Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery

Guralnik, J. M.; Ferrucci, L.; Pieper, C. F.; Leveille, S. G.; Markides, K. S.; Ostir, G. V.; Studenski, S.; Berkman, L. F.; Wallace, R. B.

doi:10.1093/gerona/55.4.m221

Cited by 2,898Frailty in Older AdultsBalance, Gait, and Falls PreventionAging, Health, and Disability

Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery

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Guralnik, J. M., Ferrucci, L., Pieper, C. F., Leveille, S. G., Markides, K. S., Ostir, G. V., Studenski, S., Berkman, L. F. +1 more·2000·The Journals of Gerontology Series A: Biological Sciences and Medical Sciences

DOI 10.1093/gerona/55.4.m221PMC PMC12149745

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Abstract

BACKGROUND: Although it has been demonstrated that physical performance measures predict incident disability in previously nondisabled older persons, the available data have not been fully developed to create usable methods for determining risk profiles in community-dwelling populations. Using several populations and different follow-up periods, this study replicates previous findings by using the Established Populations for the Epidemiologic Study of the Elderly (EPESE) performance battery and provides equations for the prediction of disability risk according to age, sex, and level of performance. METHODS: Tests of balance, time to walk 8 ft, and time to rise from a chair 5 times were administered to 4,588 initially nondisabled persons in the four sites of the EPESE and to 1,946 initially nondisabled persons in the Hispanic EPESE. Follow-up assessment for activity of daily living (ADL) and mobility-related disability occurred from 1 to 6 years later. RESULTS: In the EPESE, compared with those with the best performance (EPESE summary performance score of 10-12), the relative risks of mobility-related disability for those with scores of 4-6 ranged from 2.9 to 4.9 and the relative risk of disability for those with scores of 7-9 ranged from 1.5 to 2.1, with similar consistent results for ADL disability. The observed rates of incident disability according to performance level in the Hispanic EPESE agreed closely with rates predicted from models developed from the EPESE sites. Receiver operating characteristic curves showed that gait speed alone performed almost as well as the full battery in predicting incident disability. CONCLUSIONS: Performance tests of lower extremity function accurately predict disability across diverse populations. Equations derived from models using both the summary score and the gait speed alone allow for the estimation of risk of disability in community-dwelling populations and provide valuable information for estimating sample size for clinical trials of disability prevention.

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Decreased physical performance, as assessed by gait speed, increased the risk of disability in elderly people.
“Decreased physical performance, as assessed by gait speed, increased the risk of disability in elderly people (42).”
From Health Consequences of Sarcopenic Obesity: A Narrative Review (2020) · cites this paper as [42]
Among the 3 components of the SPPB (balance, chair stands, and gait speed), the steepest gradient of risk of disability was observed across the categories of gait speed.
“Of the 3 components of the SPPB (balance, chair stands and gait speed), the steepest gradient of risk of disability was observed across the categories of gait speed”
From Gait speed at usual pace as a predictor of adverse outcomes in community-dwelling older people an International Academy on Nutrition and Aging (IANA) Task Force (2009) · cites this paper as [3]
The Short Physical Performance Battery (SPPB) has demonstrated excellent reliability, predictive validity for a large number of adverse outcomes, and sensitivity to clinically important change.
“Extensive work on the SPPB has demonstrated excellent reliability, predictive validity for a large number of adverse outcomes and sensitivity to clinical important change (3).”
From Gait speed at usual pace as a predictor of adverse outcomes in community-dwelling older people an International Academy on Nutrition and Aging (IANA) Task Force (2009) · cites this paper as [3]
The 4-meter walk's longer distance (compared to the 8 feet walk) may improve measurement accuracy.
“As stated by Guralnik and colleagues, the assessment of gait speed over a short distance, such as the 4-meter walk, should be the choice because it has been demonstrated to be feasible at home as well as in clinical settings and its longer distance (compared to the 8 feet walk) may improve measurements accuracy (3).”
From Gait speed at usual pace as a predictor of adverse outcomes in community-dwelling older people an International Academy on Nutrition and Aging (IANA) Task Force (2009) · cites this paper as [3]
The 4-meter walk is feasible at home as well as in clinical settings.
“As stated by Guralnik and colleagues, the assessment of gait speed over a short distance, such as the 4-meter walk, should be the choice because it has been demonstrated to be feasible at home as well as in clinical settings and its longer distance (compared to the 8 feet walk) may improve measurements accuracy (3).”
From Gait speed at usual pace as a predictor of adverse outcomes in community-dwelling older people an International Academy on Nutrition and Aging (IANA) Task Force (2009) · cites this paper as [3]

