Physical Function Assessment of Older Veterans With Serious Mental Illness

Am J Geriatr Psychiatry. 2023 Sep;31(9):657-666. doi: 10.1016/j.jagp.2023.02.048. Epub 2023 Mar 2.


Objective: To characterize the physical function of older veterans with serious mental illness (SMI) across endurance, strength, and mobility domains.

Design: Retrospective analysis of clinical performance data.

Setting: Gerofit program, a national outpatient supervised exercise program for older veterans, delivered in Veterans Health Administration sites.

Participants: Older veterans aged 60 and older (n = 166 with SMI, n = 1,441 without SMI) enrolled across eight national Gerofit sites between 2010 and 2019.

Measurements: Performance measures of physical function covering endurance (6-minute walk test), strength (chair stands, arm curls), and mobility (10-m walk, 8-foot-up-and-go), were administered at Gerofit enrollment. Baseline data from these measures were analyzed to characterize the functional profiles of older veterans with SMI. One sample t tests were examined to compare functional performance of older veterans with SMI to age- and sex-based reference scores. Propensity score matching (1:3) and linear mixed effects models were used to evaluate differences in function between veterans with and without SMI.

Results: Older veterans with SMI performed worse on all measures of function (chair stands, arm curls, 10-m walk, 6-minute walk test, 8-foot-up-and-go) compared to age- and sex-based reference scores with statistically significant differences present in the male sample. Functional performance of those with SMI was also worse compared to propensity-score matched older veterans without SMI with statistically significant differences on chair stands, 6-minute walk test, and 10-m walk.

Conclusion: Older veterans with SMI have compromised strength, mobility, and endurance. Physical function should be a core component of screening and treatment for this population.

Keywords: Endurance; bipolar disorder; depression; mobility; schizophrenia; strength.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Exercise
  • Humans
  • Male
  • Mental Disorders* / epidemiology
  • Middle Aged
  • Physical Functional Performance
  • Retrospective Studies
  • Veterans*