Background/Study context: Determining whether C-reactive protein (CRP), blood lipids, total and trunk fat mass (FM), and waist circumference (WC) are associated with changes in physical capacity over 3 years (Δ) in elderly.Methods: One hundred twenty-two men and women 68–83 years of age participated in a 3-year follow-up study. Physical capacity was measured using five objective tests: (1) Timed Up and Go (TUG), (2) chair stand (CS), (3) normal walking speed (NWS), (4) fast walking speed (FWS), and (5) one-leg stand (LS), along with physical performance score (PPS) at baseline (T1) and 3 years later (T4). Total and trunk FM, WC, blood lipids, and CRP measured at baseline, were considered as potential predictors.Results: At baseline, CRP and total FM were significantly correlated with all physical capacity tests, whereas trunk FM was correlated with CS and LS, and blood lipids only with FSW. No significant correlation was observed for WC. Total and trunk FM measured at baseline were correlated with ΔTUG and ΔPPS, whereas trunk FM and WC measured at baseline were correlated with ΔNWS. CRP and blood lipids, measured at baseline, were not associated with any changes over 3 years. At the end, WC measured at baseline was the strongest independent predictor for all physical capacity measures at baseline (T1), and ΔPPS measured over 3 years could be predicted by baseline WC.Conclusion: FM distribution seems more useful to determine physical capacity than inflammation. Interestingly, over a short follow-up of 3 years, WC significantly predicted changes in a composite score of physical activity. More studies are needed to elucidate factors that may influence physical capacity decline over time.