Peripheral arterial disease and disability from NHANES 2001-2004 data

Abstract

Peripheral arterial disease (PAD) can lead to long-term disability, but diagnosis frequently occurs late in the process. The purpose was to study the relationship between severity of PAD and disability (health-related quality of life), using a national sample (NHANES 2001-2004). A cross-sectional design examined 4559 adults age 40 and over. An ankle-brachial index (ABI) measured PAD severity and the Center for Disease Control and Prevention Health-Related Quality of Life 4-question set measured physical, mental and activity disability. Sociodemographic level, chronic disease diagnosis, biological risk factors, pain, mobility and activity alterations in response to PAD were explored. Moderately-severe (ABI less than 0.7), mild (ABI 0.7 - 0.9) and no disease (0.91 - 1.5) showed that differences in pain, activity, mobility and risk factors become apparent when PAD is considered asymptomatic. Logistic regression showed physical disability was 1.7 times (95% CI 1.3, 2.2) more likely with mild PAD than with no disease. Education, poverty income ratio and hypertension were confounding factors. Mobility difficulty and calf pain with walking were mediators between PAD and physical disability. Age, ability to do vigorous activity, total cholesterol and obesity were effect moderators. Mobility, vigorous activity and calf pain made the most difference in the relationship between PAD and physical disability.