Comorbidity and physical function: results from the aging and longevity study in the Sirente geographic area (ilSIRENTE study).
BACKGROUND
Physical function measures have gained increased importance in the evaluation of older persons. The presence of comorbidity is a major and growing issue in geriatrics.


OBJECTIVE
To evaluate the relationship between comorbidity and physical function in community-dwelling older persons.


METHODS
Data are from baseline evaluation of the ilSIRENTE study (n = 364). Physical performance was assessed using the Short Physical Performance Battery (SPPB) and the 4-meter walking test. Muscle strength was measured by hand-grip strength. Functional performance was assessed using Basic and Instrumental Activities of Daily Living (ADLs and IADLs, respectively). Comorbidity was defined as >or=3 clinical conditions. Analyses of covariance and linear regressions were performed to evaluate the relationship between comorbidity and physical function.


RESULTS
The mean age of participants was 85.9 (SD = 4.9) years. About one third (37.4%) of participants reported >or=3 clinical conditions. Participants with comorbidity had significantly worse results in all the physical function tests. Participants with comorbidity had significantly lower adjusted results for the 4-meter walking test (0.444 m/s) and the SPPB score (6.131) compared to those without comorbidity (0.531 m/s and 7.221; all p = 0.001, respectively). Participants with comorbidity were more IADL-impaired (3.152) than participants without comorbidity (2.767; p = 0.04). No significant association of ADLs and hand-grip strength with comorbidity was reported. Similar strengths of association for the 4-meter walking test (per SD increase, beta = -0.280; p = 0.001) and the SPPB (per SD increase, beta = -0.285; p = 0.001) with comorbidity were reported.


CONCLUSIONS
Physical function measures, especially walking speed and SPPB, are associated with comorbidity. Physical performance measures may improve the clinical evaluation of older persons.
Cesari
Matteo
M
Department of Gerontology, Geriatrics and Physiatry, Catholic University of Sacred Heart, Rome, Italy. mcesari@aging.ufl.edu
Onder
Graziano
G
Russo
Andrea
A
Zamboni
Valentina
V
Barillaro
Christian
C
Ferrucci
Luigi
L
Pahor
Marco
M
Bernabei
Roberto
R
Landi
Francesco
F
D000203:Activities of Daily Living; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D002561:Cerebrovascular Disorders / Q000453:epidemiology; D002908:Chronic Disease; D015897:Comorbidity; D003704:Dementia / Q000453:epidemiology; D003866:Depressive Disorder / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D015577:Geriatric Assessment; D018737:Hand Strength / Q000502:physiology; D006304:Health Status; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008136:Longevity; D008297:Male; D008403:Mass Screening; D010300:Parkinson Disease / Q000453:epidemiology; D011446:Prospective Studies; D016138:Walking / Q000502:physiology