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Previous Volume 332:556-562 March 2, 1995 Number 9 Next

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ABSTRACT

Background Functional assessment is an important part of the evaluation of elderly persons. We conducted this study to determine whether objective measures of physical function can predict subsequent disability in older persons.

Methods This prospective cohort study included men and women 71 years of age or older who were living in the community, who reported no disability in the activities of daily living, and who reported that they were able to walk one-half mile (0.8 km) and climb stairs without assistance. The subjects completed a short battery of physical-performance tests and participated in a follow-up interview four years later. The tests included an assessment of standing balance, a timed 8-ft (2.4-m) walk at a normal pace, and a timed test of five repetitions of rising from a chair and sitting down.

Results Among the 1122 subjects who were not disabled at base line and who participated in the four-year follow-up, lower scores on the base-line performance tests were associated with a statistically significant, graduated increase in the frequency of disability in the activities of daily living and mobility-related disability at follow-up. After adjustment for age, sex, and the presence of chronic disease, those with the lowest scores on the performance tests were 4.2 to 4.9 times as likely to have disability at four years as those with the highest performance scores, and those with intermediate performance scores were 1.6 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 predictive of subsequent disability. Measures of physical performance may identify older persons with a preclinical stage of disability who may benefit from interventions to prevent the development of 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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• Maraldi, C., Volpato, S., Penninx, B. W., Yaffe, K., Simonsick, E. M., Strotmeyer, E. S., Cesari, M., Kritchevsky, S. B., Perry, S., Ayonayon, H. N., Pahor, M. (2007). Diabetes Mellitus, Glycemic Control, and Incident Depressive Symptoms Among 70- to 79-Year-Old Persons: The Health, Aging, and Body Composition Study. Arch Intern Med 167: 1137-1144 [Abstract] [Full Text]  
• Wicherts, I. S., van Schoor, N. M., Boeke, A. J. P., Visser, M., Deeg, D. J. H., Smit, J., Knol, D. L., Lips, P. (2007). Vitamin D Status Predicts Physical Performance and Its Decline in Older Persons. J. Clin. Endocrinol. Metab. 92: 2058-2065 [Abstract] [Full Text]  
• Ruo, B., Liu, K., Tian, L., Tan, J., Ferrucci, L., Guralnik, J. M., McDermott, M. M. (2007). Persistent Depressive Symptoms and Functional Decline Among Patients With Peripheral Arterial Disease. Psychosom. Med. 69: 415-424 [Abstract] [Full Text]  
• Patel, K. V., Harris, T. B., Faulhaber, M., Angleman, S. B., Connelly, S., Bauer, D. C., Kuller, L. H., Newman, A. B., Guralnik, J. M., for the Health, Aging, and Body Composition Study, (2007). Racial variation in the relationship of anemia with mortality and mobility disability among older adults. Blood 109: 4663-4670 [Abstract] [Full Text]  
• Rodin, M. B., Mohile, S. G. (2007). A Practical Approach to Geriatric Assessment in Oncology. JCO 25: 1936-1944 [Abstract] [Full Text]  
• Sainio, P., Martelin, T., Koskinen, S., Heliovaara, M. (2007). Educational differences in mobility: the contribution of physical workload, obesity, smoking and chronic conditions. J. Epidemiol. Community Health 61: 401-408 [Abstract] [Full Text]  
• Jinks, C., Jordan, K., Croft, P. (2007). Osteoarthritis as a public health problem: the impact of developing knee pain on physical function in adults living in the community: (KNEST 3). Rheumatology (Oxford) 46: 877-881 [Abstract] [Full Text]  
• Hilmer, S. N., Mager, D. E., Simonsick, E. M., Cao, Y., Ling, S. M., Windham, B. G., Harris, T. B., Hanlon, J. T., Rubin, S. M., Shorr, R. I., Bauer, D. C., Abernethy, D. R. (2007). A Drug Burden Index to Define the Functional Burden of Medications in Older People. Arch Intern Med 167: 781-787 [Abstract] [Full Text]