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The journal of nutrition, health & aging

, Volume 17, Issue 4, pp 370–376 | Cite as

Ankle-brachial pressure index and mini nutritional assessment in community-dwelling elderly people

  • B. Andre MuzemboEmail author
  • Y. Nagano
  • N. Dumavibhat
  • N. R. Ngatu
  • T. Matsui
  • S. A. Bhatti
  • M. Eitoku
  • R. Hirota
  • K. Ishida
  • N. Suganuma
Article

Abstract

Background

A low ankle-brachial pressure index (an ABPI value <0.90) is considered predictive of cardiovascular disease, and is widely thought to increase morbidity and mortality in the elderly. However, good nutrition is beneficial both for the health and the ability to resist and recover from the disease.

Objective

The aim of the present study was to evaluate the relationship between the ankle-brachial pressure index and the nutritional status of the elderly in a city of Kochi prefecture, Japan.

Methods

This was a cross-sectional study in which a total of 100 elderly people, both males and females, were screened for ankle-brachial pressure index (ABPI), nutritional status (through the use of the short form of the mini nutritional assessment), activities of daily living, lifestyle, gait speed (10MWT), postural stability (OLST), and functional mobility (TUg).

Results

About 67% of the participants were found to have a normal nutritional status, 27% were at risk of malnutrition, and six percent were classified as malnourished. The mean ABPI of the participants was 1.08±0.10, and three participants had an ABPI lower than 0.90. The ABPI was statistically higher in well nourished participants compared with those at risk of malnutrition or the malnourished. The mean ABPI was significantly higher in non-smokers compared with former smokers. The ABPI was found to correlate negatively with gait speed and with TUg score.

Conclusion

Well-nourished elderly had a higher normal ankle-brachial pressure index as compared with the malnourished elderly. This study provides supportive evidence for the necessity of adequate nutrition for elderly people.

