Abstract
Background
Physical performance may predict survival independently of other current predictors in non selected elderly subjects. We determined if poor balance and decreased gait speed may predict mortality after adjustment for both baseline and follow-up confounders in well-functioning elderly women.
Methods
A subgroup of participants in the Epidemiology of osteoporosis (EPIDOS) study (N = 1,300) was followed for 8 years. Participants were community-dwelling women aged 75 or older able to go outside home without assistance. The baseline examination included a questionnaire and a clinical and functional examination. Participants were contacted every year thereafter by mail.
Results
Poor balance, defined by the inability to stand in a tandem position or to complete ten foot taps in less than 4.6 seconds, and poor mobility, defined by a gait speed of less than 0.80 m/s or a stride length of less than 0.5 m were significant predictors of low 8-year survival, independently of other predictors of death at baseline (educational level, social network, number of drugs, fear of falling, visual acuity, perceived health, IADL score, physical activity, and comorbidities) and during follow-up (falls, IADL score, the need to be accompanied to go outside, weight loss, hospitalization, and the report of new comorbidities).
Conclusion
The current study shows that poor balance and mobility are significant predictors of 8-year mortality independently of baseline and intermediate events in pre-disabled women aged 75 years and older, suggesting that they may reflect a certain failure to respond adequately in the face of present and future medical and non-medical events.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Puts MT, Lips P, Deeg DJ. Sex differences in the risk of frailty for mortality independent of disability and chronic diseases. J Am Geriatr Soc. 2005;53:40–47.
Woods NF, LaCroix AZ, Gray SL, et al. Women’s Health Initiative. Frailty: emergence and consequences in women aged 65 and older in the Women’s Health Initiative Observational Study. J Am Geriatr Soc. 2005;53:1321–1330.
Fried L, Kronmal RA, Newman AB, et al. Risk factors for 5-year mortality in older adults: The Cardiovascular Health Study. JAMA. 1998;279:585–592.
Ostbye Y, Steenhuis R, Wolfson C, et al. Predictors of five-year mortality in older Canadians: the Canadian Study of Health and Aging. J Am Geriatr Soc. 1999;47:1249–1254.
Saliba D, Elliott M, Rubenstein LZ, et al. The vulnerable elders survey: a tool for identifying vulnerable older people in the community. J Am Geriatr Soc. 2001;49:1691–1699.
Fried LP, Ferrucci L, Darer J, et al. Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol A Biol Sci Med Sci. 2004;59:255–263.
Al Snih S, Markides KS, Ray L, et al. Handgrip strength and mortality in older Mexican Americans. J Am Geriatr Soc. 2002;50:1250–1256.
Sahyoun NR, Serdula MK, Galuska DA, et al. The epidemiology of recent involuntary weight loss in the United States population. J Nutr Health Aging. 2004;8:510–517.
Lee SJ, Lindquist K, Segal MR, et al. Development and validation of a prognostic index for 4-year mortality in older adults. JAMA. 2006;295:801–808.
Tsuji I, Minami Y, Keyl PM, et al. The predictive power of self-rated health, activities of daily living, and ambulatory activity for cause-specific mortality among the elderly: a three-year follow-up in urban Japan. J Am Geriatr Soc. 1994;42:153–156.
Nourashemi F, Andrieu S, Gillette-Guyonnet S, et al. instrumental activities of daily living as apotential marker of frailty. A study of 7364 community-dwelling elderly women (the EPIDOS study). J Gerontol Biol Sci Med Sci. 2001;56A:448–453.
Rockwood K, Song X, MacKnight C et al. A global clinical measure of fitness and frailty in elderly people. CMAJ 2005;173:489–495.
Walston J, lHadley EC, Ferrucci L, et al. Research agenda for frailty in older adults: toward a better understanding of physiology and etiology: summary from the American Geriatrics Society/National Institute on Aging Research Conference on Frailty in Older Adults. J Am Geriatr Soc. 2006;54:991–1001.
Bergman H, Ferrucci L, Guralnik J, et al. Frailty: an emerging research and clinical paradigm—issues and controversies. J Gerontol A Biol Sci Med Sci. 2007 Jul;62:731–737.
Abellan Van Kan G, Rolland Y, Bergman H, et al. on behalf of the Geriatric Advisory Panel. The I.A.N.A. task force on frailty assessment of older people in clinical practice. J Nutr health Aging. 2008;12:29–37.
Dargent-Molina P, Favier F, Grandjean H, et al. Fall-related factors and risk of hip fracture: the EPIDOS prospective study. Lancet. 1996;348:145–149. [Erratum: Lancet. 1996;348:416].
Pfeiffer E. A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. J Am Geriatr Soc. 1975;23:433–441.
Ainsworth BE, Haskell WL, Whitt MC, et al. Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc. 2000;32:S498–S504.
Schafer, J. L. Analysis of Incomplete Multivariate Data. Chapman & Hall, London, 1997.
