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

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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.

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body mass index


confidence interval


chronic obstructive pulmonary disease


dual-energy X-ray absorptiometry


established populations for epidemiological studies in the elderly


Epidémiologie de l’ostéoporose


hazards ratios


instrumental activities of daily living


standard deviations


short physical performance battery


  1. JM Guralnik L Ferrucci CF Pieper SG Leveille KS Markides GV Ostir S Studenski LF Berkman RB Wallace (2000) ArticleTitleLower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery J Gerontol A Biol Sci Med Sci 55 M221–M231 Occurrence Handle1:STN:280:DC%2BD3c3mvFaruw%3D%3D Occurrence Handle10811152

    CAS  PubMed  Google Scholar 

  2. L Ferrucci BW Penninx SG Leveille MC Corti M Pahor R Wallace TB Harris RJ Havlik JM Guralnik (2000) ArticleTitleCharacteristics of nondisabled older persons who perform poorly in objective tests of lower extremity function J Am Geriatr Soc 48 1102–1110 Occurrence Handle1:STN:280:DC%2BD3cvjslKmtw%3D%3D Occurrence Handle10983911

    CAS  PubMed  Google Scholar 

  3. BW Penninx L Ferrucci SG Leveille T Rantanen M Pahor JM Guralnik (2000) ArticleTitleLower extremity performance in nondisabled older persons as a predictor of subsequent hospitalization J Gerontol A Biol Sci Med Sci 55 M691–M697 Occurrence Handle1:STN:280:DC%2BD3M%2Fjs1ymuw%3D%3D Occurrence Handle11078100

    CAS  PubMed  Google Scholar 

  4. JM Guralnik L Ferrucci EM Simonsick ME Salive RB Wallace (1995) ArticleTitleLower-extremity function in persons over the age of 70 years as a predictor of subsequent disability N Engl J Med. 332 556–561 Occurrence Handle10.1056/NEJM199503023320902 Occurrence Handle1:STN:280:ByqC2c%2Fgs1U%3D Occurrence Handle7838189

    Article  CAS  PubMed  Google Scholar 

  5. JM Guralnik EM Simonsick L Ferrucci RJ Glynn LF Berkman DG Blazer PA Scherr RB Wallace (1994) ArticleTitleA short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission J Gerontol. 49 M85–94 Occurrence Handle1:STN:280:ByuC2s3itFE%3D Occurrence Handle8126356

    CAS  PubMed  Google Scholar 

  6. JM Guralnik TE Seeman ME Tinetti MC Nevitt LF Berkman (1994) ArticleTitleValidation and use of performance measures of functioning in a non-disabled older population: MacArthur studies of successful aging Aging (Milano) 6 410–419 Occurrence Handle1:STN:280:ByqB28jot1A%3D

    CAS  Google Scholar 

  7. T Rantanen (2003) ArticleTitleMuscle strength, disability and mortality Scand J Med Sci Sports 13 3–8 Occurrence Handle10.1034/j.1600-0838.2003.00298.x Occurrence Handle1:STN:280:DC%2BD3s%2FivFSjtw%3D%3D Occurrence Handle12535311

    Article  CAS  PubMed  Google Scholar 

  8. T Rantanen T Harris SG Leveille M Visser D Foley K Masaki JM Guralnik (2000) ArticleTitleMuscle strength and body mass index as long-term predictors of mortality in initially healthy men J Gerontol A Biol Sci Med Sci 55 M168–M173 Occurrence Handle1:STN:280:DC%2BD3c3lsVOnug%3D%3D Occurrence Handle10795731

    CAS  PubMed  Google Scholar 

  9. S Giampaoli L Ferrucci F Cecchi C Lo Noce A Poce F Dima A Santaquilani MF Vescio A Menotti (1999) ArticleTitleHand-grip strength predicts incident disability in non-disabled older men Age Ageing 28 283–288 Occurrence Handle10.1093/ageing/28.3.283 Occurrence Handle1:STN:280:DyaK1MzhsVyltw%3D%3D Occurrence Handle10475865