Key words

ABPI MNA functional mobility elderly 

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References

  1. 1.
    Vogt MT, Wolfson SK, Kuller LH. Lower extremity arterial disease and the aging process: a review. J Clin Epidemiol. 1992; 45:529–542.PubMedCrossRefGoogle Scholar
  2. 2.
    Fowkes FG, Housley E, Cawood EH, Macintyre CC, Ruckley CV, Prescott RJ. Edinburgh Artery Study: prevalence of asymptomatic and symptomatic peripheral arterial disease in the general population. Int J Epidemiol. 1991; 20:384–392.PubMedCrossRefGoogle Scholar
  3. 3.
    Al-Qaisi M, Nott DM, King DH, Kaddoura S. Ankle brachial pressure index (ABPI): An update for practitioners. Vasc Health Risk Manag. 2009; 5:833–841.PubMedCrossRefGoogle Scholar
  4. 4.
    Meijer WT, Grobbee DE, Hunink MG, Hofman A, Hoes AW. Determinants of peripheral arterial disease in the elderly: the Rotterdam study. Arch Intern Med. 2000; 160:2934–2938.PubMedCrossRefGoogle Scholar
  5. 5.
    McDermott MM, Feinglass J, Slavensky R, Pearce WH. The ankle-brachial index as a predictor of survival in patients with peripheral vascular disease. J Gen Intern Med. 1994; 9:445–449.PubMedCrossRefGoogle Scholar
  6. 6.
    Heald CL, Fowkes FG, Murray GD, Price JF. Risk of mortality and cardiovascular disease associated with the ankle-brachial index: Systematic review. Atherosclerosis. 2006; 189:61–69.PubMedCrossRefGoogle Scholar
  7. 7.
    Stoffers HE, Kester AD, Kaiser V, Rinkens PE, Kitslaar PJ, Knottnerus JA. The diagnostic value of the measurement of the ankle-brachial systolic pressure index in primary health care. J Clin Epidemiol. 1996; 49:1401–1405.PubMedCrossRefGoogle Scholar
  8. 8.
    Wild SH, Byrne CD, Smith FB, Lee AJ, Fowkes FG. Low ankle-brachial pressure index predicts increased risk of cardiovascular disease independent of the metabolic syndrome and conventional cardiovascular risk factors in the Edinburgh Artery Study. Diabetes Care. 2006; 29:637–642.PubMedCrossRefGoogle Scholar
  9. 9.
    Hooi JD, Kester AD, Stoffers HE, Overdijk MM, van Ree JW, Knottnerus JA. Incidence of and risk factors for asymptomatic peripheral arterial occlusive disease: a longitudinal study. Am J Epidemiol. 2001; 153:666–672.PubMedCrossRefGoogle Scholar
  10. 10.
    Sullivan DH, Walls RC. The risk of life-threatening complications in a select population of geriatric patients: the impact of nutritional status. J Am Coll Nutr. 1995; 14:29–36.PubMedGoogle Scholar
  11. 11.
    Persson MD, Brismar KE, Katzarski KS, Nordenstrom J, Cederholm TE. Nutritional status using mini nutritional assessment and subjective global assessment predict mortality in geriatric patients. J Am Geriatr Soc. 2002; 50:1996–2002.PubMedCrossRefGoogle Scholar
  12. 12.
    Gerber V, Krieg MA, Cornuz J, Guigoz Y, Burckhardt P. Nutritional status using the Mini Nutritional Assessment questionnaire and its relationship with bone quality in a population of institutionalized elderly women. J Nutr Health Aging. 2003; 7:140–145.PubMedGoogle Scholar
  13. 13.
    Kumakura H, Kanai H, Aizaki M, Mitsui K, Araki Y, Kasama S, Iwasaki T, Ichikawa S. The influence of the obesity paradox and chronic kidney disease on long-term survival in a Japanese cohort with peripheral arterial disease. J Vasc Surg. 2010; 52:110–117.PubMedCrossRefGoogle Scholar
  14. 14.
    Portrait F, Teeuwiszen E, Deeg D. Early life undernutrition and chronic diseases at older ages: the effects of the Dutch famine on cardiovascular diseases and diabetes. Soc Sci Med. 2011; 73:711–718.PubMedCrossRefGoogle Scholar
  15. 15.
    Reis JP, Michos ED, von Muhlen D, Miller ER, 3rd. Differences in vitamin D status as a possible contributor to the racial disparity in peripheral arterial disease. Am J Clin Nutr. 2008; 88:1469–1477.PubMedCrossRefGoogle Scholar
  16. 16.
    Li YC, Qiao G, Uskokovic M, Xiang W, Zheng W, Kong J. Vitamin D: a negative endocrine regulator of the renin-angiotensin system and blood pressure. J Steroid Biochem Mol Biol. 2004; 89–90:387–392.PubMedCrossRefGoogle Scholar
  17. 17.
    Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of Illness in the Aged. The Index of Adl: A Standardized Measure of Biological and Psychosocial Function. JAMA. 1963; 185:914–919.PubMedCrossRefGoogle Scholar
  18. 18.
    Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969; 9:179–186.PubMedCrossRefGoogle Scholar
  19. 19.
    Guigoz Y. The Mini Nutritional Assessment (MNA) review of the literature—What does it tell us? J Nutr Health Aging. 2006; 10:466–485.PubMedGoogle Scholar
  20. 20.
    Olin JW, Allie DE, Belkin M, Bonow RO, Casey DE, Jr., Creager MA, Gerber TC, Hirsch AT, Jaff MR, et al. ACCF/AHA/ACR/SCAI/SIR/SVM/SVN/SVS 2010 performance measures for adults with peripheral artery disease. A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Performance Measures, the American College of Radiology, the Society for Cardiac Angiography and Interventions, the Society for Interventional Radiology, the Society for Vascular Medicine, the Society for Vascular Nursing, and the Society for Vascular Surgery (Writing Committee to Develop Clinical Performance Measures for Peripheral Artery Disease). Vasc Med. 2010; 15:481–512.PubMedCrossRefGoogle Scholar