ROC curves showed very similar areas under the curve for gait speed (0.67) and SPPB (0.69), with a non-significant p-value (p=0.18) between the curves when predicting ADL disability at 4 years of follow-up.
“In detail, the ROC curves showed very similar areas under the curve (AUC) for gait speed (0.67) and SPPB (0.69) showing a non-significant p-value (p=0.18) in between the curves when predicting ADL disability at 4 years of follow-up (3).”
From Gait speed at usual pace as a predictor of adverse outcomes in community-dwelling older people an International Academy on Nutrition and Aging (IANA) Task Force (2009) · cites this paper as [3]
Physical performance measures of lower extremity function accurately predicted disability in 6534 non-disabled, community-dwelling patients after a follow-up of 1-6 years.
“Physical performance measures of lower extremity function accurately predicted disability in 6534 non-disabled, community-dwelling patients after a follow-up of 1-6 years.”
From Gait speed at usual pace as a predictor of adverse outcomes in community-dwelling older people an International Academy on Nutrition and Aging (IANA) Task Force (2009) · cites this paper as [3]
Gait speed alone was nearly as good a predictor of disability outcomes as the full performance battery.
“the subsequent Receiver-operator characteristic (ROC) curves for the prediction of ADL and mobility disability proved that gait speed alone was nearly as good a predictor of disability outcomes as the full performance battery (3).”
From Gait speed at usual pace as a predictor of adverse outcomes in community-dwelling older people an International Academy on Nutrition and Aging (IANA) Task Force (2009) · cites this paper as [3]
SPPB test score performs particularly well in predicting incident disability, with significantly higher accuracy than measurement of gait speed alone.
“SPPB test score performs particularly well in predicting incident disability, with a significantly higher accuracy than the measurement of gait speed alone [106].”
From Gut Microbiota, Muscle Mass and Function in Aging: A Focus on Physical Frailty and Sarcopenia (2019) · cites this paper as [106]
Scores on the Short Physical Performance Battery and walking speed predict onset of difficulty in activities of daily living and disability in community-dwelling older adults.
“Scores on the SPPB and walking speed have been found to predict onset of difficulty in activities of daily living (Wennie Huang, Perera, VanSwearingen, and Studenski 2010) and disability in community-dwelling older adults.”
From Successful aging: Advancing the science of physical independence in older adults (2015) · cites this paper as Guralnik, Ferrucci, Pieper, Leveille, Markides, Ostir, Studenski, Berkman, and Wallace 2000

