Differences in Physical Fitness and Health‐Related Variables Between Older Adults With Versus Without Self‐Reported Impairments in Activities of Daily Living: A Population‐Based Study

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Abstract
Activities of daily living (ADL) are associated with declines in physical fitness and subjective health. However, it remains unclear as to whether ADL impairments are related to specific components of physical fitness and health variables. Therefore, we examined differences between community‐dwelling older persons with versus without ADL impairments with regard to various physical fitness components, physical complaints as well as subjective and objective health outcomes. Cross‐sectional study among 254 participants aged ≥ 55 years [51% female; 84 with ADL impairments; mean (SD) age 62.1 (6.6) years] enrolled in the population‐based “Gesundheit zum Mitmachen” study in Southwestern Germany. ADL, physical complaints and subjective health status were assessed using a self‐report questionnaire, physical fitness (cardiorespiratory fitness, strength, gross motor coordination, flexibility, and functional mobility) was assessed using a fitness test battery, and objective health status was derived from health exam performed by a physician. We ran analyses of covariance, adjusted for age, sex, body mass index and education. Participants with ADL impairments had statistically significantly worse subjective ( p < 0.001) and objective ( p < 0.001) health and reported more physical complaints ( p < 0.001) compared to those without ADL impairments. Regarding physical fitness, ADL‐impaired participants performed worse in 10 out of 12 variables. The findings provide additional evidence that ADL impairments are related to decreased objective and subjective health and physical fitness in older community‐dwelling adults. Future studies employing more comprehensive, preferably objective, ADL assessments and considering cognitive impairments, which may also impact ADL performance, are warranted.

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