    Article  CAS  PubMed  Google Scholar 

  10. T Rantanen JM Guralnik D Foley K Masaki S Leveille JD Curb L White (1999) ArticleTitleMidlife hand grip strength as a predictor of old age disability J Am Med Assoc 281 558–560 Occurrence Handle10.1001/jama.281.6.558 Occurrence Handle1:STN:280:DyaK1M7ksVOisw%3D%3D

    Article  CAS  Google Scholar 

  11. ME Williams SA Gaylord MS Gerritty (1994) ArticleTitleThe Timed Manual Performance test as a predictor of hospitalization and death in a community-based elderly population J Am Geriatr Soc 42 21–27 Occurrence Handle1:STN:280:ByuC3czls10%3D Occurrence Handle8277110

    CAS  PubMed  Google Scholar 

  12. J Woo SC Ho AL Yu (1999) ArticleTitleWalking speed and stride length predicts 36 months dependency, mortality, and institutionalization in Chinese aged 70 and older J Am Geriatr Soc 47 1257–1260 Occurrence Handle1:STN:280:DyaK1MvltVOqtQ%3D%3D Occurrence Handle10522962

    CAS  PubMed  Google Scholar 

  13. Y Fujita Y Nakamura J Hiraoka K Kobayashi K Sakata M Nagai H Yanagawa (1995) ArticleTitlePhysical-strength tests and mortality among visitors to health-promotion centers in Japan J Clin Epidemiol 48 1349–1359 Occurrence Handle10.1016/0895-4356(95)00533-1 Occurrence Handle1:STN:280:BymD1MrgslM%3D Occurrence Handle7490598

    Article  CAS  PubMed  Google Scholar 

  14. P Phillips (1986) ArticleTitleGrip strength, mental performance and nutritional status as indicators of mortality risk among female geriatric patients Age Ageing 15 53–56 Occurrence Handle1:STN:280:BimC2Mrhs1Q%3D Occurrence Handle3953331

    CAS  PubMed  Google Scholar 

  15. T Rantanen S Volpato L Ferrucci E Heikkinen LP Fried JM Guralnik (2003) ArticleTitleHand grip strength and cause-specific and total mortality in older disabled women: exploring the mechanism J Am Geriatr Soc 51 636–641 Occurrence Handle10.1034/j.1600-0579.2003.00207.x Occurrence Handle12752838

    Article  PubMed  Google Scholar 

  16. EJ Metter LA Talbot M Schrager RA Conwit (2002) ArticleTitleSkeletal muscle strength as a predictor of all-cause mortality in healthy men J Gerontol A Biol Sci Med Sci 57 B359–B365 Occurrence Handle12242311

    PubMed  Google Scholar 

  17. P Laukkanen E Heikkinen M Kauppinen (1995) ArticleTitleMuscle strength and mobility as predictors of survival in 75–84-year-old people Age Ageing 24 468–473 Occurrence Handle1:STN:280:BymC287jtFI%3D Occurrence Handle8588534

    CAS  PubMed  Google Scholar 

  18. P Dargent-Molina F Favier H Grandjean C Baudoin AM Schott E Hausherr PJ Meunier G Breart (1996) ArticleTitleFall-related factors and risk of hip fracture: the EPIDOS prospective study Lancet 348 145–149 Occurrence Handle1:STN:280:BymB1MrivFA%3D Occurrence Handle8684153

    CAS  PubMed  Google Scholar 

  19. JM Guralnik L Ferrucci BW Penninx JD Kasper SG Leveille K Bandeen-Roche LP Fried (1999) ArticleTitleNew and worsening conditions and change in physical and cognitive performance during weekly evaluations over 6 months: the Women’s Health and Aging Study J Gerontol A Biol Sci Med.Sci 54 M410–M422 Occurrence Handle1:STN:280:DyaK1MvisVyltA%3D%3D Occurrence Handle10496547

    CAS  PubMed  Google Scholar 

  20. GV Ostir S Volpato LP Fried P Chaves JM Guralnik (2002) ArticleTitleReliability and sensitivity to change assessed for a summary measure of lower body function: results from the Women’s Health and Aging Study J Clin Epidemiol 55 916–921 Occurrence Handle10.1016/S0895-4356(02)00436-5 Occurrence Handle12393080

