Effect of calendar age on physical performance: A comparison of standard clinical measures with instrumented measures in middle-aged to older adults
Introduction
Decline in physical performance is highly prevalent during aging leading to loss of independence and a poorer quality of life [1]. Furthermore, older adults with impaired physical performance have a high risk of falls, further reducing the quality of life and placing a heavy economic burden on society [2]. Identification of sensitive markers of age-related changes in physical performance is of utmost importance for the early detection, development of therapeutic strategies and insight into underlying mechanisms.
Assessment of physical performance is part of the comprehensive geriatric assessment (CGA) in clinical practice. Important clinical measures of physical performance commonly include walking speed and the duration of repeated sit-to-stand movements, assessed by the chair stand test (CST) [3], [4]. Walking speed is an important indicator of health status and function by reflecting the interaction of several underlying systems, such as the central and peripheral nervous, sensory, muscular, skeletal, and cardiopulmonary system [5], [6]. Sit-to-stand movements are one of the most mechanically demanding functional tasks during daily activities [7]. Furthermore, the CST is an important indicator for the performance of other daily activities, like climbing stairs, by measuring lower body strength [8].
Standard clinical measures of physical performance, using simply total time as the outcome, provide a common output representing a combination of possible underlying mechanisms. Based on previous studies showing the association of calendar age with various instrumented measures of physical performance and their use in the early identification and prediction of pathology [9], [10], [11], instrumented measures might be sensitive markers of age-related changes in physical performance providing possible insights into underlying determinants. Therefore, we assessed the association of calendar age with standard clinical and instrumented measures of the 25-meter walk and CST in a study population of offspring of nonagenarian siblings together with their partners. We used this study population of middle-aged to older adults to be able to assess changes in physical performance that are already observable from middle age in the absence of overt diseases. Additionally, we compared both measures between the offspring of nonagenarian siblings, who are enriched for familial factors of longevity, and their partners to assess the sensitivity for familial longevity representing the biological age of the participants, i.e. the person's rate of aging compared to their calendar age.
Section snippets
Leiden Longevity Study
The Leiden Longevity Study is a longitudinal cohort consisting of 421 families of long-lived Caucasian siblings of Dutch descent [12]. Families were recruited if at least two long-lived siblings were alive and met the age criteria of ≥89 years for males and ≥91 years for females. Additionally, the offspring of these long-lived families were included together with their partners as controls being of comparable age and sharing the same socioeconomic and geographical background. Enrolment took
Results
The characteristics of the participants are shown in Table 1 together with the characteristics stratified for offspring and partners. Mean age (SD) of all participants was 65.3 (6.7) years. Offspring and partners had similar calendar age, years of education and measures of anthropometrics. The prevalence of age-related diseases, like diabetes mellitus and hypertension, was lower among offspring compared to their partners. In Fig. 2, the 25-meter walking speed and duration of the CST for all
Discussion
In this study population of middle-aged to older adults, physical performance assessed with the 25-meter walk and CST was lower at higher calendar age. The effect size for the standard clinical measures dependent on calendar age was similar to those of instrumented measures assessed with a body fixed sensor at the lower back. No statistically significant association was found between familial longevity and both standard clinical and instrumented measures of physical performance, comparing
Conflict of interest
None to declare for all authors.
Acknowledgements
This work was supported by a grant from the Netherlands Organization for Scientific Research (ZonMw), the Ministry of Health, Welfare and Sports, the Netherlands Genomics Initiative/Netherlands Organization for Scientific Research (NGI/NWO; 05040202 and 050-060-810 Netherlands Consortium for Healthy Aging (NCHA)) and the seventh framework program MYOAGE (HEALTH-2007-2.4.5-10).
References (29)
- et al.
Mechanics of a constrained chair-rise
J Biomech
(1991) - et al.
Gait patterns in a community-dwelling population aged 50 years and older
Gait Posture
(2013) - et al.
Automated approach for quantifying the repeated sit-to-stand using one body fixed sensor in young and older adults
Gait Posture
(2013) - et al.
Consistency of gait characteristics as determined from acceleration data collected at different trunk locations
Gait Posture
(2014) - et al.
Gait variability and stability measures: minimum number of strides and within-session reliability
Comput Biol Med
(2014) - et al.
Gait and cognition: the relationship between gait stability and variability with executive function in persons with and without dementia
Gait Posture
(2012) - et al.
Acceleration patterns of the head and pelvis when walking on level and irregular surfaces
Gait Posture
(2003) - et al.
Evaluation of age-related differences in the stride-to-stride fluctuations, regularity and symmetry of gait using a waist-mounted tri-axial accelerometer
Gait Posture
(2014) - et al.
Gait variability and fall risk in community-living older adults: a 1-year prospective study
Arch Phys Med Rehabil
(2001) - et al.
Functional performance in community living older adults
J Geriatr Phys Ther
(2003)
Falls in old age: a study of frequency and related clinical factors
Age Ageing
Gait speed as a measure in geriatric assessment in clinical settings: a systematic review
J Gerontol A Biol Sci Med Sci
A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission
J Gerontol
White paper: “walking speed: the sixth vital sign”
J Geriatr Phys Ther
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Assessment of health status by molecular measures in adults ranging from middle-aged to old: Ready for clinical use?
2017, Experimental GerontologyCitation Excerpt :Subjects were recruited from July 2002 to May 2006. Over several years (November 2006 to May 2008, and September 2009 to December 2010) data on functional capacity and molecular measures were acquired from these participants, many of which have been published previously (Stijntjes et al., 2015; Stijntjes et al., 2013; Ling et al., 2012; Waaijer et al., 2012; Derhovanessian et al., 2010). The study was approved by the Medical Ethics Committee of Leiden University Medical Center and all participants gave their informed consent.