BACKGROUND: Gender-specific trajectories of lower extremity function (LEF) and the potential for bias in LEF estimation due to differences in survival have been understudied. METHODS: We evaluated longitudinal data from 690 initially nondisabled adults age 70 or older from the Precipitating Events Project. LEF was assessed every 18 months for 12 years using a modified Short Physical Performance Battery (mSPPB). Hierarchical linear models with adjustments for length-of-survival estimated the intraindividual trajectory of LEF and differences in trajectory intercept and slope between men and women. RESULTS: LEF declined following a nonlinear trajectory. In the full sample, and among participants with high (mSPPB 10-12) and intermediate (mSPPB 7-9) baseline LEF, the rate-of-decline in mSPPB was slower in women than in men, with no gender differences in baseline mSPPB scores. Among participants with low baseline LEF (mSPPB ≤6), men had a higher starting mSPPB score, whereas women experienced a deceleration in the rate-of-decline over time. In all groups, participants who survived longer had higher starting mSPPB scores and slower rates-of-decline compared with those who died sooner. CONCLUSIONS: Over the course of 12 years, older women preserve LEF better than men. Nonadjustment for differences in survival results in overestimating the level and underestimating the rate-of-decline in LEF over time.
BACKGROUND: Gender-specific trajectories of lower extremity function (LEF) and the potential for bias in LEF estimation due to differences in survival have been understudied. METHODS: We evaluated longitudinal data from 690 initially nondisabled adults age 70 or older from the Precipitating Events Project. LEF was assessed every 18 months for 12 years using a modified Short Physical Performance Battery (mSPPB). Hierarchical linear models with adjustments for length-of-survival estimated the intraindividual trajectory of LEF and differences in trajectory intercept and slope between men and women. RESULTS: LEF declined following a nonlinear trajectory. In the full sample, and among participants with high (mSPPB 10-12) and intermediate (mSPPB 7-9) baseline LEF, the rate-of-decline in mSPPB was slower in women than in men, with no gender differences in baseline mSPPB scores. Among participants with low baseline LEF (mSPPB ≤6), men had a higher starting mSPPB score, whereas women experienced a deceleration in the rate-of-decline over time. In all groups, participants who survived longer had higher starting mSPPB scores and slower rates-of-decline compared with those who died sooner. CONCLUSIONS: Over the course of 12 years, older women preserve LEF better than men. Nonadjustment for differences in survival results in overestimating the level and underestimating the rate-of-decline in LEF over time.
Authors: Graziano Onder; Brenda W J H Penninx; Pablo Lapuerta; Linda P Fried; Glenn V Ostir; Jack M Guralnik; Marco Pahor Journal: J Gerontol A Biol Sci Med Sci Date: 2002-05 Impact factor: 6.053
Authors: Fredric D Wolinsky; Padmaja Ayyagari; Theodore K Malmstrom; J Phillip Miller; Elena M Andresen; Mario Schootman; Douglas K Miller Journal: J Gerontol A Biol Sci Med Sci Date: 2013-12-13 Impact factor: 6.053
Authors: Daniel K Leibel; Megan R Williams; Leslie I Katzel; Michele K Evans; Alan B Zonderman; Shari R Waldstein Journal: J Gerontol B Psychol Sci Soc Sci Date: 2020-06-02 Impact factor: 4.077
Authors: Anda Botoseneanu; Heather G Allore; Carlos F Mendes de Leon; Evelyne A Gahbauer; Thomas M Gill Journal: J Gerontol A Biol Sci Med Sci Date: 2016-04-12 Impact factor: 6.053