year follow-up period than those without CVD; however, CVD was not significantly associated with an increased incidence of poor gait speed and disability over 8 years of follow-up. Importantly, no associations were observed when utilizing propensity score matching.


Cardiovascular disease Chair stand time Gait Speed WOMAC Osteoarthritis 


Compliance with ethical guidelines

Conflict of interest

N. Veronese, B. Stubbs, S.E. Jackson, A. Koyanagi, V. Noventa, F. Bolzetta, A. Cester, P. Soysal, S. Maggi, G.F. López-Sánchez, M. Loosemore, J. Demurtas, and L. Smith declare that they have no competing interests.

Ethical standards

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008. Informed consent was obtained from all individual participants included in the study.

Supplementary material

508_2019_1567_MOESM1_ESM.docx (41 kb)
Supplementary Table 1. Regression analysis using chair stand time at the last follow-up as outcome. Supplementary Table 2. Regression analysis using walking speed at the last follow-up as outcome. Supplementary Table 3. Regression analysis using disability at the last follow-up as outcome.


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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2019

Authors and Affiliations

  • Nicola Veronese
    • 1
    • 2
  • Brendon Stubbs
    • 3
  • Sarah E Jackson
    • 4
  • Ai Koyanagi
    • 5
  • Vania Noventa
    • 6
  • Francesco Bolzetta
    • 7
  • Alberto Cester
    • 7
  • Pinar Soysal
    • 8
  • Stefania Maggi
    • 1
    • 2
  • Guillermo F. López-Sánchez
    • 9
  • Mike Loosemore
    • 10
  • Jacopo Demurtas
    • 11
  • Lee Smith
    • 12
    Email author
  1. 1.Aging Branch, Neuroscience InstituteNational Research CouncilPadovaItaly
  2. 2.Department of Geriatric Care, Orthogeriatrics and RehabilitationE. O. Galliera Hospital, National Relevance & High Specialization HospitalGenoaItaly
  3. 3.Department of Psychological Medicine, Institute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUK
  4. 4.Department of Behavioural Science and HealthUniversity College LondonLondonUK
  5. 5.Research and Development Unit, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM)Parc Sanitari Sant Joan de DéuBarcelonaSpain
  6. 6.Primary Care DepartmentAzienda ULSS (Unità Locale Socio Sanitaria) 3 “Serenissima”DoloItaly
  7. 7.Medical Department, Geriatric UnitAzienda ULSS (Unità Locale Socio Sanitaria) 3 “Serenissima”DoloItaly
  8. 8.Department of geriatric Medicine, Faculty of MedicineBezmialem Vakif UniversityIstanbulTurkey
  9. 9.Faculty of Sport SciencesUniversity of MurciaMurciaSpain
  10. 10.Institute of Sport Exercise and Health SciencesUniversity College London HospitalLondonUK
  11. 11.Primary Care DepartmentAzienda USL Toscana Sud EstGrossetoItaly
  12. 12.The Cambridge Centre for Sport and Exercise SciencesAnglia Ruskin UniversityCambridgeUK

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