Identification of measures of physical function that mediate or link impaired physical ability with disability in activities of daily living (ADL) is necessary to facilitate the development of interventions to prevent or delay the onset of ADL disability. We examined whether measures of physical function at baseline are determinants of the Short Physical Performance Battery, as measure of physical ability, and disability, at ten years follow-up.
Prospective cohort study in 625 middle-aged and older persons.
Main outcome measures
Physical ability was measured by Guralniks Short Physical Performance Battery (impaired physical ability: score <6) and ADL ability by the KATZ questionnaire (ADL disability: score ≥1). Physical function was measured by lung function (in men only), handgrip strength, leg strength, and physical activity. The associations between physical function and the dichotomized impaired physical ability and disability-score were estimated using Poisson regression.
Better lung function and higher leg strength were associated with a lower risk of having impaired physical ability, RR = 0.98, 95% CI [0.96; 0.99] per 10 L/min and RR = 0.97, 95% CI [0.94; 0.99] per 10 Nm, respectively.
Higher handgrip strength, leg strength and level of physical activity were associated with a lower risk of having ADL disability, RR = 0.72, 95% CI [0.57; 0.92] per 10 kg, RR = 0.95, 95% CI [0.92; 0.98] per 10 Nm, RR = 0.98, 95% CI [0.96; 0.99] per point-score, respectively.
Additional adjustment for baseline ADL disability did not materially changed the point-estimates (except for handgrip strength).
Overall, leg extensor strength was associated with both an impaired physical ability and ADL disability. Other measures of physical functioning were either related to an impaired physical ability or ADL disability. ADL disability may be an intermediate factor for hand grip strength in the causal chain from impaired physical ability to ADL disability at follow-up. The results of this study show that leg strength might be a relevant parameter to consider for future intervention studies.
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- Predictors of functional change: a longitudinal study of nondemented people aged 65 and older.Journal of the American Geriatrics Society. 2002; 50: 1525-1534
- Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care.Journals of Gerontology. Series A, Biological Sciences and Medical Sciences. 2004; 59: 255-263
- Factors associated with recovery of independence among newly disabled older persons.Archives of Internal Medicine. 2005; 165: 106-112
- The dynamic nature of mobility disability in older persons.Journal of the American Geriatrics Society. 2006; 54: 248-254
- Recovery from disability among community-dwelling older persons.JAMA: The Journal of the American Medical Association. 2004; 291: 1596-1602
- Risk of functional decline among well elders.Journal of Clinical Epidemiology. 1989; 42: 895-904
- Disability in older adults: evidence regarding significance, etiology, and risk.Journal of the American Geriatrics Society. 1997; 45: 92-100
- Impairment and disability in the aged.Journal of Chronic Diseases. 1985; 38: 59-65
- Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability.New England Journal of Medicine. 1995; 332: 556-561
- Cardiovascular disease and cognitive performance in middle-aged and elderly men.Atherosclerosis. 2007; 190: 143-149
- Arterial stiffness in postmenopausal women: determinants of pulse wave velocity.Journal of Hypertension. 2002; 20: 2165-2172
- A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission.Journal of Gerontology. 1994; 49: M85-M94
- A measure of primary sociobiological functions.International Journal of Health Services. 1976; 6: 493-508
- Katz index of independence in ADL. Reliability and validity in short-term care.Scandinavian Journal of Rehabilitation Medicine. 1984; 16: 125-132
- A physical activity questionnaire for the elderly.Medicine and Science in Sports and Exercise. 1991; 23: 974-979
- Activity of daily living staging, chronic health conditions, and perceived lack of home accessibility features for elderly people living in the community.Journal of the American Geriatrics Society. 2011; 59: 454-462
- Prevalence of functional disability in activities of daily living (ADL), instrumental activities of daily living (IADL) and associated factors, as predictors of morbidity and mortality.Archives of Gerontology and Geriatrics. 2010; 50: 306-310
- Association between lung function and disability in African-Americans.Journal of Epidemiology and Community Health. 2009; 63: 541-545
- Pulmonary function, muscle strength, and incident mobility disability in elders.Proceedings of the American Thoracic Society. 2009; 6: 581-587
- Performance tests and disability: developing an objective index of mobility-related limitation in older populations.Journals of Gerontology. Series A, Biological Sciences and Medical Sciences. 2002; 57: M294-M301
- Hand-grip strength predicts incident disability in non-disabled older men.Age and Ageing. 1999; 28: 283-288
- Limitations in physical functioning among older people as a predictor of subsequent disability in instrumental activities of daily living.Age and Ageing. 2011; 40: 463-469
- Midlife hand grip strength as a predictor of old age disability.JAMA: The Journal of the American Medical Association. 1999; 281: 558-560
- Performance measures predict onset of activity of daily living difficulty in community-dwelling older adults.Journal of the American Geriatrics Society. 2010; 58: 844-852
- Measures of physical performance and risk for progressive and catastrophic disability: results from the Women's Health and Aging Study.Journals of Gerontology. Series A, Biological Sciences and Medical Sciences. 2005; 60: 74-79
- Physical activity and functional status in community-dwelling older women: a 14-year prospective study.Archives of Internal Medicine. 2003; 163: 2565-2571
- Physical activity prevented functional decline among frail community-living elderly subjects in an international observational study.Journal of Clinical Epidemiology. 2007; 60: 518-524
- Physical activity, functional limitations, and disability in older adults.Journal of the American Geriatrics Society. 2000; 48: 1264-1272
- Threshold of lower body muscular strength necessary to perform ADL independently in community-dwelling older adults.Clinical Rehabilitation. 2008; 22: 902-910
- Gender differences in the comparison of self-reported disability and performance measures.Journals of Gerontology. Series A, Biological Sciences and Medical Sciences. 1997; 52: M19-M26
- The disablement process.Social Science and Medicine. 1994; 38: 1-14
Published online: November 07, 2012
Accepted: October 19, 2012
Received in revised form: October 12, 2012
Received: July 17, 2012
© 2012 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.