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The ankle brachial index is associated with leg function and physical activity: the Walking and Leg Circulation Study
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A Comparison of Leg Power and Leg Strength Within the InCHIANTI Study: Which Influences Mobility More?
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What is a meaningful change in physical performance? Findings from a clinical trial in older adults (the LIFE-P study)
Kwon, S., Perera, S., Pahor, M., Katula, J. A., King, A. C., Groessl, E. J., & Studenski, S. A. (2009) · The Journal of nutrition, health and aging · doi:10.1007/s12603-009-0104-z · Cited by 494 · see citing works
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Sarcopenia, sarcopenic obesity and mortality in older adults: results from the national health and nutrition examination survey III
Batsis, J. A., Mackenzie, T. A., Barre, L. K., Lopez-Jimenez, F., & Bartels, S. J. (2014) · European Journal of Clinical Nutrition · doi:10.1038/ejcn.2014.117 · Cited by 479 · see citing works
Validity and Reliability of Tools to Measure Muscle Mass, Strength, and Physical Performance in Community-Dwelling Older People: A Systematic Review
Mijnarends, D. M., Meijers, J. M. M., Halfens, R. J. G., ter Borg, S., Luiking, Y. C., Verlaan, S., Schoberer, D., Cruz Jentoft, A. J., van Loon, L. J. C., & Schols, J. M. G. A. (2013) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2012.10.009 · Cited by 475 · see citing works
Treadmill Exercise and Resistance Training in Patients With Peripheral Arterial Disease With and Without Intermittent Claudication: A Randomized Controlled Trial
McDermott, M. M., Ades, P., Guralnik, J. M., Dyer, A., Ferrucci, L., Liu, K., Nelson, M., Lloyd-Jones, D., Van Horn, L., Garside, D., et al. (2009) · JAMA · doi:10.1001/jama.2008.962 · Cited by 449 · see citing works
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Prognostic significance of potential frailty criteria
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Quality of Life in Sarcopenia and Frailty
Rizzoli, R., Reginster, J.-Y., Arnal, J.-F., Bautmans, I., Beaudart, C., Bischoff-Ferrari, H., Biver, E., Boonen, S., Brandi, M.-L., Chines, A., et al. (2013) · Calcified Tissue International · doi:10.1007/s00223-013-9758-y · Cited by 425 · see citing works
Gut Microbiota, Muscle Mass and Function in Aging: A Focus on Physical Frailty and Sarcopenia
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Computed tomographic measurements of thigh muscle cross-sectional area and attenuation coefficient predict hip fracture: the health, aging, and body composition study
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An evidence-based comparison of operational criteria for the presence of sarcopenia
Dam, T.-T., Peters, K. W., Fragala, M., Cawthon, P. M., Harris, T. B., McLean, R., Shardell, M., Alley, D. E., Kenny, A., Ferrucci, L., et al. (2014) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/glu013 · Cited by 363 · see citing works
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Functional consequences of sarcopenia and dynapenia in the elderly
Clark, B. C., & Manini, T. M. (2010) · Current Opinion in Clinical Nutrition and Metabolic Care · doi:10.1097/mco.0b013e328337819e · Cited by 359 · see citing works
Skeletal muscle and mortality results from the InCHIANTI study
Cesari, M., Pahor, M., Lauretani, F., Zamboni, V., Bandinelli, S., Bernabei, R., Guralnik, J. M., & Ferrucci, L. (2009) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/gln031 · Cited by 346 · see citing works
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Slow walking speed and cardiovascular death in well functioning older adults: prospective cohort study
Dumurgier, J., Elbaz, A., Ducimetiere, P., Tavernier, B., Alperovitch, A., & Tzourio, C. (2009) · BMJ · doi:10.1136/bmj.b4460 · Cited by 344 · see citing works
Measures of Physical performance and risk for progressive and catastrophic disability: results from the Women’s Health and Aging Study
Onder, G., Penninx, B. W. J. H., Ferrucci, L., Fried, L. P., Guralnik, J. M., & Pahor, M. (2005) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/60.1.74 · Cited by 347 · see citing works
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Sarcopenia and sarcopenic obesity
Choi, K. M. (2016) · The Korean Journal of Internal Medicine · doi:10.3904/kjim.2016.193 · Cited by 344 · see citing works
Muscle power of the ankle flexors predicts functional performance in community-dwelling older women.
Suzuki, T., Bean, J. F., & Fielding, R. A. (2001) · Journal of the American Geriatrics Society · doi:10.1046/j.1532-5415.2001.49232.x · Cited by 343 · see citing works
Relation between use of angiotensin-converting enzyme inhibitors and muscle strength and physical function in older women: an observational study
Onder, G., Penninx, B. W., Balkrishnan, R., Fried, L. P., Chaves, P. H., Williamson, J., Carter, C., Bari, M. D., Guralnik, J. M., & Pahor, M. (2002) · The Lancet · doi:10.1016/s0140-6736(02)08024-8 · Cited by 339 · see citing works
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Benefits of resistance training in physically frail elderly: a systematic review
Lopez, P., Pinto, R. S., Radaelli, R., Rech, A., Grazioli, R., Izquierdo, M., & Cadore, E. L. (2018) · Aging Clinical and Experimental Research · doi:10.1007/s40520-017-0863-z · Cited by 338 · see citing works
