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Published in: BMC Geriatrics 1/2022

Open Access 01-12-2022 | Research

Physical performance in older age by sex and educational level: the HUNT Study

Authors: Kjerstin N. Melsæter, Gro G. Tangen, Håvard K. Skjellegrind, Beatrix Vereijken, Bjørn H. Strand, Pernille Thingstad

Published in: BMC Geriatrics | Issue 1/2022

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Abstract

Background

Population-based studies on physical performance provide important information on older people’s health but rarely include the oldest and least-healthy segment of the population. The aim of this study was to provide representative estimates of physical performance by age, sex, and educational level based on recent data from a population-based health study in Norway that includes older people with a wide range in age and function.

Methods

In the fourth wave of the Trøndelag Health Study (2017–2019), all participants aged 70 + were invited to an additional examination of physical performance assessed by the Short Physical Performance Battery (SPPB), either by attending a testing station or by visits from ambulatory teams. The distribution and variation in SPPB total and subscores, as well as gait speed, are presented by sex, age, and educational level.

Results

The SPPB was registered in 11,394 individuals; 54.8% were women; the age range was 70–105.4 years, with 1,891 persons aged 85 + . SPPB scores decreased by 0.27 points (men) and 0.33 points (women) for each year of age, and gait speed by 0.02 m/sec (men) and 0.03 m/sec (women). Using a frailty cut-off for gait speed at < 0.8 m/sec, the proportion of participants categorized as frail increased from 13.9% in the 70–74 years cohort to 73.9% in participants aged 85 + . Level of education \(\le\) 10 years corresponded to 6 years (men) and 4 years (women) earlier onset of frailty (SPPB \(\le\) 9) compared to education \(\ge\) 14 years.

