title: Predicting late-life disability and death by the rate of decline in physical performance measures.
abstract: BACKGROUND
  the rate of performance decline may influence the risk of disability or death.
  
  
  METHODS
  for 4,182 Cardiovascular Health Study participants, we used multinomial Poisson log-linear models to assess the contribution of physical performance in 1998-99, and the rate of performance change between 1992-93 and 1998-99, to the risk of death or disability in 2005-06 in three domains: mobility, upper-extremity function (UEF) and activities of daily living (ADL). We evaluated performance in finger-tapping, grip strength, stride length, gait speed and chair stands separately and together for each outcome, adjusting for age, gender, race and years of disability in that outcome between 1992-93 and 1998-99.
  
  
  RESULTS
  participants' age averaged 79.4 in 1998-99; 1,901 died over 7 years. Compared with the lowest change quintile in stride length, the highest quintile had a 1.32 relative risk (RR) of ADL disability (95% CI: 1.16 -1.96) and a 1.27 RR of death (95% CI: 1.07 -1.51). The highest change quintile for grip strength increased the risk of ADL disability by 35% (95% CI: 1.13 -1.61) and death by 31% (95% CI: 1.16 -1.49), compared with the lowest quintile. The annual change in stride length and grip strength also predicted disability in mobility and UEF.
  
  
  CONCLUSIONS
  performance trajectories independently predict death and disability.
authors.affiliation: Division of General Medicine, University of California, Davis Medical Center, 4150 V Street PSSB Suite 2400, Sacramento, CA 95817, USA. chhirsch@ucdavis.edu
authors.forename: Calvin Hayes
authors.initials: CH
authors.lastname: Hirsch
authors.forename: Petra
authors.initials: P
authors.lastname: Buzková
authors.forename: John A
authors.initials: JA
authors.lastname: Robbins
authors.forename: Kushang V
authors.initials: KV
authors.lastname: Patel
authors.forename: Anne B
authors.initials: AB
authors.lastname: Newman
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D005260:Female; D015577:Geriatric Assessment / Q000706:statistics & numerical data; D018737:Hand Strength; D006306:Health Surveys; D006801:Humans; D016014:Linear Models; D008297:Male; D051346:Mobility Limitation; D009026:Mortality; D009048:Motor Skills; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D034941:Upper Extremity / Q000503:physiopathology*; D016138:Walking