Baker DW, Wolf MS, Feinglass J, et al. Health literacy and mortality among elderly persons. Arch Intern Med. 2007 23;167:1503–1509.
Scheffer AC, Schuurmans MJ, van Dijk N, et al. Fear of falling: measurement strategy, prevalence, risk factors and consequences among older persons. Age Ageing. 2008;37:19–24.
Andrew MK, Mitnitski AB, Rockwood K. Social vulnerability, frailty and mortality in elderly people. PloS ONE. 2008;3:e2232.
Lee SJ, Moody-Ayers SY, Landefeld CS, et al. The relationship between self-rated health and mortality in older black and white Americans. J Am Geriatr Soc. 2007;55:1624–1629.
Page RL 2nd, Ruscin JM. The risk of adverse drug events and hospital-related morbidity and mortality among older adults with potentially inappropriate medication use. Am J Geriatr Pharmacother. 2006;4:297–305.
Purser JL, Kuchibhatla MN, Fillenbaum GG, et al. Identifying frailty in hospitalized older adults with significant coronary heart disease. J Am Geriatr Soc. 2006;54:1674–1681.
Friedman PJ, Richmond DE, Baskett JJ. A prospective trial of serial gait speed as a measure of rehabilitation in the elderly. Age Ageing. 1988;17:227–235.
Perera S, Studenski S, Chandler JM, et al. Magnitude and patterns of decline in health and function in 1 year affect subsequent 5-year survival. J Gerontol A Biol Sci Med Sci. 2005;60:894–900.
Hardy SE, Perera S, Roumani YF, et al. Improvement in usual gait speed predicts better survival in older adults. J Am Geriatr Soc. 2007;55:1727–1734.
Woo J, Ho SC, Yu AL. Walking speed and stride length predicts 36 months dependency, mortality, and institutionalization in Chinese aged 70 and older. J Am Geriatr Soc. 1999;47:1257–1260.
Rolland Y, Lauwers-cances V, Cesari M, et al. Physical performance measures as predictors of mortality in a cohort of community-dwelling older French women. Eur J Epidemiol. 2006;21:113–122.
Studenski S, Perera S, Wallace D, et al. Physical performance measures in the clinical setting. J Am Geriatr Soc. 2003;51:314–322.
Hall WJ. Update in geriatrics. Ann Intern Med 2006;145:538–543.
Atkinson HH, Rosano C, Simonsick EM, et al. Health ABC study. Cognitive function, gait speed decline, and comorbidities: the health, aging and body composition study. J Gerontol A Biol Sci Med Sci. 2007;62:844–850.
Hardy SE, Concato J, Gill TM. Resilience of community-dwelling older persons. J Am Geriatr Soc. 2004;52:257–262.
Rothman MD, Leo-Summers, L, Gill TM. Prognostic significance of potential frailty criteria. J Am Geriatr Soc. 2008;56:2211–2216.
Carrière I, Colvez A, Favier F, et al. for the EPIDOS study group. Hierarchical components of physical frailty predicted incidence of dependency in a cohort of elderly women. J Clin Epidemiol. 2005;58:1180–1187.
Manini TM, Visser M, Won-Park S, et al. Knee extension strength cutpoints for maintaining mobility. J Am Geriatr Soc. 2007;55:451–457.
Ferrucci L, Bandinelli S, Benvenuti E, et al. Subsystems contributing to the decline in ability to walk: bridging the gap between epidemiology and geriatric practice in the InCHIANTI study. J Am Geriatr Soc. 2000;48:1618–1625.
Lopopolo RB, Greco M, Sullivan D, et al. Effect of therapeutic exercise on gait speed in community-dwelling elderly people: a meta-analysis. Phys Ther. 2006;86:520–540.
Vestergaard S, Kronborg C, Puggaard L. Home-based video exercise intervention for community-dwelling frail older women: a randomized controlled trial. Aging Clin Exp Res. 2008;20:479–486.
Gill TM, Allore HG, Hardy SE, et al. The dynamic nature of mobility disability in older persons. J Am Geriatr Soc. 2006;54:248–254.
Gill TM, Baker DI, Gottschalk M, et al. A program to prevent functional decline in physically frail, elderly persons who live at home. N Engl J Med. 2002;347:1068–1074.
Lang IA, Llewellyn DJ, Alexander K, Melzer D. Obesity, physical function, and mortality in older adults. J Am Geriatr Soc. 2008;56:1474–1478.
Villareal DT, Apovian CM, Kushner RF, Klein S. American Society for Nutrition; NAASO, The Obesity Society. Obesity in older adults: technical review and position statement of the American Society for Nutrition and NAASO, The Obesity Society. Am J Clin Nutr. 2005;82:923–934.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Blain, H., Carriere, I., Sourial, N. et al. Balance and walking speed predict subsequent 8-year mortality independently of current and intermediate events in well-functioning women aged 75 years and older. J Nutr Health Aging 14, 595–600 (2010). https://doi.org/10.1007/s12603-010-0111-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12603-010-0111-0