Abstract
BACKGROUND: Our objectives were to investigate the existence of a group of nondemented elderly individuals who simultaneously have impairments in cognition, mobility, and mood, and to examine the association between being a member of this group and elevated blood pressure and other cardiovascular conditions. METHODS: The Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly of Boston study is an ongoing prospective observational study of community-dwelling individuals. We analyzed the cross-sectional data collected at baseline (N=580, mean age=77.8 years, 64% women, 14% African American, mean Mini-Mental State Examination=27.2). Using latent profile analysis, we investigated the existence of a group of elderly participants with impairments in executive function (Trail Making Test Part B [TMT-B]), gait speed (two 4-m walk tests), and depressive symptoms (Center for Epidemiological Studies-Depression scale [CES-D]). RESULTS: We identified a group (n=99 [17%]) with prolonged TMT-B, slow gait speed, and high CES-D scores. This group did not exist when we used a memory measure. Hypertension (p=.001), diabetes (p=.0002), congestive heart failure (p=.006), stroke (p=.005), and higher Framingham cardiovascular risk score (p=.0001) were associated with an increased likelihood of being a member in this group. This association with elevated systolic and pulse pressure, and stroke remained significant after multiple covariate adjustments. CONCLUSIONS: There exists a group of elderly individuals in whom poor executive function, slow gait speed, and depressive symptoms occur simultaneously. Memory measures did not identify such a grouping. Elevated blood pressure and other cardiovascular diseases are independently associated with being a member of this group. Assessing these domains is an important part of the evaluation of the elderly patients with high vascular risk.