Added value of physical performance measures in predicting adverse health-related events: results from the health, aging and body composition study
Open accessAbstract
OBJECTIVES: To determine how three different physical performance measures (PPMs) combine for added utility in predicting adverse health events in elders. DESIGN: Prospective cohort study. SETTING: Health, Aging and Body Composition Study. PARTICIPANTS: Three thousand twenty‐four well‐functioning older persons (mean age 73.6). MEASUREMENTS: Timed gait, repeated chair stands, and balance (semi‐ and full‐tandem, and single leg stands each held for 30 seconds) tests were administered at baseline. Usual gait speed was categorized to distinguish high‐ and low‐risk participants using the previously established 1‐m/s cutpoint. The same population‐percentile (21.3%) was used to identify cutpoints for the repeated chair stands (17.1 seconds) and balance (53.0 seconds) tests. Cox proportional hazard analyses were performed to evaluate the added value of PPMs in predicting mortality, hospitalization, and (severe) mobility limitation events over 6.9 years of follow‐up. RESULTS: Risk estimates for developing adverse health‐related events were similarly large for each of the three high‐risk groups considered separately. Having more PPM scores at the high‐risk level was associated with a greater risk of developing adverse health‐related events. When all three PPMs were considered, having only one poor performance was sufficient to indicate a highly significantly higher risk of (severe) lower extremity and mortality events. CONCLUSION: Although gait speed is considered to be the most important predictor of adverse health events, these findings demonstrate that poor performance on other tests of lower extremity function are equally prognostic. This suggests that chair stand and standing balance performance may be adequate substitutes when gait speed is unavailable.
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A prospective cohort study of Health ABC participants showed increased risks of functional limitation and mortality in participants with slow gait speed.
“Another prospective cohort study of Health ABC participants showed increased risks of functional limitation and mortality in participants with slow gait speed (43).”
From Health Consequences of Sarcopenic Obesity: A Narrative Review (2020) · cites this paper as [43]
Institutionalisation and hospitalisation are health-related conditions that were identified by physical performance measures like gait speed in a variety of populations.
“Institutionalisation and hospitalisation are health-related conditions that were identified by physical performance measures like gait speed in a variety of populations (19, 20, 27, 43).”
A second analysis of the Health ABC cohort after a median follow-up of 6.9 years with 3024 participants found that gait speed continued to predict persistent lower extremity limitation with a relative risk of 1.53 (95% CI 1.35-1.74).
“A second analysis of the same cohort after a longer follow-up (median of 6.9 years) with slightly lower participants (n=3024) found that gait speed continued to predict persistent lower extremity limitation with a RR of 1.53 (95%CI 1.35-1.74)”
Short-term mortality is strongly predicted by usual gait speed, and a cutpoint of 1 ms-1 predicts risk of mortality in many cohorts of autonomous older people.
“Short-term mortality was also strongly predicted by usual gait speed, and a cutpoint of 1 ms-1 predicted risk of mortality in many cohorts of autonomous older people”
In the Health ABC study (N=3024, well-functioning older persons, 6.9 years follow-up), the slow gait speed group (<1.0 m/s) had a hospitalisation relative risk of 1.26 (1.00-1.58).
“| Health ABC study (20) | N=3024 | 6 meter walk | Hospitalisation RR 1.26 (1.00-1.58) |”
The 1.0 ms-1 cutpoint was used to predict mortality.
“The 1.0 ms-1 cutpoint was used to predict mortality (19, 20)”
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- Authors
- Cesari, M., Kritchevsky, S. B., Newman, A. B., Simonsick, E. M., Harris, T. B., Penninx, B. W., Brach, J. S., Tylavsky, F. A., Satterfield, S., Bauer, D. C., Rubin, S. M., Visser, M., Pahor, M., & for the Health, A. A. B. C. S.
- Affiliations
- University of Florida (US)
- National Institutes of Health (US)
- ORCID
- Venue
- Journal of the American Geriatrics Society
- Publisher
- Wiley
- Published
- 2009-01-28
- Volume
- 57
- Issue
- 2
- Pages
- 251-259
- ISSN
- 0002-8614 (ISSN-L)
- 1532-5415
- PMC
- PMC2695653
- OpenAlex
- W1938427760
- Cited by
- 702
- References
- 28
- Citations by year
- 2026: 42 · 2025: 49 · 2024: 54 · 2023: 57 · 2022: 67 · 2021: 53 · 2020: 57 · 2019: 49 · 2018: 26 · 2017: 36 · 2016: 39 · 2015: 40 · 2014: 26 · 2013: 26 · 2012: 36
- FWCI
- 18.66
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of the American Geriatrics Society (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- VU Research Portal (publishedVersion)
- PubMed Central (acceptedVersion)
- Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- National Institutes of Health
- National Institute on Aging (N01‐AG‐6–2101, N01AG62106, N01-AG-62103, P30AG024827, T32AG021885, P30AG028740, P30AG021332)
- Institute on Aging, College of Medicine, University of Florida
- 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 › Physiology › Nutrition and Health in Aging
- Keywords
- physical performance measures, older adults, walking speed, chair stand, standing balance, tandem stance, mortality, hospitalization, mobility limitations, prognostic value, lower limb function, Health, Aging, and Body Composition Study
- MeSH terms
- Aged, Postural Balance, Female, Follow-Up Studies, Hospitalization, Humans, Leg, Male, Mortality, Motor Activity, Posture, Prospective Studies, Sensitivity and Specificity, Cohort Studies, Mobility Limitation
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