title: Objective measures of physical capability and subsequent health: a systematic review.
abstract: BACKGROUND
  measures of physical capability may be predictive of subsequent health, but existing published studies have not been systematically reviewed. We hypothesised that weaker grip strength, slower walking speed and chair rising and shorter standing balance time, in community-dwelling populations, would be associated with higher subsequent risk of fracture, cognitive outcomes, cardiovascular disease, hospitalisation and institutionalisation.
  
  
  METHODS
  studies were identified through systematic searches of the electronic databases MEDLINE and EMBASE (to May 2009). Reference lists of eligible papers were also manually searched.
  
  
  RESULTS
  twenty-four papers had examined the associations between at least one physical capability measure and one of the outcomes. As the physical capability measures and outcomes had been assessed and categorised in different ways in different studies, and there were differences in the potential confounding factors taken into account, this made it impossible to pool results. There were more studies examining fractures than other outcomes, and grip strength and walking speed were the most commonly examined capability measures. Most studies found that weaker grip strength and slower walking speed were associated with increased risk of future fractures and cognitive decline, but residual confounding may explain results in some studies. Associations between physical capability levels and the other specified outcomes have not been tested widely.
  
  
  CONCLUSIONS
  there is some evidence to suggest that objective measures of physical capability may be predictors of subsequent health in older community-dwelling populations. Most hypothesised associations have not been studied sufficiently to draw definitive conclusions suggesting the need for further research.
authors.affiliation: MRC Unit for Lifelong Health and Ageing, Division of Population Health, University College London, London, UK. r.cooper@nshd.mrc.ac.uk
authors.forename: Rachel
authors.initials: R
authors.lastname: Cooper
authors.forename: Diana
authors.initials: D
authors.lastname: Kuh
authors.forename: Cyrus
authors.initials: C
authors.lastname: Cooper
authors.forename: Catharine R
authors.initials: CR
authors.lastname: Gale
authors.forename: Debbie A
authors.initials: DA
authors.lastname: Lawlor
authors.forename: Fiona
authors.initials: F
authors.lastname: Matthews
authors.forename: Rebecca
authors.initials: R
authors.lastname: Hardy
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology; D003072:Cognition Disorders / Q000453:epidemiology; D005260:Female; D018737:Hand Strength / Q000502:physiology; D006304:Health Status; D006801:Humans; D008297:Male; D010809:Physical Fitness / Q000502:physiology*; D012307:Risk Factors; D016138:Walking / Q000502:physiology