Chronic inflammation is associated with low physical function in older adults across multiple comorbidities
Brinkley, T. E., Leng, X., Miller, M. E., Kitzman, D. W., Pahor, M., Berry, M. J., Marsh, A. P., Kritchevsky, S. B., & Nicklas, B. J. (2009) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/gln038 · Cited by 311 · see citing works
Health Consequences of Sarcopenic Obesity: A Narrative Review
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Role of muscle mass and muscle quality in the association between diabetes and gait speed
Volpato, S., Bianchi, L., Lauretani, F., Lauretani, F., Bandinelli, S., Guralnik, J. M., Zuliani, G., & Ferrucci, L. (2012) · Diabetes Care · doi:10.2337/dc11-2202 · Cited by 294 · see citing works
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Successful aging: Advancing the science of physical independence in older adults
Anton, S. D., Woods, A. J., Ashizawa, T., Barb, D., Buford, T. W., Carter, C. S., Clark, D. J., Cohen, R. A., Corbett, D. B., Cruz-Almeida, Y., et al. (2015) · Ageing Research Reviews · doi:10.1016/j.arr.2015.09.005 · Cited by 292 · see citing works
“…Satterfield, Schwartz, and Simonsick 2008;Mold, Vesely, Keyl, Schenk, and Roberts 2004;Resnick, Vinik, Schwartz, Leveille, Brancati, Balfour, and Guralnik 2000) In order to enhance somatosensory input to lower extremity somatosensory receptors, a number of researchers have investigated shoe…”
BackgroundInfluential
Association between lower digit symbol substitution test score and slower gait and greater risk of mortality and of developing incident disability in well-functioning older adults
Rosano, C., Newman, A. B., Katz, R., Hirsch, C. H., & Kuller, L. H. (2008) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2008.01856.x · Cited by 280 · see citing works
Impact of muscle power and force on gait speed in disabled older men and women
Cuoco, A., Callahan, D. M., Sayers, S., Frontera, W. R., Bean, J., & Fielding, R. A. (2004) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/59.11.1200 · Cited by 283 · see citing works
Is stair climb power a clinically relevant measure of leg power impairments in at-risk older adults?
Bean, J. F., Kiely, D. K., LaRose, S., Alian, J., & Frontera, W. R. (2007) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2007.02.004 · Cited by 278 · see citing works
Poor sleep is associated with poorer physical performance and greater functional limitations in older women
Goldman, S. E., Stone, K. L., Ancoli-Israel, S., Blackwell, T., Ewing, S. K., Boudreau, R., Cauley, J. A., Hall, M., Matthews, K. A., & Newman, A. B. (2007) · SLEEP · doi:10.1093/sleep/30.10.1317 · Cited by 277 · see citing works
Physiological Aging: Links Among Adipose Tissue Dysfunction, Diabetes, and Frailty
Stout, M. B., Justice, J. N., Nicklas, B. J., & Kirkland, J. L. (2017) · Physiology · doi:10.1152/physiol.00012.2016 · Cited by 272 · see citing works
Associations between body composition and gait-speed decline: results from the health, aging, and body composition study
Beavers, K. M., Beavers, D. P., Houston, D. K., Harris, T. B., Hue, T. F., Koster, A., Newman, A. B., Simonsick, E. M., Studenski, S. A., Nicklas, B. J., et al. (2013) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.112.047860 · Cited by 259 · see citing works
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The effect of obesity combined with low muscle strength on decline in mobility in older persons: results from the InCHIANTI Study
Stenholm, S., Alley, D., Bandinelli, S., Griswold, M. E., Koskinen, S., Rantanen, T., Guralnik, J. M., & Ferrucci, L. (2009) · International Journal of Obesity · doi:10.1038/ijo.2009.62 · Cited by 248 · see citing works
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<p>Preserving Mobility in Older Adults with Physical Frailty and Sarcopenia: Opportunities, Challenges, and Recommendations for Physical Activity Interventions</p>
Billot, M., Calvani, R., Urtamo, A., Sánchez-Sánchez, J. L., Ciccolari-Micaldi, C., Chang, M., Roller-Wirnsberger, R., Wirnsberger, G., Sinclair, A., Vaquero-Pinto, M. N., et al. (2020) · Clinical Interventions in Aging · doi:10.2147/cia.s253535 · Cited by 242 · see citing works
Longitudinal decline of lower extremity muscle power in healthy and mobility-limited older adults: influence of muscle mass, strength, composition, neuromuscular activation and single fiber contractile properties.
Reid, K. F., Pasha, E., Doros, G., Clark, D. J., Patten, C., Phillips, E. M., Frontera, W. R., & Fielding, R. A. (2014) · European Journal of Applied Physiology · doi:10.1007/s00421-013-2728-2 · Cited by 246 · see citing works
Effects of Resistance Exercise Training on Cognitive Function and Physical Performance in Cognitive Frailty: A Randomized Controlled Trial
Yoon, D. H., Lee, J.-Y., & Song, W. (2018) · The Journal of nutrition, health and aging · doi:10.1007/s12603-018-1090-9 · Cited by 232 · see citing works
Malnutrition as a strong predictor of the onset of sarcopenia
Beaudart, C., Sanchez-Rodriguez, D., Locquet, M., Reginster, J.-Y., Lengelé, L., & Bruyère, O. (2019) · Nutrients · doi:10.3390/nu11122883 · Cited by 226 · see citing works
Increased Velocity Exercise Specific to Task (InVEST) training: a pilot study exploring effects on leg power, balance, and mobility in community‐dwelling older women
Bean, J. F., Herman, S., Kiely, D. K., Frey, I. C., Leveille, S. G., Fielding, R. A., & Frontera, W. R. (2004) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2004.52222.x · Cited by 218 · see citing works
