Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Mar 25;19(1):92.
doi: 10.1186/s12877-019-1092-4.

Relative importance of four functional measures as predictors of 15-year mortality in the older Dutch population

Elisabeth M W Eekhoff  1 , Natasja M van Schoor  2 , Joseph S Biedermann  3 , Mirjam M Oosterwerff  4 , Renate de Jongh  5 , Nathalie Bravenboer  6 , Mireille N M van Poppel  7   8 , Dorly J H Deeg  2
Affiliations

Relative importance of four functional measures as predictors of 15-year mortality in the older Dutch population

Elisabeth M W Eekhoff et al. BMC Geriatr. .

Abstract

Background: Decreased physical function is known to raise mortality risk. Little is known about how different physical function measures compare in predicting mortality risk in older men and women. The objective of this study was to compare four, objective and self-reported, physical function measures in predicting 15-year mortality risk in older men and women.

Methods: Data were used from the Longitudinal Aging Study Amsterdam (LASA), an ongoing cohort study in a population-based sample of the older Dutch population, sampled from municipal records. The 1995-96 cycle, including 727 men and 778 women aged 65-88 years, was considered as the baseline. Mortality was followed up through September 1, 2011. Physical function measures were: lower-body performance (chair stands test, walk test and tandem stand); handgrip strength (grip strength dynamometer); lung function (peak expiratory flow rate); functional limitations (self-report of difficulties in performing six activities of daily living). Cox proportional hazard models were used to determine the predictive value of each physical function measure for 15-year mortality risk, adjusted for demographic, lifestyle and health variables as potential confounders.

Results: 1031 participants (68.5%) had died. After adjustments for confounders, in models assessing single functional measures, peak flow was the strongest predictor of all-cause mortality in men (HR 1.76, CI 1.38-2.26, CI) and lower-body performance in women (HR 1.97,CI 1.40-2.76, CI). In a model including all four functional measures only peak flow was statistically significant in predicting mortality in both genders (men HR 1.54,CI 1.18-2.01 and women HR 1.45,CI 1.08-1.94). In women, lower-body performance (HR 1.66, CI 1.15-2.41) followed by grip strength (HR 1.38, CI 1.02-1.89), and in men, functional limitations (HR 1.43, CI 1.14-1.8) were the other significant predictors of all-cause mortality.

Conclusion: Both objective and self-reported measures of physical functioning predicted all-cause mortality in a representative sample of the older Dutch population to different extents in men and women. Peak flow contributed important unique predictive value for mortality in both men and women. In women, however, lower-body performance tests had better predictive ability. A second-best predictor in men was self-reported functional limitations. Peak flow, and possibly one of the other measures, may be used in clinical practice for assessment in the context of time constraints.

Keywords: Functional limitations; Handgrip strength; LASA; Lower-body performance; Lung function; Mortality.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

The VU University Medical Centre’s Medical Ethics Evaluation Committee approved of the study; archive numbers 92/138 (1992-) and 2002/141 (2002-). A written informed consent was obtained from all participants of this study.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Hazard ratios for mortality of sex-specific tertiles of physical function measures, men. Notes: HR = Hazard Ratio; Lower body = Lower body performance; Grip = Grip strength; Peak flow = Peak expiratory flow; Func lims = Functional limitations; Separate model = Separately for each test; Combined model = Contribution if all four tests combined
Fig. 2
Fig. 2
Hazard ratios for mortality of sex-specific tertiles of physical function measures, women. Notes: HR = Hazard Ratio; Lower body = Lower body performance; Grip = Grip strength; Peak flow = Peak expiratory flow; Func lims = Functional limitations; Separate model = Separately for each test; Combined model = Contribution if all four tests combined
See this image and copyright information in PMC

References

    1. Cesari M, Onder G, Zamboni V, Manini T, Shorr RI, Russo A, Bernabei R, Pahor M, Landi F. Physical function and self-rated health status as predictors of mortality: results from longitudinal analysis in the ilSIRENTE study. BMC Geriatr. 2008;8:34. doi: 10.1186/1471-2318-8-34. - DOI - PMC - PubMed
    1. Markides KS, Black SA, Ostir GV, Angel RJ, Guralnik JM, Lichtenstein M. Lower body function and mortality in Mexican American elderly people. J Gerontol A Biol Sci Med Sci. 2001;56(4):M243–M247. doi: 10.1093/gerona/56.4.M243. - DOI - PubMed
    1. Cesari M, Kritchevsky SB, Newman AB, Simonsick EM, Harris TB, Penninx BW, Brach JS, Tylavsky FA, Satterfield S, Bauer DC, et al. Added value of physical performance measures in predicting adverse health-related events: results from the health, aging and body composition study. J Am Geriatr Soc. 2009;57(2):251–259. doi: 10.1111/j.1532-5415.2008.02126.x. - DOI - PMC - PubMed
    1. Rolland Y, Lauwers-Cances V, Cesari M, Vellas B, Pahor M, Grandjean H. Physical performance measures as predictors of mortality in a cohort of community-dwelling older French women. Eur J Epidemiol. 2006;21(2):113–122. doi: 10.1007/s10654-005-5458-x. - DOI - PubMed
    1. Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, Scherr PA, Wallace RB. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994;49(2):M85–M94. doi: 10.1093/geronj/49.2.M85. - DOI - PubMed

Publication types

LinkOut - more resources