Trajectories of physical performance and associated factors in community-dwelling older adults

To investigate 10-year trajectories of physical performance and identify associated socioeconomic, demographic, health-related, and behavioral factors among community-dwelling older adults.

Longitudinal cohort using data from three waves (2014, 2019, and 2024) of a population-based study of adults aged ≥60 in southern Brazil.

Physical performance was assessed using gait speed (GS, m/s) and the Timed Up and Go test (TUG, seconds). Trajectories were modeled using a group-based semiparametric approach. Associations with socioeconomic, demographic, health-related, and behavioral factors were examined using multinomial and binomial logistic regression.

746 participants had their physical performance trajectories over 10 years modeled. Three GS trajectories (lower, 27.4%; intermediate, 60.8%; higher, 11.8%) and two TUG trajectories (gradual increase, 83.0%; rapid increase, 17.0%) were identified. Poorer physical performance trajectories were associated with sex, age, schooling, economic level, functional capacity, polypharmacy, low muscle strength, and self-rated health. The highest relative risk (RR) and odds ratio (OR) of being classified in the poorest GS and TUG trajectories were observed among women (RR 10.01, 95%CI 5.22-19.17; OR 2.26, 95%CI 1.40-3.63), individuals with <8 years of schooling/no schooling (RR 6.82, 95%CI 3.24-14.38; OR 2.80, 95%CI 1.69-4.64), and those with low muscle strength (RR 7.60, 95%CI 1.95-29.65; OR 2.70, 95%CI 1.46-4.97). Conversely, being physically active was associated with a lower risk of belonging to the poorest GS trajectory (RR 0.36, 95%CI 0.18-0.74).

All trajectories demonstrated a decline in physical performance over time. The poorest trajectories were associated with socioeconomic, demographic, health-related, and behavioral factors, indicating that decline in physical performance is not solely attributable to chronological aging.