Changes in Physical Performance among Community-Dwelling Older Adults in Six Years

Abstract

Changes in physical performance (PP) occur with aging, and understanding the magnitude of these changes over time is important. This study evaluated changes in Gait Speed (GS) and Timed Up and Go (TUG) performance and their association with related factors among community-dwelling older adults over a period of five to six years. A cohort study of 476 older adults with baseline assessment conducted in 2014 and reassessment in 2019–2020 was carried out. Associations between PP changes over time and sociodemographic, behavioral, and health variables were evaluated using mixed linear models. Approximately 68% of the participants declined PP; 20% had no relevant change in GS and 9% in TUG time (sustained PP); 12% increased GS, and 23% decreased TUG time (improved PP). Being male (p = 0.023), living without a partner/separated (p = 0.035), higher education (p = 0.019), and alcohol consumption in the prior month (p = 0.045) were associated with decreased GS, while older age (p < 0.001), having lower socioeconomic status (p < 0.004), physical inactivity (p = 0.017), and being overweight (p = 0.007) were associated with increased TUG time. PP declined for most participants. Factors most strongly associated with PP decline are non-modifiable. The high prevalence of PP decline over time signals the importance of including physical tests in yearly health assessments.

Low Physical Performance Could Be Associated with Adverse Health Outcomes over Time: Results from a Cohort of Older Adults

“…Decline in GS from 2014 to 2019–2020 was a predictor of increased risk of hospitalizations (PR = 1.86, 95%CI = 1.05; 3.31) among community-dwelling older Brazilians. The assessment of PP decline (instead of the isolated use of PP tests at baseline) can identify individuals who were previously above the low performance threshold, but over time accumulated risk factors that contributed to both PP decline and the higher risk of hospitalizations, such as multimorbidity, polypharmacy, and depressive symptoms, in addition to socioeconomic and behavioral factors, as previously investigated in our sample [ 9 ]. A recent study found that GS decline was the only determinant associated with hospital readmission (OR = 0.35, 95%CI = 0.16–0.79) [ 27 ].…”

“…The decline in PP among older people may be the result of the complex interaction between physiological factors (declines in cardiovascular, musculoskeletal, and neuromuscular systems’ functioning, resulting in the progressive loss of muscle mass and strength; reduced testosterone levels), clinical factors (e.g., depressive symptoms, multimorbidity, polypharmacy), lifestyle (e.g., diet quality), and sociodemographic (e.g., age, sex) [ 6 , 7 , 8 , 9 ]. However, the decline in PP can be reduced by intervening on potentially modifiable risk factors.…”