Functional limitations and poor physical performance as independent risk factors for self-reported fractures in older persons

Stel, Vianda S.; Pluijm, Saskia M. F.; Deeg, D.J.H.; Smit, Jan; Bouter, Lex M.; Lips, Paul

doi:10.1007/s00198-004-1604-7

Cited by 48 publications

(46 citation statements)

References 34 publications

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“…The walking test is an indicator of coordination, proximal muscle strength and balance; the chair stands test is an indicator of proximal muscle strength; and the tandem stand is an indicator of balance (Wicherts et al, 2007). Physical performance, especially walking speed, has been associated with multiple negative health outcomes (Guralnik et al, 1994;Stel et al, 2003Stel et al, , 2004Ostir et al, 2007;Hamer et al, 2009).…”

Section: Discussionmentioning

confidence: 99%

“…Physical performance decreases with aging and is associated with multiple negative health outcomes, such as cardiovascular disease (Hamer et al, 2009), falls and fractures (Stel et al, 2003(Stel et al, , 2004, nursing home admission and mortality (Guralnik et al, 1994;Ostir et al, 2007). Five previous studies observed associations between elevated homocysteine and lower physical performance in the general older population (Kado et al, 2002;Soumare et al, 2006;Gerdhem et al, 2007;Kuo et al, 2007;Rolita et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

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Cross-sectional and longitudinal association between homocysteine, vitamin B12 and physical performance in older persons

et al. 2011

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Background/Objectives: Decreases in physical performance are associated with multiple negative health outcomes. The objective of this study was to examine whether high plasma homocysteine and low serum vitamin B12 are independent risk factors for lower physical performance, both cross-sectionally and longitudinally. Subjects/Methods: This study was performed in persons aged X65 years of the LASA (Longitudinal Aging Study Amsterdam), an ongoing cohort study. Blood was collected in 1995/1996 (n ¼ 1352). Physical performance was assessed in 1995/1996 and in 1998/1999 using three tests: the walking test, the chair stands test and the tandem stand (n ¼ 901-1155). Results: After adjustment for confounding, women in the highest quartile of homocysteine had a significantly lower physical performance than did those in the lowest quartile in the cross-sectional analyses (b ¼ À0.93, s.e. ¼ 0.34, Po0.01). This association was borderline statistically significant in the longitudinal analyses (b ¼ À0.69, s.e. ¼ 0.35, P ¼ 0.05). After additional adjustment for serum vitamin B12, both associations were statistically significant (Po0.05). For vitamin B12 in women, and for homocysteine and vitamin B12 in men, the observed associations were less consistent. Conclusions: High plasma homocysteine is an independent risk factor for lower physical performance in older women. The association between vitamin B12 and physical performance is less clear.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cross-sectional and longitudinal association between homocysteine, vitamin B12 and physical performance in older persons

et al. 2011

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“…Self-reported activity limitations were assessed with a validated questionnaire concerning the degree of difficulty with the following six activities of daily living: climbing stairs, walking 5 min outdoors without resting, getting up and sitting down in a chair, dressing and undressing oneself, using own or public transportation, and cutting one's own toe nails (26). Participants reported a score of zero (not any difficulty) to six (difficulty with all activities).…”

Section: Physical Functionmentioning

confidence: 99%

“…Participants reported a score of zero (not any difficulty) to six (difficulty with all activities). The number was dichotomized to the presence of none or one activity limitation or the presence of two or more activity limitations (26). Two or more activity limitations are more likely to be due to an underlying disease than one activity limitation.…”

Section: Physical Functionmentioning

confidence: 99%

Endogenous subclinical thyroid disorders, physical and cognitive function, depression, and mortality in older individuals

Jongh

Lips

Schoor

et al. 2011

European Journal of Endocrinology

136

108

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Objective: To what extent endogenous subclinical thyroid disorders contribute to impaired physical and cognitive function, depression, and mortality in older individuals remains a matter of debate. Design: A population-based, prospective cohort of the Longitudinal Aging Study Amsterdam. Methods: TSH and, if necessary, thyroxine and triiodothyronine levels were measured in individuals aged 65 years or older. Participants were classified according to clinical categories of thyroid function. Participants with overt thyroid disease or use of thyroid medication were excluded, leaving 1219 participants for analyses. Outcome measures were physical and cognitive function, depressive symptoms (cross-sectional), and mortality (longitudinal) Results: Sixty-four (5.3%) individuals had subclinical hypothyroidism and 34 (2.8%) individuals had subclinical hyperthyroidism. Compared with euthyroidism (nZ1121), subclinical hypo-, and hyperthyroidism were not significantly associated with impairment of physical or cognitive function, or depression. On the contrary, participants with subclinical hypothyroidism did less often report more than one activity limitation (odds ratio 0.44, 95% confidence interval (CI) 0.22-0.86). After a median follow-up of 10.7 years, 601 participants were deceased. Subclinical hypo-and hyper-thyroidism were not associated with increased overall mortality risk (hazard ratio 0.89, 95% CI 0.59-1.35 and 0.69, 95% CI 0.40-1.20 respectively). Conclusions: This study does not support disadvantageous effects of subclinical thyroid disorders on physical or cognitive function, depression, or mortality in an older population.

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“…Prolonged inactivity and immobility lead to bone loss and muscle weakness and subsequent decline in physical functioning, with increased risks of falls and fractures (DiPietro 2001;Stel et al 2004;Visser et al 2005;Booth et al 2011). Hence, a downward spiral becomes apparent.…”

Section: Introductionmentioning

confidence: 99%

Changes in physical functioning over 6 years in older women: effects of sitting time and physical activity

2013

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The combined effects of physical activity (PA) and sitting time (ST) on physical functioning (PF) may be stronger than for each factor separately. This study examined associations between ST, PA, and PF over 6 years in older women. Data were from 6,611 participants in the Australian Longitudinal Study on Women's Health (mean age 78 ± 1.5 years). Activity pattern at baseline (2002) was categorized as one of 12 combinations of ST (\4, 4-7, or C8 h/day) and PA (\40, 40-450, 450-900, or C900 MET min/week). PF was measured using the SF-36 (range 0-100) in 2002, 2005, and 2008. General estimating equations for linear regression were used with adjustment for confounders. Baseline PF ranged from 40 to 74 in the least to the most active groups. PF was 6.3 (95 % confidence interval [CI] -7.6 to -5.0) points lower in participants sitting C8 h/day than in participants sitting\4 h/day, and 16.9 (CI 15.7-18.0) points higher in participants reporting C900 MET min/week than in participants reporting \40 MET min/week PA.Compared with the least active pattern, those in the most active pattern scored 24.5 (CI 22.5-26.4) points higher. The decline over 6 years was greater in the more active categories: 5 and 16 points in the least and most active categories. In conclusion, in women, both high physical activity and low sitting time are important for establishing a certain level of PF prior to age 76-81, but do not protect against decline in PF over time later in life. The combined effect of ST and PA did not differ from their individual effects on PF.

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Functional limitations and poor physical performance as independent risk factors for self-reported fractures in older persons

Cited by 48 publications

References 34 publications

Cross-sectional and longitudinal association between homocysteine, vitamin B12 and physical performance in older persons

Cross-sectional and longitudinal association between homocysteine, vitamin B12 and physical performance in older persons

Endogenous subclinical thyroid disorders, physical and cognitive function, depression, and mortality in older individuals

Changes in physical functioning over 6 years in older women: effects of sitting time and physical activity

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