Abstract P270: The Association between Physical Performance Characteristics and Independence in Activities of Daily Living in Middle-aged and Elderly Men
Authors: den Ouden Marjolein E , Schuurmans Marieke J , Arts Ilse E , van der Schouw Yvonne T 
Published: July 2021

Introduction:
The functional status at one moment in time is a strong determinant of future functional status and survival in older persons. Physical functioning is an important component of functional status. Physical deterioration tends to occur early in the disabling process and is therefore suitable to interventions. The aim of this study was to investigate the association of physical performance characteristics (muscle capacity, lung function, physical performance score and physical activity) and functioning independently in middle aged and elderly men.

Methods:
In a cross-sectional study 400 independently living men aged 40-80 were included. Preservation of function was measured using the Stanford Health Assessment Questionnaire. Physical characteristics were grip strength and leg strength by dynamometer, lung function by peak flow, lower extremity function by Guralniks physical performance score and physical activity by Voorrips questionnaire. Logistic regression analysis was used to estimate the association between potential determinants and the dichotomized HAQ-score, adjusting for confounders.

Results:
After adjustment for confounders, higher walking speed (OR=2.96, [95% CI 1.31; 6.72]) and shorter time to perform the chair stand test (OR=0.84, [95% CI 0.76; 0.94]) were associated with a higher probability of being independent in activities of daily living (ADL). Borderline significant associations were found for higher lung function and higher leg strength with a higher probability of being independent in ADL. No associations were found for grip strength and physical activity.

Discussion and conclusion:
The results are in line with previous studies, except for the associations between grip strength and physical activity with ADL independency. Longitudinal studies showed associations between grip strength and the probability of being independent in ADL. These results might indicate that whereas grip strength at a particular moment is not a determinant of ADL independency, change in grip strength over several years is. In addition, grip strength changes little until the 6
th
decade but then decreases 1.0% to 1.5% per year from 50 to 70 years. The (relatively young) age of our study population could explain why we did not find an association. The mean total score on the Voorrips questionnaire was much higher compared to previous studies and very low scores of physical activity did not occur, indicating that our study population was relatively active. In the present study, lower body function and peak flow were associated with a higher probability of being independent in ADL. Future research should focus on the relation of physical performance characteristics and living independently using a longitudinal design for better insight in the direction of the associations. It seems that even at a younger age lower extremity function is associated with living independently.