Characteristics of nondisabled older persons who perform poorly in objective tests of lower extremity function

J Am Geriatr Soc. 2000 Sep;48(9):1102-10. doi: 10.1111/j.1532-5415.2000.tb04787.x.


Objectives: It has been suggested that nondisabled older persons with poor performance of lower extremity function are ideal targets for interventions of disability prevention. However, health-related factors associated with poor performance are largely unknown. Using data from a representative sample of nondisabled older persons, this study identifies the diseases and biological markers that characterize this group of the population.

Design and participants: A total of 3,381 persons aged 71 or older, interviewed and administered a battery of physical performance tests at the sixth annual follow-up of the Established Populations for Epidemiologic Studies of the Elderly (EPESE), who reported no need for help in walking 1/4 mile or climbing stairs.

Measurements: Lower extremity performance was measured using a short battery of tests including assessment of standing balance, a timed 2.4-m walk, and timed test of rising 5 times from a chair. Chronic conditions were ascertained as self-report of a physician diagnosis. Data on previous hospitalizations were obtained from the Medicare database. Nonfasting blood samples were obtained and processed with standard methods.

Results: In a multivariate analysis, older age, female gender, higher BMI, history of hip fracture and diabetes, one or more hospital admissions for acute infection in the last 3 years, lower levels of hemoglobin and albumin, and higher leukocytes and gamma-glutamyl transferase were all associated independently with poor performance.

Conclusions: Screening for older patients who are not disabled but have poor lower extremity performance selects a subgroup of the population with a high percentage of women, high prevalence of diabetes and hip fracture, and high levels of biological markers of inflammation. This group represents about 10% of the US population 70 to 90 years old. These findings should be considered in planning specifically tailored interventions for disability prevention in this subgroup.

MeSH terms

  • Activities of Daily Living*
  • Aged
  • Aged, 80 and over
  • Biomarkers
  • Boston
  • Chronic Disease
  • Connecticut
  • Disabled Persons
  • Female
  • Follow-Up Studies
  • Geriatric Assessment*
  • Hemoglobins / analysis
  • Humans
  • Iowa
  • Leg / physiopathology*
  • Leukocyte Count
  • Male
  • Mass Screening / methods
  • Multivariate Analysis
  • Patient Admission / statistics & numerical data
  • Predictive Value of Tests
  • Serum Albumin / analysis
  • Walking
  • gamma-Glutamyltransferase / blood


  • Biomarkers
  • Hemoglobins
  • Serum Albumin
  • gamma-Glutamyltransferase