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. Prediction, progression and outcomes of chronic kidney disease in older adults.
Anderson, S., Halter, J. B., Hazzard, W. R., Himmelfarb, J., Horne, F. M., Kaysen, G. A., Kusek, J. W., Nayfield, S. G., Schmader, K., Tian, Y., et al. (2009) · Journal of the American Society of Nephrology · doi:10.1681/asn.2008080860 · Cited by 218 · see citing works
The effect of resistance training on muscle strength and physical function in older, postmenopausal breast cancer survivors: a randomized controlled trial
Winters-Stone, K. M., Dobek, J., Bennett, J. A., Nail, L. M., Leo, M. C., & Schwartz, A. (2012) · Journal of Cancer Survivorship · doi:10.1007/s11764-011-0210-x · Cited by 211 · see citing works
Effects of three types of exercise interventions on healthy old adults’ gait speed: a systematic review and meta-analysis.
Hortobágyi, T., Lesinski, M., Gäbler, M., VanSwearingen, J. M., Malatesta, D., & Granacher, U. (2015) · Sports Medicine · doi:10.1007/s40279-015-0371-2 · Cited by 204 · see citing works
Gait speed predicts decline in attention and psychomotor speed in older adults: The Health Aging and Body Composition Study
Inzitari, M., Newman, A. B., Yaffe, K., Boudreau, R., de Rekeneire, N., Shorr, R., Harris, T. B., & Rosano, C. (2007) · Neuroepidemiology · doi:10.1159/000111577 · Cited by 200 · see citing works
Sex differences in the effect of fish-oil supplementation on the adaptive response to resistance exercise training in older people: a randomized controlled trial
Da Boit, M., Sibson, R., Sivasubramaniam, S., Meakin, J. R., Greig, C. A., Aspden, R. M., Thies, F., Jeromson, S., Hamilton, D. L., Speakman, J. R., et al. (2017) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.116.140780 · Cited by 185 · see citing works
Bimagrumab vs Optimized Standard of Care for Treatment of Sarcopenia in Community-Dwelling Older Adults: A Randomized Clinical Trial
Rooks, D., Swan, T., Goswami, B., Filosa, L. A., Bunte, O., Panchaud, N., Coleman, L. A., Miller, R. R., Garcia Garayoa, E., Praestgaard, J., et al. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2020.20836 · Cited by 177 · see citing works
Physical Activity and Sarcopenic Obesity: Definition, Assessment, Prevalence and Mechanism
Lee, D.-C., Shook, R. P., Drenowatz, C., & Blair, S. N. (2016) · Future Science OA · doi:10.4155/fsoa-2016-0028 · Cited by 177 · see citing works
Functional Outcomes for Clinical Trials in Frail Older Persons: Time To Be Moving: Working Group on Functional Outcome Measures for Clinical Trials
(2008) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/63.2.160 · Cited by 172 · see citing works
Allogeneic Mesenchymal Stem Cells Ameliorate Aging Frailty: A Phase II Randomized, Double-Blind, Placebo-Controlled Clinical Trial
Tompkins, B. A., DiFede, D. L., Khan, A., Landin, A. M., Schulman, I. H., Pujol, M. V., Heldman, A. W., Miki, R., Goldschmidt-Clermont, P. J., Goldstein, B. J., et al. (2017) · The Journals of Gerontology: Series A · doi:10.1093/gerona/glx137 · Cited by 169 · see citing works
Measures of lower body function and risk of mortality over 7 years of follow-up
Ostir, G. V., Kuo, Y.-F., Berges, I. M., Markides, K. S., & Ottenbacher, K. J. (2007) · American Journal of Epidemiology · doi:10.1093/aje/kwm121 · Cited by 165 · see citing works
Self-citation
Hyperglycemia and incidence of frailty and lower extremity mobility limitations in older women
Kalyani, R. R., Tian, J., Xue, Q., Walston, J., Cappola, A. R., Fried, L. P., Brancati, F. L., & Blaum, C. S. (2012) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2012.04099.x · Cited by 157 · see citing works
Lower extremity power training in elderly subjects with mobility limitations: a randomized controlled trial.
Reid, K. F., Callahan, D. M., Carabello, R. J., Phillips, E. M., Frontera, W. R., & Fielding, R. A. (2008) · Aging Clinical and Experimental Research · doi:10.1007/bf03324865 · Cited by 153 · see citing works
Mobility Limitation in Self-Described Well-Functioning Older Adults: Importance of Endurance Walk Testing
Simonsick, E. M., Newman, A. B., Visser, M., Goodpaster, B., Kritchevsky, S. B., Rubin, S., Nevitt, M. C., Harris, T. B., & for the Health, A. A. B. C. S. (2008) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/63.8.841 · Cited by 147 · see citing works
Magnitude and patterns of decline in health and function in 1 year affect subsequent 5-year survival
Perera, S., Studenski, S., Chandler, J. M., & Guralnik, J. M. (2005) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/60.7.894 · Cited by 134 · see citing works
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Sarcopenia in Korean Community-Dwelling Adults Aged 70 Years and Older: Application of Screening and Diagnostic Tools From the Asian Working Group for Sarcopenia 2019 Update
Kim, M., & Won, C. W. (2020) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2020.03.018 · Cited by 141 · see citing works
Regular Multicomponent Exercise Increases Physical Fitness and Muscle Protein Anabolism in Frail, Obese, Older Adults
Villareal, D. T., Smith, G. I., Sinacore, D. R., Shah, K., & Mittendorfer, B. (2011) · Obesity · doi:10.1038/oby.2010.110 · Cited by 140 · see citing works
