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Correlates of Decline in Lower Extremity Performance in Older Women: A 10-Year Follow-Up Study

¹ Department of Health and Safety, Slippery Rock University of Pennsylvania.
² Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania.

Address correspondence to Kimberly Y. Z. Forrest, PhD, Department of Health and Safety, Slippery Rock University of Pennsylvania, Slippery Rock, PA 16057. E-mail: kimberly.forrest{at}sru.edu

Background. Decline in lower extremity performance increases the risk of functional disability. This study examined the correlates of decline in lower extremity performance in older women.

Methods. A total of 5178 women aged 65–91 years were recruited from population-based listings from four centers in the United States. Clinical examinations were performed and lifestyle information was obtained at baseline and 10 years later. Lower extremity performance was measured by walking speed (meters/second) and time (seconds) to complete five chair-stands. Changes were calculated by subtracting baseline values from follow-up values.

Results. During the 10-year follow-up period, walking speed declined 17% and time to complete five chair-stands increased 22% (p <.0001). The decline in performance during the follow-up increased with baseline age: women aged 65–69 years experienced an 11% decline in walking speed and a 16% increase in the time to complete five chair-stands, while women aged 80 years or older experienced a 37% decline in walking speed and a 38% increase in chair-stand time. After adjusting for age, baseline physical performance, greater weight, greater height loss, smoking, history of arthritis and diabetes, and use of thyroid and estrogen medications were independently related to greater declines in lower extremity performance.

Conclusions. Lower extremity performance decreased dramatically with advancing age in older women. Effective management of common diseases, such as arthritis and diabetes, and a healthy lifestyle, including avoidance of smoking and weight control, could help older women maintain their lower extremity physical functions.

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