The physical functioning inventory: a procedure for assessing physical function in adults.

The Physical Functioning Inventory, an instrument designed to assess changes in how and how often activities are performed in persons reporting difficulty with a task as well as in those who do not, is described. The measure is designed for adults. Interrater and test-retest reliability were assessed with active participants in the Baltimore Longitudinal Study of Aging (BLSA). Percentage agreement ranged from 63% to 100%. The instrument was also given to 392 inactive BLSA participants as part of a follow-up telephone interview. Fifty-eight percent of the respondents reported no difficulty in performing a task, yet reported a change in how often they performed that task. The results indicate that the instrument is reliable and effective in detecting early stages of disability in activities of daily living, instrumental activities of daily living, and mobility. The instrument is somewhat less reliable for moderate and strenuous physical activities.

Early repolarization: an electrocardiographic predictor of enhanced aerobic fitness.

The presence or absence of early repolarization on the electrocardiogram at rest was correlated with aerobic exercise capacity in healthy volunteers from the Baltimore Longitudinal Study of Aging. Patients with early repolarization had both longer treadmill exercise duration and higher peak oxygen consumption than age-and gender-matched control subjects.

Independent prognostic significance of ischemic ST-segment response limited to recovery from treadmill exercise in asymptomatic subjects.

BACKGROUND: Although exercise-induced ST depression is an independent predictor of future coronary events in asymptomatic populations, the predictive value of ST depression beginning after exercise cessation is unknown. METHODS AND RESULTS: We analyzed the treadmill exercise tests of 825 healthy volunteers who were 22 to 89 years of age from the Baltimore Longitudinal Study of Aging. All subjects were free from coronary heart disease by history, physical examination, and resting ECG. From 825 participants, 611 (group 0) had no ischemic ST-segment changes during or after treadmill exercise, while 214 subjects developed > or = 1-mm flat or downsloping ST depression: 151 (group 1) had ST changes starting during exercise, and 63 (group 2) had changes limited to recovery. Groups 1 and 2 were similar in age, sex, smoking status, hypertension prevalence, fasting plasma glucose, and serum cholesterol (CHOL). However, both groups were older and had higher CHOL and prevalence of hypertension than group 0. Treadmill exercise duration, peak oxygen consumption, and maximal heart rate were similar between groups 1 and 2 but were lower than in group 0 (each P < 0.05). During a mean follow-up time of 9 years, 55 subjects developed coronary events (angina pectoris, myocardial infarction, or coronary death): 21 of 611 (3.4%) in group 0, 22 of 151 (14.6%) in group 1, and 12 of 63 (19%) in group 2 (P = 0.001). By survival analysis, the risk of coronary events was similar in groups 1 and 2 but significantly higher than in group 0 (P < 0.0001). Multiple logistic regression showed that age (odds ratio [OR] = 1.07 per year, P = 0.00001), CHOL (OR = 1.02 per 1 mg, P = 0.0001), and presence of ST-segment depression (OR = 2.59, P = 0.007 and OR = 2.38, P = 0.04 for groups 1 and 2, respectively) were independent predictors of events. CONCLUSIONS: Thus, ischemic ST-segment changes developing during recovery from treadmill exercise in apparently healthy individuals have adverse prognostic significance similar to those appearing during exercise.

Age related changes in visual acuity.

Longitudinal visual acuity assessments of men, and cross-sectional assessments of men and women in the Baltimore Longitudinal Study of Aging are presented. The longitudinal data relate presenting far, uncorrected far, presenting near and uncorrected near visual acuities to age. The cross-sectional data relate presenting far acuity to age. The prevalence of cataract, glaucoma and retinal pathologies are reported for the longitudinal sample at the time of their last vision test. The effect of visual pathologies in general, and cataract in particular, upon presenting far visual acuity was examined. The longitudinal data are consistent with cross-sectional data from previously published reports. Older persons who were free from specific visual pathologies exhibited an age-related decline in presenting far acuity as did those with documented visual pathologies. Despite the demonstrated loss in acuity with age, the majority of persons maintain at least fair acuity (20/40 or better) into their 80's.