Association between cardiovascular health metrics and self-reported walking difficulty in community-dwelling middle-aged and older adults: results from the longevity check-up (Lookup) 8+

Objectives: To examine the association between cardiovascular health, assessed through an 8-factor cardiovascular health (8F-CVH) score, and self-reported walking difficulty in middle-aged (40-64 years) and older adults (≥65 years) living in the community. Study design: Cross-sectional study. Main outcome measures: Self-reported walking difficulty was evaluated by a single-item question: "Do you have any difficulty in walking 400 meters?". Cardiovascular health was assessed using a composite 8F-CVH score inspired by Life's Essential 8, including diet, physical activity, body mass index, blood pressure, total cholesterol, fasting blood glucose, smoking status, and sleep quality. Results: Among 4141 participants (mean age 60.5 ± 11.2 years; 53.1 % women), 16.0 % reported walking difficulty. Prevalence was higher in older adults (25.0 %) than in middle-aged individuals (11.0 %; p for trend <0.001). Self-reported walking difficulty was more frequent in participants with low 8F-CVH scores (32.8 %), compared to moderate (15.5 %) and high (4.8 %) scores (p <0.001). ROC curve analysis showed modest discrimination for the total score (area under the curve [AUC] 0.67; 95 % confidence interval [CI] 0.65-0.69), with physical activity performing best among individual components (AUC 0.69; 95 % CI 0.67-0.71). After adjusting for confounders, moderate and high scores were associated with 61 % (OR 0.39, 95 % CI 0.31-0.48) and 84 % (OR 0.16, 95 % CI 0.10-0.24) lower odds of self-reported walking difficulty, respectively. Conclusions: Better cardiovascular health is independently associated with lower odds of self-reported walking difficulty. Promoting cardiovascular health may help preserve mobility in late life.