Measures of Physical performance and risk for progressive and catastrophic disability: results from the Women’s Health and Aging Study
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BACKGROUND: Physical performance measures can predict incident disability, but little research has assessed and compared how these measures predict progressive and rapid-onset (catastrophic) disability. The authors evaluated the ability of upper and lower extremity performance measures to predict progressive and catastrophic disability in activities of daily living (ADL), mobility, and upper extremity function. METHODS: The incidence of progressive and catastrophic disability was assessed semiannually during a 3-year period in 884 women participating in the Women's Health and Aging Study I. Four-meter walking speed, balance, and chair stands tests were used to evaluate lower extremity function. The putting-on-blouse test, the Purdue pegboard test, and grip strength were used to assess upper extremity function. Summary performance scores (SPS) for the lower and upper extremities were calculated. Among participants in whom disability developed, those who reported no difficulty in the previous year were defined as cases of catastrophic disability, and those who previously reported little or some difficulty were considered to be cases of progressive disability. Cox proportional hazard regression analyses were used to evaluate the association of performance measures and time to incident disability. The predictive ability of performance measures was compared using receiver-operator characteristic curves. RESULTS: All lower and upper extremity measures, with the exception of grip strength, significantly predicted the onset of progressive ADL disability, but only walking speed was significantly associated with the onset of catastrophic ADL disability. The chair stands test, walking speed, and the lower extremity SPS were significantly associated with the onset of both progressive and catastrophic mobility disability. Only lower extremity individual tests and SPS significantly predicted the onset of both progressive and catastrophic upper extremity disability. The receiver-operator characteristic curves for ADL and mobility disability showed that all performance measures evaluated had a greater predictive ability for progressive than for catastrophic incident disability. This finding was not consistent for upper extremity disability. The areas under the curve for walking speed and lower extremity SPS were very similar, ranging from 0.58 to 0.81 and from 0.57 to 0.85, and the predictive ability of these two measures was the greatest for all disability outcomes assessed. CONCLUSION: Physical performance measures of lower extremity and, in particular, walking speed and lower extremity SPS are valuable tools to predict different forms of disability, especially those with a progressive onset.
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In the Women's Health and Aging Study-I, gait speed measured over 4 meters was the only lower and upper extremity performance measure significantly associated with catastrophic disability, with a relative risk of 0.72 (95% CI 0.53-0.99) per 0.31 ms-1 increase.
“Gait speed (measured over 4 meters), among all lower and upper extremity performance measures, was the only measure significantly associated with catastrophic disability (defined as onset of ADL disability within 1 year). A RR of 0.72 (95% CI 0.53-0.99) per 0.31 ms-1 was found”
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“Additionally, healthy lifestyle behaviors can ameliorate the rate of functional decline, which is inversely related to the ability to live independently [6,7].”
Background
- Authors
- Onder, G., Penninx, B. W. J. H., Ferrucci, L., Fried, L. P., Guralnik, J. M., & Pahor, M.
- Affiliations
- Università Cattolica del Sacro Cuore (IT)
- Wake Forest University Health Sciences (US)
- National Institutes of Health (US)
- Johns Hopkins University (US)
- Corresponding author
- Onder, G.
- Venue
- The Journals of Gerontology Series A: Biological Sciences and Medical Sciences
- Publisher
- Oxford University Press (OUP)
- Published
- 2005-01-01
- Volume
- 60
- Issue
- 1
- Pages
- 74-79
- ISSN
- 1079-5006 (ISSN-L)
- 1758-535X
- OpenAlex
- W2137257211
- Cited by
- 347
- References
- 35
- Citations by year
- 2026: 1 · 2025: 6 · 2024: 9 · 2023: 13 · 2022: 17 · 2021: 15 · 2020: 20 · 2019: 16 · 2018: 9 · 2017: 13 · 2016: 21 · 2015: 30 · 2014: 21 · 2013: 27 · 2012: 26
- FWCI
- 8.15
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journals of Gerontology Series A (publishedVersion)
- PubMed (publishedVersion)
- VU Research Portal (publishedVersion, other-oa)
- Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- National Institutes of Health (n01ag012112-014)
- National Institute on Aging (N01AG12112, 1P30 AG 21332-01, P30AG021332)
- 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
- physical performance, disability prediction, disability progression, activities of daily living, mobility impairment, upper limb function, walking speed, grip strength, balance, women's health, aging
- MeSH terms
- Activities of Daily Living, Aged, Arm, Female, Geriatrics, Persons with Disabilities, Disabled Persons, Humans, Leg, Physical Examination, Risk Factors, Disease Progression
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