“These activities are necessary for independent mobility and are independent predictors of the ability to perform instrumental activities of daily living such as the ability to cook, travel, and shop; furthermore, they are predictors of disability and nursing home admission (44,45).”
Background
Increased velocity exercise specific to task training versus the National Institute on Aging's strength training program: changes in limb power and mobility
Bean, J. F., Kiely, D. K., LaRose, S., O'Neill, E., Goldstein, R., & Frontera, W. R. (2009) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/glp056 · Cited by 138 · see citing works
CAPABLE trial: A randomized controlled trial of nurse, occupational therapist and handyman to reduce disability among older adults: Rationale and design
Szanton, S. L., Wolff, J. W., Leff, B., Thorpe, R. J., Tanner, E. K., Boyd, C., Xue, Q., Guralnik, J., Bishai, D., & Gitlin, L. N. (2014) · Contemporary Clinical Trials · doi:10.1016/j.cct.2014.03.005 · Cited by 138 · see citing works
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Muscle wasting and aging: Experimental models, fatty infiltrations, and prevention
Brioche, T., Pagano, A. F., Py, G., & Chopard, A. (2016) · Molecular Aspects of Medicine · doi:10.1016/j.mam.2016.04.006 · Cited by 129 · see citing works
The biomechanical mechanism of how strength and power training improves walking speed in old adults remains unknown
Beijersbergen, C. M. I., Granacher, U., Vandervoort, A. A., DeVita, P., & Hortobágyi, T. (2013) · Ageing Research Reviews · doi:10.1016/j.arr.2013.03.001 · Cited by 136 · see citing works
Overweight and Obesity Over the Adult Life Course and Incident Mobility Limitation in Older Adults: The Health, Aging and Body Composition Study
Houston, D. K., Ding, J., Nicklas, B. J., Harris, T. B., Lee, J. S., Nevitt, M. C., Rubin, S. M., Tylavsky, F. A., Kritchevsky, S. B., & Study, F. T. H. A. (2009) · American Journal of Epidemiology · doi:10.1093/aje/kwp007 · Cited by 132 · see citing works
Effect of moderate intensity resistance training during weight loss on body composition and physical performance in overweight older adults
Avila, J. J., Gutierres, J. A., Sheehy, M. E., Lofgren, I. E., & Delmonico, M. J. (2010) · European Journal of Applied Physiology · doi:10.1007/s00421-010-1387-9 · Cited by 128 · see citing works
Epidemiology of sarcopenia among community‐dwelling older adults in <scp>T</scp>aiwan: A pooled analysis for a broader adoption of sarcopenia assessments
Wu, I., Lin, C., Hsiung, C. A., Wang, C., Wu, C., Chan, D. D., Li, T., Lin, W., Huang, K., Chen, C., et al. (2014) · Geriatrics & Gerontology International · doi:10.1111/ggi.12193 · Cited by 124 · see citing works
Are Changes in Leg Power Responsible for Clinically Meaningful Improvements in Mobility in Older Adults?
Bean, J. F., Kiely, D. K., LaRose, S., Goldstein, R., Frontera, W. R., & Leveille, S. G. (2010) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2010.03155.x · Cited by 126 · see citing works
Self-citation
Resistance training reduces disability in prostate cancer survivors on androgen deprivation therapy: evidence from a randomized controlled trial
Winters-Stone, K. M., Dobek, J. C., Bennett, J. A., Dieckmann, N. F., Maddalozzo, G. F., Ryan, C. W., & Beer, T. M. (2015) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2014.08.010 · Cited by 126 · see citing works
Effects of Multicomponent Exercise on Frailty in Long-Term Nursing Homes: A Randomized Controlled Trial
Arrieta, H., Rezola‐Pardo, C., Gil, S. M., Virgala, J., Iturburu, M., Antón, I., González‐Templado, V., Irazusta, J., & Rodriguez‐Larrad, A. (2019) · Journal of the American Geriatrics Society · doi:10.1111/jgs.15824 · Cited by 111 · see citing works
Adherence to multidomain interventions for dementia prevention: data from the FINGER and MAPT trials.
Coley, N., Ngandu, T., Lehtisalo, J., Soininen, H., Vellas, B., Richard, E., Kivipelto, M., Andrieu, S., & HATICE, F. (2019) · Alzheimer's & Dementia · doi:10.1016/j.jalz.2019.03.005 · Cited by 118 · see citing works
Linking C-Reactive Protein to Late-Life Disability in the National Health and Nutrition Examination Survey (NHANES) 1999-2002
Kuo, H.-K., Bean, J. F., Yen, C.-J., & Leveille, S. G. (2006) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/61.4.380 · Cited by 115 · see citing works
Self-citation
Osteosarcopenic obesity syndrome: what is it and how can it be identified and diagnosed?
Ilich, J. Z., Kelly, O. J., & Inglis, J. E. (2016) · Current Gerontology and Geriatrics Research · doi:10.1155/2016/7325973 · Cited by 115 · see citing works
Recommendations for the conduct of clinical trials for drugs to treat or prevent sarcopenia
Reginster, J.-Y., Cooper, C., Rizzoli, R., Kanis, J. A., Appelboom, G., Bautmans, I., Bischoff-Ferrari, H. A., Boers, M., Brandi, M. L., Bruyère, O., et al. (2016) · Aging Clinical and Experimental Research · doi:10.1007/s40520-015-0517-y · Cited by 112 · see citing works
Muscle performance and physical function are associated with voluntary rate of neuromuscular activation in older adults
Clark, D. J., Patten, C., Reid, K. F., Carabello, R. J., Phillips, E. M., & Fielding, R. A. (2011) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/glq153 · Cited by 108 · see citing works
Long-Term Physical Activity and Inflammatory Biomarkers in Older Adults
BEAVERS, K. M., HSU, F.-C., ISOM, S., KRITCHEVSKY, S. B., CHURCH, T., GOODPASTER, B., PAHOR, M., & NICKLAS, B. J. (2010) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e3181e3ac80 · Cited by 108 · see citing works