    Article  PubMed  Google Scholar 

  21. E Pfeiffer (1975) ArticleTitleA short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients J Am Geriatr Soc 23 433–441 Occurrence Handle1:STN:280:CSmD3cnktFY%3D Occurrence Handle1159263

    CAS  PubMed  Google Scholar 

  22. TG Lohman AF Roche R Martorell (Eds) (1988) Anthropometric Standardization Reference Manual Human Kinetics, Inc. Champaign IL

    Google Scholar 

  23. InstitutionalAuthorNameWriting Group for the ISCD Position Development Conference (2004) ArticleTitleDiagnostic of osteoporosis in men, premenopausal women and children J Clin Densitom 7 17–26

    Google Scholar 

  24. MP Lawton EM Brody (1969) ArticleTitleAssessment of older people: self-maintaining and instrumental activities of daily living Gerontologist 9 179–186 Occurrence Handle1:STN:280:CS%2BD38fpslw%3D Occurrence Handle5349366

    CAS  PubMed  Google Scholar 

  25. S Al Snih KS Markides L Ray GV Ostir JS. Goodwin (2002) ArticleTitleHandgrip strength and mortality in older Mexican Americans J Am Geriatr Soc 50 1250–1256 Occurrence Handle10.1046/j.1532-5415.2002.50312.x Occurrence Handle12133020

    Article  PubMed  Google Scholar 

  26. C Rostagno G Olivo M Comeglio V Boddi M Banchelli G Galanti GF Gensini (2003) ArticleTitlePrognostic value of 6-minute walk corridor test in patients with mild to moderate heart failure: comparison with other methods of functional evaluation Eur J Heart Fail 5 247–252 Occurrence Handle12798821

    PubMed  Google Scholar 

  27. S Studenski S Perera D Wallace JM Chandler PW Duncan E Rooney M Fox JM Guralnik (1998) ArticleTitleGait speed as a clinical vital sign J Am Geriatr Soc 46 S59

    Google Scholar 

  28. P Bettencourt A Ferreira P Dias J Pimenta F Frioes L Martins M Cerqueira-Gomes (2000) ArticleTitlePredictors of prognosis in patients with stable mild to moderate heart failure J Card Fail 6 306–313 Occurrence Handle1:STN:280:DC%2BD3M7ltlKkug%3D%3D Occurrence Handle11145755

    CAS  PubMed  Google Scholar 

  29. JB Bowen JJ Votto RS Thrall MC Haggerty R Stockdale-Woolley T Bandyopadhyay RL ZuWallack (2000) ArticleTitleFunctional status and survival following pulmonary rehabilitation Chest 118 697–703 Occurrence Handle10.1378/chest.118.3.697 Occurrence Handle1:STN:280:DC%2BD3cvktlGrsQ%3D%3D Occurrence Handle10988191

    Article  CAS  PubMed  Google Scholar 

  30. D Carmelli M Kelly-Hayes PA Wolf GE Swan LM Jack T Reed JM Guralnik (2000) ArticleTitleThe contribution of genetic influences to measures of lower-extremity function in older male twins J Gerontol A Biol Sci Med Sci 55 B49–B53 Occurrence Handle1:STN:280:DC%2BD3c7ot1KrsA%3D%3D Occurrence Handle10719763

    CAS  PubMed  Google Scholar 

  31. YM Rolland M Cesari ME Miller BW Penninx HH Atkinson M Pahor (2004) ArticleTitleReliability of the 400-m usual-pace walk test as an assessment of the mobility limitation in older adults J Am Geriatr Soc 52 972–976 Occurrence Handle10.1111/j.1532-5415.2004.52267.x Occurrence Handle15161464

    Article  PubMed  Google Scholar 

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Correspondence to Yves Rolland.

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Rolland, Y., Lauwers-Cances, V., Cesari, M. et al. Physical Performance Measures as Predictors of Mortality in a Cohort of Community-dwelling Older French Women. Eur J Epidemiol 21, 113–122 (2006).

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