PREDICTORS OF FUNCTIONAL STATUS DECLINE

Abstract

As the population of those aged 65 and older in the USA is projected to be ∼ 70 million by 2030, it is increasingly important to understand the predictors of functional status decline (FSD). To date, research focused on FSD has been plagued by non-uniform physiological and psychological measures that frequently lack sufficient validation. We aim to: 1) develop a universal model for future research in this area based on a battery of nationally validated functional tests developed at CSU, Fullerton, and 2) determine the factors involved in FSD to more fully understand the role physical activity (PA) has in attenuating the age-related decline in functional capacity. To achieve these aims, we are conducting a longitudinal study utilizing residents of an independent living facility and assessing both physiological and psychological abilities. We will test the hypothesis that age, level of PA, SES, demographics, and psychological factors will be predictors of FSD. The Physical Activity Scale for the Elderly (PASE) and the Instrumental Activities of Daily Living (IADL) questionnaires are administered to gauge current levels of PA and ability to perform ADLs. The Fullerton Function Tests are used to assess the following physiological parameters: 1. upper and lower body strength; 2. upper and lower body flexibility; 3. aerobic endurance; and 4. motor agility/dynamic balance. The psychological assessments include the Folsteim Mini-Mental State Exam (MMSE) and the Center for Epidemiologic Studies-Depression (CES-D) Test. To date, baseline data have been collected from 11 subjects (8 females and 3 males), with an age range of 67 to 89 (mean 81.4 ± 6.3), and a BMI range of 21.1 to 34.7 (mean 27.0 ± 4.0). Data collected for the MMSE and CES-D tests range from 22 to 30 (mean 28.1 ± 2.5), and from 11 to 24 (mean 14.8 ± 3.4), respectively. The self reported PASE scores range from 51.5 to 137.5 (mean 84.2 ± 26.8). Baseline data for the physiological assessments include a range of 0 to 18 repetitions for the 30 s chair stand (mean 11.1 ± 6.1), arm curl repetition range of 9.0 to 22.0 (mean 13.0 ± 3.5), chair sit and reach range of −20.3 cm to 8.4 cm (mean −2.8 ± 8.1), backscratch range of −40.6 cm to 6.4 cm (mean −8.1 ± 14.5), 6 minute walk range of 196 m to 490.1 m (mean 307.9 ± 77.7), and 8 foot up-and-go range of 4.5 s to 11.0 s (mean 7.3 ± 2.0). Discovering and understanding the variables associated with FSD will enhance the ability of exercise physiologists to prescribe more effective programs to attenuate the decline.