Conclusion

We found that the SPPB captured a gradual decline and wide distribution in physical performance in old age. The results provide information about physical performance, health status, and risk profiles at a population level and can serve as reference data for clinicians, researchers, and healthcare planners.
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Literature
1.
go back to reference WHO Clinical Consortium on Healthy Ageing. Report of consortium meeting 1–2 December 2016 in Geneva. Switzerland: World Health Organization; 2017. WHO Clinical Consortium on Healthy Ageing. Report of consortium meeting 1–2 December 2016 in Geneva. Switzerland: World Health Organization; 2017.
2.
go back to reference Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994;49(2):M85-94.CrossRef Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994;49(2):M85-94.CrossRef
3.
go back to reference Freiberger E, de Vreede P, Schoene D, Rydwik E, Mueller V, Frändin K, et al. Performance-based physical function in older community-dwelling persons: a systematic review of instruments. Age Ageing. 2012;41(6):712–21.CrossRef Freiberger E, de Vreede P, Schoene D, Rydwik E, Mueller V, Frändin K, et al. Performance-based physical function in older community-dwelling persons: a systematic review of instruments. Age Ageing. 2012;41(6):712–21.CrossRef
4.
go back to reference de Fátima Ribeiro Silva C, Ohara DG, Matos AP, Pinto A, Pegorari MS. Short physical performance battery as a measure of physical performance and mortality predictor in older adults: a comprehensive literature review. Int J Environ Res Public Health. 2021;18(20):10612. de Fátima Ribeiro Silva C, Ohara DG, Matos AP, Pinto A, Pegorari MS. Short physical performance battery as a measure of physical performance and mortality predictor in older adults: a comprehensive literature review. Int J Environ Res Public Health. 2021;18(20):10612.
5.
go back to reference Guralnik JM, Ferrucci L, Pieper CF, Leveille SG, Markides KS, Ostir GV, et al. Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A Biol Sci Med Sci. 2000;55(4):M221–31.CrossRef Guralnik JM, Ferrucci L, Pieper CF, Leveille SG, Markides KS, Ostir GV, et al. Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A Biol Sci Med Sci. 2000;55(4):M221–31.CrossRef
6.
go back to reference Studenski S, Perera S, Wallace D, Chandler JM, Duncan PW, Rooney E, et al. Physical performance measures in the clinical setting. J Am Geriatr Soc. 2003;51(3):314–22.CrossRef Studenski S, Perera S, Wallace D, Chandler JM, Duncan PW, Rooney E, et al. Physical performance measures in the clinical setting. J Am Geriatr Soc. 2003;51(3):314–22.CrossRef
7.
go back to reference Cesari M, Landi F, Calvani R, Cherubini A, Di Bari M, Kortebein P, et al. Rationale for a preliminary operational definition of physical frailty and sarcopenia in the SPRINTT trial. Aging Clin Exp Res. 2017;29(1):81–8.CrossRef Cesari M, Landi F, Calvani R, Cherubini A, Di Bari M, Kortebein P, et al. Rationale for a preliminary operational definition of physical frailty and sarcopenia in the SPRINTT trial. Aging Clin Exp Res. 2017;29(1):81–8.CrossRef
8.
go back to reference Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16–31.CrossRef Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16–31.CrossRef
9.
go back to reference Strand BH, Bergland A, Jørgensen L, Schirmer H, Emaus N, Cooper R. Do more recent born generations of older adults have stronger grip? A comparison of three cohorts of 66- to 84-year-olds in the Tromsø study. J Gerontol A Biol Sci Med Sci. 2019;74(4):528–33.CrossRef Strand BH, Bergland A, Jørgensen L, Schirmer H, Emaus N, Cooper R. Do more recent born generations of older adults have stronger grip? A comparison of three cohorts of 66- to 84-year-olds in the Tromsø study. J Gerontol A Biol Sci Med Sci. 2019;74(4):528–33.CrossRef
10.
go back to reference Bergland A, Strand BH. Norwegian reference values for the Short Physical Performance Battery (SPPB): the Tromso study. BMC Geriatr. 2019;19(1):216.CrossRef Bergland A, Strand BH. Norwegian reference values for the Short Physical Performance Battery (SPPB): the Tromso study. BMC Geriatr. 2019;19(1):216.CrossRef
11.
go back to reference Ramírez-Vélez R, Pérez-Sousa MA, Venegas-Sanabria LC, Cano-Gutierrez CA, Hernández-Quiñonez PA, Rincón-Pabón D, et al. Normative Values for the Short Physical Performance Battery (SPPB) and their association with anthropometric variables in older Colombian adults. The SABE Study, 2015 Front Med (Lausanne). 2020;7:52. Ramírez-Vélez R, Pérez-Sousa MA, Venegas-Sanabria LC, Cano-Gutierrez CA, Hernández-Quiñonez PA, Rincón-Pabón D, et al. Normative Values for the Short Physical Performance Battery (SPPB) and their association with anthropometric variables in older Colombian adults. The SABE Study, 2015 Front Med (Lausanne). 2020;7:52.
12.
go back to reference Cooper R, Hardy R, Aihie Sayer A, Ben-Shlomo Y, Birnie K, Cooper C, et al. Age and gender differences in physical capability levels from mid-life onwards: the harmonisation and meta-analysis of data from eight UK cohort studies. PLoS ONE. 2011;6(11): e27899.CrossRef Cooper R, Hardy R, Aihie Sayer A, Ben-Shlomo Y, Birnie K, Cooper C, et al. Age and gender differences in physical capability levels from mid-life onwards: the harmonisation and meta-analysis of data from eight UK cohort studies. PLoS ONE. 2011;6(11): e27899.CrossRef
