Predictors of decline in manual performance in older adults

Susan Hughes*, James Gibbs, Dorothy Dunlop, Perry Edelman, Ruth Singer, Rowland W. Chang

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

59 Scopus citations


OBJECTIVE: To determine factors that predict decline in manual performance using a multivariate model of determinants of functional limitation. DESIGN: Longitudinal observational study. SETTINGS: Ambulatory general medicine clinics, residences of homebound individuals, and a continuing care retirement community. PARTICIPANTS: Subjects were 485 persons more than 60 years of age and included continuing care retirement community (CCRC) residents (n = 215), chronically homebound older persons (n = 65), and ambulatory older adults (n = 205). Mean age at baseline was 78 years. MEASUREMENT: Independent variables included demographics, physician measures of upper-extremity joint impairment, comorbidities derived from physical examination and chart abstract, self-assessed arthritis pain, depression, and anxiety. The major dependent variable was 2-year decline in timed manual performance below a threshold associated with need for long-term care services. RESULTS: The proportion of subjects who exceed a Timed Manual Performance Test threshold of 350 seconds increased slowly from baseline through Year 4 for all age groups but rose rapidly from Year 4 to Year 6 for the oldest group (>85 years at baseline). Using a discrete survival model, we found that age, education, grip strength, and psychological status predicted crossing the manual performance threshold within a 2-year period. CONCLUSIONS: The findings, coupled with earlier findings that upper extremity joint impairment predicted both grip strength and manual performance, suggest that joint impairment may be an important risk factor for future functional limitation. Since diminished hand function has been shown to predict dependency, development and testing of interventionsto maintain or restore upper extremity joint function and reduce pain would appear to be a high research priority.

Original languageEnglish (US)
Pages (from-to)905-910
Number of pages6
JournalJournal of the American Geriatrics Society
Issue number8
StatePublished - Aug 1997

ASJC Scopus subject areas

  • Geriatrics and Gerontology


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