Abstract
Objective
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.
Study design
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.
Results
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).
Conclusion
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.
Keywords
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Article info
Publication history
Published online: November 07, 2012
Accepted:
October 19,
2012
Received in revised form:
October 12,
2012
Received:
July 17,
2012
Identification
Copyright
© 2012 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