13.
go back to reference Tangen GG, Robinson HS. Measuring physical performance in highly active older adults: associations with age and gender? Aging Clin Exp Res. 2020;32(2):229–37.CrossRef Tangen GG, Robinson HS. Measuring physical performance in highly active older adults: associations with age and gender? Aging Clin Exp Res. 2020;32(2):229–37.CrossRef
14.
go back to reference Harber-Aschan L, Calderon-Larranaga A, Darin-Mattson A, Hu X, Fratiglioni L, Dekhtyar S. Beyond the social gradient: the role of lifelong socioeconomic status in older adults’ health trajectories. Aging (Albany NY). 2020;12(24):24693–708.CrossRef Harber-Aschan L, Calderon-Larranaga A, Darin-Mattson A, Hu X, Fratiglioni L, Dekhtyar S. Beyond the social gradient: the role of lifelong socioeconomic status in older adults’ health trajectories. Aging (Albany NY). 2020;12(24):24693–708.CrossRef
15.
go back to reference Sund ER, Rangul V, Krokstad S. Folkehelsepolitisk rapport med helsestatistikk fra HUNT inkludert tall fra HUNT4 (2017–19) (Public health policy report with health statistics from HUNT including figures from HUNT4 (2017–19)). HUNT forskningssenter: Institutt for samfunnsmedisin og sykepleie, Fakultet for medisin og helsevitenskap, NTNU; 2019. Sund ER, Rangul V, Krokstad S. Folkehelsepolitisk rapport med helsestatistikk fra HUNT inkludert tall fra HUNT4 (2017–19) (Public health policy report with health statistics from HUNT including figures from HUNT4 (2017–19)). HUNT forskningssenter: Institutt for samfunnsmedisin og sykepleie, Fakultet for medisin og helsevitenskap, NTNU; 2019.
16.
go back to reference Welmer AK, Kåreholt I, Rydwik E, Angleman S, Wang HX. Education-related differences in physical performance after age 60: a cross-sectional study assessing variation by age, gender and occupation. BMC Public Health. 2013;13:641.CrossRef Welmer AK, Kåreholt I, Rydwik E, Angleman S, Wang HX. Education-related differences in physical performance after age 60: a cross-sectional study assessing variation by age, gender and occupation. BMC Public Health. 2013;13:641.CrossRef
17.
go back to reference Hoogendijk EO, van Hout HP, Heymans MW, van der Horst HE, Frijters DH, Broese van Groenou MI, et al. Explaining the association between educational level and frailty in older adults: results from a 13-year longitudinal study in the Netherlands. Ann Epidemiol. 2014;24(7):538-44.e2.CrossRef Hoogendijk EO, van Hout HP, Heymans MW, van der Horst HE, Frijters DH, Broese van Groenou MI, et al. Explaining the association between educational level and frailty in older adults: results from a 13-year longitudinal study in the Netherlands. Ann Epidemiol. 2014;24(7):538-44.e2.CrossRef
18.
go back to reference Krokstad S, Langhammer A, Hveem K, Holmen TL, Midthjell K, Stene TR, et al. Cohort profile: the HUNT study. Norway Int J Epidemiol. 2013;42(4):968–77.CrossRef Krokstad S, Langhammer A, Hveem K, Holmen TL, Midthjell K, Stene TR, et al. Cohort profile: the HUNT study. Norway Int J Epidemiol. 2013;42(4):968–77.CrossRef
19.
go back to reference Åsvold BO, Langhammer A, Rehn TA, Kjelvik G, Grøntvedt TV, Sørgjerd EP, et al. Cohort Profile Update: The HUNT Study, Norway. Int J Epidemiol. 2022;00(00):1-12. Åsvold BO, Langhammer A, Rehn TA, Kjelvik G, Grøntvedt TV, Sørgjerd EP, et al. Cohort Profile Update: The HUNT Study, Norway. Int J Epidemiol. 2022;00(00):1-12.
21.
go back to reference Barrabés N, Østli GK. Norsk standard for utdanningsgruppering 2016 (Norwegian standard for education grouping 2016). Statistisk sentralbyrå. 2016(30). Barrabés N, Østli GK. Norsk standard for utdanningsgruppering 2016 (Norwegian standard for education grouping 2016). Statistisk sentralbyrå. 2016(30).
22.
go back to reference Huisingh-Scheetz M, Buta B, Bandeen-Roche K, Huang ES, Varadhan R, Walston J, et al. 2015–2016 normative data for the 3-m usual walk, five repeated chair stands, and static balance components of the SPPB among U.S. older adults across two nationally representative data sets: NSHAP and NHATS. J Gerontol B Psychol Sci Soc Sci. 2021;76(Suppl 3):S299-s312.CrossRef Huisingh-Scheetz M, Buta B, Bandeen-Roche K, Huang ES, Varadhan R, Walston J, et al. 2015–2016 normative data for the 3-m usual walk, five repeated chair stands, and static balance components of the SPPB among U.S. older adults across two nationally representative data sets: NSHAP and NHATS. J Gerontol B Psychol Sci Soc Sci. 2021;76(Suppl 3):S299-s312.CrossRef
23.
go back to reference da Camara SM, Alvarado BE, Guralnik JM, Guerra RO, Maciel AC. Using the short physical performance battery to screen for frailty in young-old adults with distinct socioeconomic conditions. Geriatr Gerontol Int. 2013;13(2):421–8.CrossRef da Camara SM, Alvarado BE, Guralnik JM, Guerra RO, Maciel AC. Using the short physical performance battery to screen for frailty in young-old adults with distinct socioeconomic conditions. Geriatr Gerontol Int. 2013;13(2):421–8.CrossRef
24.
