Faster decline of physical performance in older adults with higher levels of baseline locomotive function

Aim: The purpose of this longitudinal study was to determine whether the rate of decline in community-dwelling older adults varies according to baseline locomotive function levels. Methods: This longitudinal study was conducted in community-dwelling older adults in Kyoto, Japan. In addition to information about falls, physical performance was assessed using a series of tests, including 10-m walking time, timed up and go (TUG) test, functional reach, one-leg stand test, and five chair stand test. The outcomes for each patient were measured once in 2009 and then followed up 1 year later. The change in physical performance was then determined. We divided the participants into tertiles (T1, T2, and T3) according to timed up and go test results, and the differences among the three groups were compared. Results: Of the 252 individuals who were enrolled in the study, 231 (91.6%) completed the 12-month follow-up: 77 in the T1 group; 78 in the T2 group; and 76 in the T3 group. The T1 group showed a significantly larger decrease than the T2 and T3 groups in the 10-m walking time and TUG tests (P < 0.05). However, there were no significant differences in functional reach, one-leg standing test, or five chair stand test among the three groups. In the T1 group, the number of falls and elderly who had developed fear of falling increased during the study period. Conclusions: This study demonstrated that elderly with the highest baseline performances were more likely to show a greater decline in locomotive performance than the other groups. Further study is required to elucidate the mechanism of faster physical functional decline in robust elderly. Geriatr Gerontol Int 2012; 12: 238-246.