THE ROLE OF CHANGE IN PHYSICAL PERFORMANCE IN DETERMINING RISK FOR DEPENDENCE IN ACTIVITIES OF DAILY LIVING AMONG NONDISABLED COMMUNITY-LIVING ELDERLY PERSONS

Among community living elderly persons, a single assessment of physica l performance is a powerful predictor of dependence in activities of d aily living (ADLs). The aim of this study was to determine whether an assessment of change in physical performance provides useful prognosti c information beyond that available from a single assessment. Among a large representative cohort of elderly persons, we evaluated the 586 p articipants who were ADL independent at both the baseline and the one year interviews. For each of the three timed tests, participants who h ad a large decline in physical performance were significantly more lik ely to develop ADL dependence at three years than those who improved o r showed no change. After adjusting for 1-year scores, however, change in physical performance was no longer associated with ADL dependence. However, among the 775 participants who were ADL independent at the b aseline interview, change in physical performance was significantly as sociated with the onset of ADL dependence at one year, even after adju sting for baseline performance. When determining risk for ADL dependen ce, an assessment of change in physical performance over one year does not provide useful prognostic information beyond that available from a single assessment. Nevertheless, change in physical performance is i ndependently associated with concurrent ADL dependence and may be usef ul in predicting future disability if measured over shorter intervals. (C) 1997 Elsevier Science Inc.