Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Japan.
Institute of Gerontology, The University of Tokyo, Japan.
J Gerontol A Biol Sci Med Sci. 2016 Nov;71(11):1492-1499. doi: 10.1093/gerona/glw029. Epub 2016 Mar 1.
Physical performance measures (PPMs) are good predictors of adverse health outcomes in later life. This prospective study used repeated measures analysis to examine sex-specific age trends in PPMs, identify potential PPM trajectory patterns, and determine whether PPM trajectory patterns were associated with all-cause mortality among older Japanese.
Among 1,524 adults aged 65 years or older who participated in a baseline survey, 1,048 adults (mean [SD] age, 71.6 [5.4] years; women, 57.0%) were followed up at least once. The total number of observations was 4,747, and the average number of follow-up assessments was 4.5 during the period from 2002 through 2011. The PPMs studied were handgrip strength, usual gait speed, and one-leg standing time. We checked local registries to identify deaths from any cause; 89 (8.5%) participants died during follow-up.
All PPMs significantly decreased with advancing age, and handgrip strength and usual gait speed showed sex-specific age trends. We identified three distinct trajectory patterns (high, middle, and low trajectory groups) for each PPM in adults aged 65-90 years, and the trajectories for handgrip strength and usual gait speed showed parallel declines in men and women, respectively. After adjusting for important confounders, the trajectory groups for handgrip strength and one-leg standing time were independent predictors of all-cause mortality.
Regardless of baseline level, the PPMs tended to show similar age-related changes in later life. However, individuals in low PPM trajectory groups had a higher mortality risk, which highlights the importance of interventions that maintain or improve physical performance, even among older adults with low physical performance.
身体机能测量指标（PPMs）是预测晚年不良健康结局的良好指标。本前瞻性研究采用重复测量分析，考察了 PPMs 在性别特异性年龄趋势，确定潜在的 PPM 轨迹模式，并确定 PPM 轨迹模式是否与老年日本人群的全因死亡率相关。
在参加基线调查的 1524 名 65 岁或以上的成年人中，有 1048 名成年人（平均[SD]年龄，71.6[5.4]岁；女性，57.0%）至少随访一次。从 2002 年到 2011 年期间，总观察数为 4747 次，平均随访评估次数为 4.5 次。研究的 PPMs 为握力、惯用步态速度和单腿站立时间。我们检查了当地的登记册以确定任何原因导致的死亡情况；在随访期间，有 89 名（8.5%）参与者死亡。
所有 PPMs 随年龄增长而显著下降，握力和惯用步态速度显示出性别特异性的年龄趋势。我们在 65-90 岁的成年人中为每个 PPM 确定了三个不同的轨迹模式（高、中、低轨迹组），握力和惯用步态速度的轨迹在男性和女性中分别呈平行下降。在调整了重要混杂因素后，握力和单腿站立时间的轨迹组是全因死亡率的独立预测因素。
无论基线水平如何，PPMs 在以后的生活中往往表现出相似的与年龄相关的变化。然而，处于低 PPM 轨迹组的个体的死亡率风险更高，这强调了维持或改善身体机能的干预措施的重要性，即使是在身体机能较低的老年人群中也是如此。
