Asymptomatic Carotid Stenosis Is Associated With Mobility Dysfunction: Results From The InChianti Study.
Sarasijhaa K. Desikan, M.D., Vicki L. Gray, PhD, Aman A. Kankaria, B.S., James Borrelli, PhD, Michael L. Terrin, M.D., Brajesh K. Lal, M.D..
University of Maryland School of Medicine, Baltimore, MD, USA.
Objectives: Older adults with balance and mobility dysfunction are at risk for falls, hospitalization, or death. We have shown that individuals with asymptomatic carotid artery stenosis (ACAS) demonstrate balance and mobility dysfunction when compared to older adults without stenosis. Using the Invecchaire in Chianti (InChianti) database, we tested whether these results are reflected in a larger community-dwelling cohort.
Methods: Participants in the NIH-funded InChianti study who completed a medical history, carotid duplex ultrasound, and mobility function testing were included in the analysis. Participants with a history of stroke or TIA were excluded. Individuals were placed in the ACAS group if they had >40% stenosis of either carotid artery. Following the individual's ultrasound visit, they underwent mobility assessment using the Short Physical Performance Battery (SPPB). A full factorial three-way ANOVA was used to test the effect of stenosis-group (ACAS vs. no ACAS), age-group (65-74 vs. 75-84 years), sex, and their interactions on SPPB score. A reduced three-way ANOVA was then performed using the significant or near-significant main effects and interaction terms. Results: 709 of 1453 InChianti participants met the inclusion criteria (116 ACAS, 593 no ACAS). After excluding the non-significant main effects and interaction terms from the full factorial ANOVA, interactions between the stenosis-group and age-group significantly affected SPPB score (p<0.05) in the reduced three-way ANOVA. Participants with ACAS in the 65-74 years age-group performed significantly worse than those without ACAS (p<0.0001) (Figure 1). Conclusions: Older adults with asymptomatic carotid artery stenosis performed worse on balance and mobility assessments than those without ACAS. ACAS may be associated with balance and mobility dysfunction in the elderly, especially in individuals ranging from 65-74 years of age. 
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