FEATURES AND DIFFERENCES OF ADEQUATE AND EQUIVALENT TRANSLATION
Кенжебaевa, У., Nadirova, G. E., & Seitmetova, Z. (2018) · DOAJ (DOAJ: Directory of Open Access Journals)
A GEOMETRIC MEAN IN THE FURUTA INEQUALITY
Fujii, M., & Nakamoto, R. (2002) · Scientiae mathematicae Japonicae · Cited by 15 · see citing works
GAIT FUNCTION OF TOTAL HIP ARTHROPLASTY PATIENTS: ANALYSIS OF PREFERRED SPEED WALKING ALONE IS NOT ENOUGH.
van den Akker‐Scheek, I., Stevens, M. J., Zijlstra, W., et al. (2010) · Orthopaedic Proceedings
Words matter: instructions dictate “self-selected” walking speed in young adults
Brinkerhoff, S. A., Murrah, W. M., Hutchison, Z. J., et al. (2019) · Gait & Posture · doi:10.1016/j.gaitpost.2019.07.379 · Cited by 53 · see citing works
Abstract TP144: The Relationship Between Gait Speed and Self-Reported Quality of Life in Stroke Survivors After Treatment With a Therapeutic Gait Device
Darcy, B., Rashford, L., Lundin, E., et al. (2020) · Stroke · doi:10.1161/str.51.suppl_1.tp144

