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Impaired Balance and Higher Prevalence of Falls in Subjects With Intermittent Claudication

^a Claude D. Pepper Older Americans Independence Center, Department of Medicine, Division of Gerontology, University of Maryland, Baltimore, and Geriatric Research, Education and Clinical Center, Maryland Veterans Affairs Health Care System at Baltimore

Andrew W. Gardner, Baltimore Veterans Affairs Medical Center, Geriatrics/GRECC (18), 10 North Greene Street, Baltimore, MD 21201-1524 E-mail: gardner{at}grecc.umaryland.edu.

Decision Editor: John E. Morley, MB, BCh

Background. The purpose of this study was to determine whether peripheral arterial disease (PAD) subjects have impaired balance and a higher prevalence of falls than non-PAD controls and to determine whether balance and falls are related to the severity of PAD and functional status.

Methods. A total of 367 PAD subjects (aged 68 ± 1 years; mean ± SEM) and 458 non-PAD controls (aged 67 ± 1 years) were recruited. Unipedal stance time, history of ambulatory stumbling and unsteadiness, and history of falling were recorded. Additionally, subjects were characterized on age, ankle/brachial index (ABI), anthropometry, measured and self-reported ambulatory function, and monitored daily physical activity.

Results. Unipedal stance time was 28% shorter ( p < .001) in the PAD subjects than in the non-PAD controls (15.9 ± 0.9 vs 22.1 ± 1.0). History of ambulatory stumbling and unsteadiness was 86% more prevalent ( p < .001) in the PAD group (150/367 = 41%) than in the controls (101/458 = 22%), and history of falling was 73% more prevalent ( p < .001) in the PAD subjects (95/367 = 26%) than in the controls (69/458 = 15%). Within the PAD group, 6-minute walk distance, self-reported ambulatory function, and daily physical activity were significantly related to the balance and falling measures ( p < .05), whereas ABI was unrelated ( p > .05).

Conclusions. Compared with the controls, PAD subjects with intermittent claudication had impaired balance and a greater likelihood of falling, both of which were associated with ambulatory function and daily physical activity.

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