  21. 21.
    Yamashina A, Tomiyama H, Takeda K, Tsuda H, Arai T, Hirose K, Koji Y, Hori S, Yamamoto Y. Validity, reproducibility, and clinical significance of noninvasive brachial-ankle pulse wave velocity measurement. Hypertens Res. 2002; 25:359–364.PubMedCrossRefGoogle Scholar
  22. 22.
    Wade DT, Wood VA, Heller A, Maggs J, Langton Hewer R. Walking after stroke. Measurement and recovery over the first 3 months. Scand J Rehabil Med. 1987; 19:25–30.PubMedGoogle Scholar
  23. 23.
    Drusini AG, Eleazer GP, Caiazzo M, Veronese E, Carrara N, Ranzato C, Businaro F, Boland R, Wieland D. One-leg standing balance and functional status in an elderly community-dwelling population in northeast Italy. Aging Clin Exp Res. 2002; 14:42–46.PubMedGoogle Scholar
  24. 24.
    Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991; 39:142–148.PubMedGoogle Scholar
  25. 25.
    Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jr., Jones DW, Materson BJ, Oparil S, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003; 289:2560–2572.PubMedCrossRefGoogle Scholar
  26. 26.
    Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: executive summary. Expert Panel on the Identification, Evaluation, and Treatment of Overweight in Adults. Am J Clin Nutr. 1998; 68:899–917.Google Scholar
  27. 27.
    Joosten E, Vanderelst B, Pelemans W. The effect of different diagnostic criteria on the prevalence of malnutrition in a hospitalized geriatric population. Aging (Milano). 1999; 11:390–394.Google Scholar
  28. 28.
    Ministry of Health, Labour and Welfare (2006) National Livelihood Survey. Tokyo: MHLW.Google Scholar
  29. 29.
    Orchard TJ, Strandness DE, Jr. Assessment of peripheral vascular disease in diabetes. Report and recommendations of an international workshop sponsored by the American Diabetes Association and the American Heart Association September 18–20, 1992 New Orleans, Louisiana. Circulation. 1993; 88:819–828.PubMedCrossRefGoogle Scholar
  30. 30.
    Chakrabarty S, Nandi A, Mukhopadhyay CK, Chatterjee IB. Protective role of ascorbic acid against lipid peroxidation and myocardial injury. Mol Cell Biochem. 1992; 111:41–47.PubMedCrossRefGoogle Scholar
  31. 31.
    Murabito JM, Evans JC, Nieto K, Larson MG, Levy D, Wilson PW. Prevalence and clinical correlates of peripheral arterial disease in the Framingham Offspring Study. Am Heart J. 2002; 143:961–965.PubMedCrossRefGoogle Scholar
  32. 32.
    Dagenais GR, Maurice S, Robitaille NM, Gingras S, Lupien PJ. Intermittent claudication in Quebec men from 1974–1986: the Quebec Cardiovascular Study. Clin Invest Med. 1991; 14:93–100.PubMedGoogle Scholar
  33. 33.
    Fowler B, Jamrozik K, Norman P, Allen Y. Prevalence of peripheral arterial disease: persistence of excess risk in former smokers. Aust N Z J Public Health. 2002; 26:219–224.PubMedCrossRefGoogle Scholar
  34. 34.
    Jepson RG, Fowkes FG, Donnan PT, Housley E. Alcohol intake as a risk factor for peripheral arterial disease in the general population in the Edinburgh Artery Study. Eur J Epidemiol. 1995; 11:9–14.PubMedCrossRefGoogle Scholar
  35. 35.
    Cesari M, Kritchevsky SB, Penninx BW, Nicklas BJ, Simonsick EM, Newman AB, Tylavsky FA, Brach JS, Satterfield S, et al. Prognostic value of usual gait speed in well-functioning older people—results from the Health, Aging and Body Composition Study. J Am Geriatr Soc. 2005; 53:1675–1680.PubMedCrossRefGoogle Scholar
  36. 36.
    Kamide N, Takahashi K, Shiba Y. Reference values for the Timed Up and go test in healthy Japanese elderly people: determination using the methodology of metaanalysis. Geriatr Gerontol Int. 2011; 11:445–451.PubMedCrossRefGoogle Scholar
  37. 37.
    Steffen TM, Hacker TA, Mollinger L. Age- and gender-related test performance in community-dwelling elderly people: Six-Minute Walk Test, Berg Balance Scale, Timed Up & Go Test, and gait speeds. Phys Ther. 2002; 82:128–137.PubMedGoogle Scholar
  38. 38.
    Newton RA. Balance screening of an inner city older adult population. Arch Phys Med Rehabil. 1997; 78:587–591.PubMedCrossRefGoogle Scholar
  39. 39.
    McDermott MM, Liu K, Guralnik JM, Mehta S, Criqui MH, Martin GJ, Greenland P. The ankle brachial index independently predicts walking velocity and walking endurance in peripheral arterial disease. J Am Geriatr Soc. 1998; 46:1355–1362.PubMedGoogle Scholar

Copyright information

© Serdi and Springer-Verlag France 2013

Authors and Affiliations

  • B. Andre Muzembo
    • 1
    • 3
    Email author
  • Y. Nagano
    • 2
  • N. Dumavibhat
    • 1
  • N. R. Ngatu
    • 1
  • T. Matsui
    • 1
  • S. A. Bhatti
    • 1
  • M. Eitoku
    • 1
  • R. Hirota
    • 1
  • K. Ishida
    • 2
  • N. Suganuma
    • 1
  1. 1.Division of Social Medicine, Department of Environmental Medicine, Kochi Medical SchoolKochi UniversityKochiJapan
  2. 2.Department of Orthopaedics, Kochi Medical SchoolKochi UniversityKochiJapan
  3. 3.Division of Social Medicine, Department of Environmental Medicine, Kochi Medical SchoolKochi UniversityKohasu, Oko-cho, Nangoku-shi, KochiJapan

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