Physical Performance Measures as Predictors of Mortality in a Cohort of Community-dwelling Older French Women

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Abstract
This prospective cohort study evaluate the predictive value of physical performance measures for mortality in older French women, in particular those with a high health status. The subjects were 7,250 community-dwelling non-disabled French women aged 75 years or older, enrolled in the Epidémiologie de l’ostéoporose (EPIDOS) study. The short physical performance battery (SPPB), including walking speed, repeated chair stands, and balance tests, was administered and handgrip strength was measured. Anthropometric measurements, physical function, cognitive performance, sensory status, smoking, medical history, medication use, subjective self-assessment of health status, and physical activity level were assessed at the baseline visit. During a mean follow-up of 3.8 years, 754 (10.4%) participants died. Complementary analysis was performed on the 2,157 non-disabled healthiest participants (no disease at baseline). The SPPB and handgrip strength distinguished a gradient of risk for mortality from a low to high functional spectrum. Risk of death was 2.04-fold higher in poor (SPPB 0–6) than in good (SPPB 10–12) performers and 1.56-fold higher in participants with lower tertile grip strength. Walking speed alone also distinguished a gradient of mortality risk. After adjustment for confounders, low SPPB, grip strength score and slow walking speed remained significantly associated with death. In the non-disabled healthiest women, no physical performance measure predicted death. In community-dwelling elderly French women, physical performance measures significantly and independently predicted mortality. Increased risk of death was partly explained by baseline health status and was absent in the healthiest elderly.