Background Functional assessment is an important part of theevaluation of elderly persons. We conducted this study to determinewhether objective measures of physical function can predictsubsequent disability in older persons.
Methods This prospective cohort study included men and women71 years of age or older who were living in the community, whoreported no disability in the activities of daily living, andwho reported that they were able to walk one-half mile (0.8km) and climb stairs without assistance. The subjects completeda short battery of physical-performance tests and participatedin a follow-up interview four years later. The tests includedan assessment of standing balance, a timed 8-ft (2.4-m) walkat a normal pace, and a timed test of five repetitions of risingfrom a chair and sitting down.
Results Among the 1122 subjects who were not disabled at baseline and who participated in the four-year follow-up, lowerscores on the base-line performance tests were associated witha statistically significant, graduated increase in the frequencyof disability in the activities of daily living and mobility-relateddisability at follow-up. After adjustment for age, sex, andthe presence of chronic disease, those with the lowest scoreson the performance tests were 4.2 to 4.9 times as likely tohave disability at four years as those with the highest performancescores, and those with intermediate performance scores were1.6 to 1.8 times as likely to have disability.
Conclusions Among nondisabled older persons living in the community,objective measures of lower-extremity function were highly predictiveof subsequent disability. Measures of physical performance mayidentify older persons with a preclinical stage of disabilitywho may benefit from interventions to prevent the developmentof frank disability.
Source Information
From the Epidemiology, Demography, and Biometry Program, National Institute on Aging, Bethesda, Md. (J.M.G., E.M.S., M.E.S.); the Geriatrics Department, Hospital "I Fraticini," National Institute for Research and Care of the Elderly (INRCA), Florence, Italy (L.F.); and the Department of Preventive Medicine and Environmental Health, University of Iowa, Iowa City (R.B.W.).
Address reprint requests to Dr. Guralnik at the National Institute on Aging, 7201 Wisconsin Ave., Rm. 3C-309, Bethesda, MD 20892.
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Inzitari, D., Simoni, M., Pracucci, G., Poggesi, A., Basile, A. M., Chabriat, H., Erkinjuntti, T., Fazekas, F., Ferro, J. M., Hennerici, M., Langhorne, P., O'Brien, J., Barkhof, F., Visser, M. C., Wahlund, L.-O., Waldemar, G., Wallin, A., Pantoni, L., for the LADIS Study Group,
(2007). Risk of Rapid Global Functional Decline in Elderly Patients With Severe Cerebral Age-Related White Matter Changes: The LADIS Study. Arch Intern Med
167: 81-88
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Sachs-Ericsson, N., Schatschneider, C., Blazer, D. G.
(2006). Perception of Unmet Basic Needs as a Predictor of Physical Functioning Among Community-Dwelling Older Adults. J Aging Health
18: 852-868
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Hughes, S. L., Seymour, R. B., Campbell, R. T., Huber, G., Pollak, N., Sharma, L., Desai, P.
(2006). Long-Term Impact of Fit and Strong! on Older Adults With Osteoarthritis. Gerontologist
46: 801-814
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Ferrucci, L., Simonsick, E. M.
(2006). A Little Exercise. Journals of Gerontology Series A: Biological Sciences and Medical Sciences
61: 1154-1156
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The LIFE Study Investigators* [*See Appendix for L,
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61: 1157-1165
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Forrest, K. Y. Z., Zmuda, J. M., Cauley, J. A.
(2006). Correlates of Decline in Lower Extremity Performance in Older Women: A 10-Year Follow-Up Study. Journals of Gerontology Series A: Biological Sciences and Medical Sciences
61: 1194-1200
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Avlund, K., Rantanen, T., Schroll, M.
(2006). Tiredness and Subsequent Disability in Older Adults: The Role of Walking Limitations. Journals of Gerontology Series A: Biological Sciences and Medical Sciences
61: 1201-1205
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Orwoll, E., Lambert, L. C., Marshall, L. M., Blank, J., Barrett-Connor, E., Cauley, J., Ensrud, K., Cummings, S. R., for the Osteoporotic Fractures in Men Study Group,
(2006). Endogenous testosterone levels, physical performance, and fall risk in older men.. Arch Intern Med
166: 2124-2131
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Williams, C. S., Tinetti, M. E., Kasl, S. V., Peduzzi, P. N.
(2006). The Role of Pain in the Recovery of Instrumental and Social Functioning After Hip Fracture. J Aging Health
18: 743-762
[Abstract]
Ortega-Alonso, A., Pedersen, N. L., Kujala, U. M., Sipila, S., Tormakangas, T., Kaprio, J., Koskenvuo, M., Rantanen, T.
(2006). A twin study on the heritability of walking ability among older women.. Journals of Gerontology Series A: Biological Sciences and Medical Sciences
61: 1082-1085
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Toth, M. J., Sites, C. K., Matthews, D. E., Casson, P. R.
(2006). Ovarian suppression with gonadotropin-releasing hormone agonist reduces whole body protein turnover in women. Am. J. Physiol. Endocrinol. Metab.
291: E483-E490
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Dominguez, L. J, Barbagallo, M., Lauretani, F., Bandinelli, S., Bos, A., Corsi, A. M., Simonsick, E. M, Ferrucci, L.
(2006). Magnesium and muscle performance in older persons: the InCHIANTI study.. Am. J. Clin. Nutr.
84: 419-426
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Kuh, D., Hardy, R., Butterworth, S., Okell, L., Richards, M., Wadsworth, M., Cooper, C., Sayer, A. A.
(2006). Developmental Origins of Midlife Physical Performance: Evidence from a British Birth Cohort. Am J Epidemiol
164: 110-121
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Bischoff-Ferrari, H. A, Giovannucci, E., Willett, W. C, Dietrich, T., Dawson-Hughes, B.
(2006). Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am. J. Clin. Nutr.
84: 18-28
[Abstract][Full Text]
Russo, A, Onder, G, Cesari, M, Zamboni, V, Barillaro, C, Capoluongo, E, Pahor, M, Bernabei, R, Landi, F
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