go back to reference Abellan van Kan G, Rolland Y, Andrieu S, Bauer J, Beauchet O, Bonnefoy M, et al. Gait speed at usual pace as a predictor of adverse outcomes in community-dwelling older people an International Academy on Nutrition and Aging (IANA) Task Force. J Nutr Health Aging. 2009;13(10):881–9.CrossRef Abellan van Kan G, Rolland Y, Andrieu S, Bauer J, Beauchet O, Bonnefoy M, et al. Gait speed at usual pace as a predictor of adverse outcomes in community-dwelling older people an International Academy on Nutrition and Aging (IANA) Task Force. J Nutr Health Aging. 2009;13(10):881–9.CrossRef
25.
go back to reference Castell M-V, Sánchez M, Julián R, Queipo R, Martín S, Otero Á. Frailty prevalence and slow walking speed in persons age 65 and older: implications for primary care. BMC Fam Pract. 2013;14(1):86.CrossRef Castell M-V, Sánchez M, Julián R, Queipo R, Martín S, Otero Á. Frailty prevalence and slow walking speed in persons age 65 and older: implications for primary care. BMC Fam Pract. 2013;14(1):86.CrossRef
26.
go back to reference Gordon EH, Peel NM, Samanta M, Theou O, Howlett SE, Hubbard RE. Sex differences in frailty: a systematic review and meta-analysis. Exp Gerontol. 2017;89:30–40.CrossRef Gordon EH, Peel NM, Samanta M, Theou O, Howlett SE, Hubbard RE. Sex differences in frailty: a systematic review and meta-analysis. Exp Gerontol. 2017;89:30–40.CrossRef
27.
go back to reference Oksuzyan A, Juel K, Vaupel JW, Christensen K. Men: good health and high mortality. Sex differences in health and aging. Aging Clin Exp Res. 2008;20(2):91–102.CrossRef Oksuzyan A, Juel K, Vaupel JW, Christensen K. Men: good health and high mortality. Sex differences in health and aging. Aging Clin Exp Res. 2008;20(2):91–102.CrossRef
28.
go back to reference Zapata-Lamana R, Poblete-Valderrama F, Cigarroa I, Parra-Rizo MA. The Practice of Vigorous Physical Activity Is Related to a Higher Educational Level and Income in Older Women. Int J Environ Res Public Health. 2021;18(20):10815. Zapata-Lamana R, Poblete-Valderrama F, Cigarroa I, Parra-Rizo MA. The Practice of Vigorous Physical Activity Is Related to a Higher Educational Level and Income in Older Women. Int J Environ Res Public Health. 2021;18(20):10815.
30.
go back to reference Guralnik J, Bandeen-Roche K, Bhasin SAR, Eremenco S, Landi F, Muscedere J, et al. Clinically meaningful change for physical performance: perspectives of the ICFSR Task Force. J Frailty Aging. 2020;9(1):9–13.PubMedPubMedCentral Guralnik J, Bandeen-Roche K, Bhasin SAR, Eremenco S, Landi F, Muscedere J, et al. Clinically meaningful change for physical performance: perspectives of the ICFSR Task Force. J Frailty Aging. 2020;9(1):9–13.PubMedPubMedCentral
31.
go back to reference Fritz S, Lusardi M. White Paper: “Walking Speed: the Sixth Vital Sign.” Journal of Geriatric Physical Therapy. 2009;32(2):2–5.CrossRef Fritz S, Lusardi M. White Paper: “Walking Speed: the Sixth Vital Sign.” Journal of Geriatric Physical Therapy. 2009;32(2):2–5.CrossRef
33.
go back to reference Gjøra L, Kjelvik G, Strand BH, Kvello-Alme M, Selbæk G. Forekomst av demens i Norge. Forlaget aldring og helse. 2020. Gjøra L, Kjelvik G, Strand BH, Kvello-Alme M, Selbæk G. Forekomst av demens i Norge. Forlaget aldring og helse. 2020.
34.
go back to reference Mody L, Miller DK, McGloin JM, Freeman M, Marcantonio ER, Magaziner J, et al. Recruitment and retention of older adults in aging research. J Am Geriatr Soc. 2008;56(12):2340–8.CrossRef Mody L, Miller DK, McGloin JM, Freeman M, Marcantonio ER, Magaziner J, et al. Recruitment and retention of older adults in aging research. J Am Geriatr Soc. 2008;56(12):2340–8.CrossRef
35.
go back to reference Langhammer A, Krokstad S, Romundstad P, Heggland J, Holmen J. The HUNT study: participation is associated with survival and depends on socioeconomic status, diseases and symptoms. BMC Med Res Methodol. 2012;12:143.CrossRef Langhammer A, Krokstad S, Romundstad P, Heggland J, Holmen J. The HUNT study: participation is associated with survival and depends on socioeconomic status, diseases and symptoms. BMC Med Res Methodol. 2012;12:143.CrossRef
36.
go back to reference Ramm J. Eldres bruk av helse- og omsorgstjenester (Elderly use of health and care services). Statistical analyses 137. Oslo: Statistisk sentralbyrå/Statistics Norway; 2013. Ramm J. Eldres bruk av helse- og omsorgstjenester (Elderly use of health and care services). Statistical analyses 137. Oslo: Statistisk sentralbyrå/Statistics Norway; 2013.
37.
go back to reference Olsen CF, Bergland A. Reliability of the Norwegian version of the short physical performance battery in older people with and without dementia. BMC Geriatr. 2017;17(1):124.CrossRef Olsen CF, Bergland A. Reliability of the Norwegian version of the short physical performance battery in older people with and without dementia. BMC Geriatr. 2017;17(1):124.CrossRef
Metadata
Title
Physical performance in older age by sex and educational level: the HUNT Study
Authors
Kjerstin N. Melsæter
Gro G. Tangen
Håvard K. Skjellegrind
Beatrix Vereijken
Bjørn H. Strand
Pernille Thingstad
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2022
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-022-03528-z

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