Elderly Health/Long-Term Care

Key treatments for high blood pressure and high blood lipids do not reduce elderly patients' risk of limited mobility

Use of angiotensin-converting enzyme (ACE) inhibitors and statins do not reduce the risk of impaired mobility in older adults, a new study finds. Impairments in mobility are common in older adults, with 15 percent of older men and 23 percent of older women unable to walk two to three blocks. Chronic inflammation, which can lead to several health problems and age-related muscle loss, has been identified as a factor leading to a decline in functional status, including mobility. Both ACE inhibitors and statins—drugs used to treat high blood pressure and high cholesterol/lipid levels, respectively—may decrease systemic inflammation. In addition, ACE inhibitors may have a direct effect on muscle mass.

To see if these medications would indirectly have a positive impact on mobility, the researchers followed 3,055 healthy older adults, who had no mobility problems at baseline, for 6.5 years. At baseline, the participants were in their 70s and had no difficulty walking a quarter-mile, climbing 10 steps, or performing basic activities of daily living; 15.2 percent used ACE inhibitors and 12.9 percent used statins. By Year 6, ACE inhibitor use had increased to 25.6 percent and statin use to 28.6 percent.

At the end of the 6.5-year study, 49.8 percent of the remaining adults had developed mobility limitation. In separate multivariable models, neither ACE inhibitor use nor statin use was significantly associated with lower risk of mobility limitation. The study was funded in part by the Agency for Healthcare Research and Quality (HS17695, HS18721, and HS19461).

More details are in "Angiotensin-converting enzyme inhibitor and statin use and incident mobility limitation in community-dwelling older adults: The Health, Aging and Body Composition Study," by Shelly L. Gray, Pharm.D., M.S., Robert M. Boudreau, Ph.D., Anne B. Newman, M.D., M.P.H., and others in the December 2011 Journal of the American Geriatrics Society 59(12), pp. 2226-2232.

— DIL

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