Background Arterial stiffness is a measure of compliance of the arterial walls to blood flow. It is a marker of cardiovascular fitness and risk of major cardiovascular events. On cross-sectional assessments, higher arterial stiffness is an indicator of poorer scores in objective and subjective measures of physical functioning. Predicting trajectories of physical function using arterial stiffness is a tool use to target individuals at risk of losing their independence. This research aimed to estimate the prospective association between baseline arterial stiffness and change in physical function in a cohort of older people.

Methods Carotid-femoral Pulse Wave Velocity (cf-PWV) is the gold-standard to assess arterial stiffness and it was measured both at baseline (Phase 9, 2008–9) and follow-up (Phase 11, 2011–12) in the cohort using the Sphygmacor ® Atcor tonometric device. Physical functioning was assessed with objective measures in the Short Physical Performance Battery as well as subjective measures using Medical Outcomes Study Short Form-36, Activities of Daily Living (ADL) and Instrumental ADL scales. Physical status was measured using the Fried frailty phenotype.

Results 4054 participants had a baseline measurement of cf-PWV and measures of change in physical functioning. Mean age at baseline was 65 years (74.8% male). A negative association between baseline arterial stiffness and score in the physical component of the SF-36 questionnaire 5 years later was observed after adjusting for sex, age and ethnicity (-0.21; 95%CI: -0.41, -0.013). There were 1.3 higher odds of incident frailty 5 years later per each additional standard deviation of cf-PWV (95% CI: 1.00, 1.56), although this association was not independent of sex, age and ethnicity.

Conclusion Arterial stiffness was a robust predictor of decline in physical functioning, including Instrumental ADL. This implies potential use of measures of arterial stiffness to identify risk of decline in physical function in older individuals.