Inluence of health status, physical activity and fitness in autonomy of community-dwelling old adults over a five year period

Abstract

Introduction As long as life expectancy increases, a significant number of people are likely to live longer while subject to infirmities and disabilities, and thus loss of autonomy. Studies focusing on disability and autonomy have been mainly cross-sectional and few studies have analyzed longitudinally predictors of health and physical functioning variables. Thus, the purpose of this study was to analyze the influence of health status, physical activity and fitness on the autonomy of community-dwelling old adults over a five year period. Methods Participants were 106 community-dwelling persons aged 60 years and older at baseline (67.4±5.4 years). They were evaluated at baseline and after the 5-year follow-up period. Measures comprised autonomy/physical functioning, co-morbidities, physical activity, physical fitness including body composition, evaluated by the Composite Physical Function scale, International Physical Activity Questionnaire, Fullerton batteries and bioimpedance, respectively. Results Linear regression revealed that the main predictors of change in autonomy over a 5-year period were initial autonomy (β=0.032, R2=9.8%); health status (initial number of co-morbidities: β=-0.191, R2=6.3%; change in the number of co-morbidities: β=-0.244, R2=10.8%); and changes in agility (β=-0.288, R2=6.7%), aerobic endurance (β =0.007, R2=3.2%), and walking related energy expenditure (β =0.001, R2=5.1%), (P<.05). Conclusion Initial autonomy level and health status appear to influence autonomy change in community-dwelling old adults over a 5-year period, however physical activity (walking) and fitness (agility and aerobic endurance) also accounted for autonomy loss variability, justifying the promotion of intervention programs for the maintenance or improvement of these factors.