Authors: Guralnik, J. M., Ferrucci, L., Pieper, C. F., Leveille, S. G., Markides, K. S., Ostir, G. V., Studenski, S., Berkman, L. F., & Wallace, R. B.
Affiliations: National Institutes of Health (US)
Duke Medical Center (US)
The University of Texas Medical Branch at Galveston (US)
University of Kansas Medical Center (US)
Harvard University (US)
University of Iowa (US)
Corresponding author: Guralnik, J. M.
ORCID: Guralnik, J. M.
Ferrucci, L.
Pieper, C. F.
Leveille, S. G.
Studenski, S.
Berkman, L. F.
Wallace, R. B.
Venue: The Journals of Gerontology Series A: Biological Sciences and Medical Sciences
Publisher: Oxford University Press (OUP)
Published: 2000-04-01
Volume: 55
Issue: 4
Pages: M221-M231
ISSN: 1079-5006 (ISSN-L)
1758-535X
DOI: 10.1093/gerona/55.4.m221
PMC: PMC12149745
OpenAlex: W2119958965
Cited by: 2,898
References: 24
Citations by year: 2026: 86 · 2025: 119 · 2024: 135 · 2023: 139 · 2022: 205 · 2021: 220 · 2020: 209 · 2019: 202 · 2018: 131 · 2017: 165 · 2016: 153 · 2015: 132 · 2014: 142 · 2013: 127 · 2012: 109
FWCI: 14.20
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: The Journals of Gerontology Series A (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institutes of Health (Z99 AG999999)
National Institute on Aging (N01AG02105, N01AG02106, N01-AG02107)
Topics: Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
Keywords: lower limb function, disability prediction, walking speed, Short Physical Performance Battery, physical performance tests, activities of daily living, older adults, community-dwelling older adults, Hispanic older adults, disability prevention
MeSH terms: Activities of Daily Living, Aged, Disability Evaluation, Postural Balance, Gait, Hispanic or Latino, Humans, Leg, Risk Factors, Geriatric Assessment, Walking

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Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery

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