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J Gerontol A Biol Sci Med Sci. 2013 Jul;68(7):861-8. doi: 10.1093/gerona/gls228. Epub 2012 Nov 16.

Long-term trajectories of lower extremity function in older adults: estimating gender differences while accounting for potential mortality bias.

Author information

  • 1Yale University, Department of Internal Medicine/Geriatrics, 20 York Street, New Haven, Connecticut, USA. anda.botoseneanu@yale.edu

Abstract

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.

KEYWORDS:

Gender differences; Lower extremity function; Survival bias; Trajectories

PMID:
23160367
[PubMed - indexed for MEDLINE]
PMCID:
PMC3674712
Free PMC Article
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