Coronary artery calcium and physical performance as determinants of mortality in older age: The AGES-Reykjavik Study

Mikaela B. Von Bonsdorff*, Danielle A.I. Groffen, Jean Sebastien Vidal, Taina Rantanen, Palmi V. Jonsson, Melissa Garcia, Thor Aspelund, Gudny Eiriksdottir, Kristin Siggeirsdóttir, Lenore Launer, Vilmundur Gudnason, Tamara B. Harris

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)


Background Coronary artery calcium (CAC) and physical performance have been shown to be associated with mortality, but it is not clear whether one of them modifies the association. We investigated the association between the extent of CAC and physical performance among older individuals and explored these individual and combined effects on cardiovascular disease (CVD) mortality and non-CVD mortality. Methods We studied 4074 participants of the AGES-Reykjavik Study who were free from coronary heart disease, had a CAC score calculated from computed tomography scans and had data on mobility limitations and gait speed at baseline in 2002-2006 at a mean age of 76 years. Register-based mortality was available until 2009. Results Odds for mobility limitation and slow gait increased according to the extent of CAC. Altogether 645 persons died during the follow-up. High CAC, mobility limitation and slow gait were independent predictors of CVD mortality and non-CVD mortality. The joint effect of CAC and gait speed on non-CVD mortality was synergistic, i.e. compared to having low CAC and normal gait, the joint effect of high CAC and slow gait exceeded the additive effect of these individual exposures on non-CVD mortality. For CVD mortality, the effect was additive i.e. The joint effect of high CAC and slow gait did not exceed the sum of the individual exposures. Conclusions The extent of CAC and decreased physical performance were independent predictors of mortality and the joint presence of these risk factors increased the risk of non-CVD mortality above and beyond the individual effects.

Original languageEnglish
Pages (from-to)2094-2099
Number of pages6
JournalInternational Journal of Cardiology
Issue number3
Publication statusPublished - 3 Oct 2013

Bibliographical note

Funding Information:
Funding sources: The AGES–Reykjavik Study was supported by a grant from the National Institutes of Health (N01-AG-1-2100) , the National Institute on Aging Intramural Research Program , Hjartavernd (the Icelandic Heart Association) , and the Althingi (the Icelandic Parliament) . The Reykjavik Study was funded by the Icelandic Heart Association . MBvB was supported by grants from the Academy of Finland ; University of Jyväskylä ; Yrjö Jahnsson Foundation and Fulbright Center , the Finland–US Educational Exchange Commission.

Other keywords

  • Aging
  • Atherosclerosis
  • Cardiovascular disease risk factors
  • Coronary artery calcification
  • Epidemiology
  • Mortality


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