The purpose of the study was to examine the association of physical capacity, as determined on the basis of self-report and physical measurements, with survival in three groups of elderly people aged 75, 80 and 75-84 years. The main aspects of physical capacity were mobility, walking speed, hand grip strength and knee extension strength. Although 1142 persons participated in mobility interview, of whom 466 also took part in the walking speed test, and 463 in the strength tests. The follow-up periods ranged from 48 to 58 months. Risk of death was significantly related to difficulties in indoor mobility among the 75-84-year-olds (odds ratio = 1.99, 95% confidence interval = 1.27-3.13) and 75- and 80- year-olds (OR = 1.60, CI = 1.07-2.38) and outdoor mobility among the 75-84-year-olds (OR = 2.44, CI = 1.63-3.67) and 75- and 80-year-olds (OR =2.75, CI = 1.72-4.40). The odds ratios for hand grip strength (OR = 1.86, CI=1.13-3.07), knee extension strength (OR =2.52, CI = 1.50-4.42) and walking time over 10 meters (OR = 1.98, CI = 1.18-3.34) for the 75- and 80-year-olds were also significant. Since these variables can be easily measured and provide valuable information about functional capacity and risk of death they merit inclusion in medical examination of elderly clients.

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Purpose: Mobility limitations and cognitive disorders have often been observed as risks for institutionalization. However, their combined effects on risk of institutionalization among initially community-dwelling older people have been less well reported. Design: A prospective cohort study with 10-year surveillance on institutionalization. Subjects: Study population (n = 476) consisted of 75- and 80-year-old people who were community-dwelling, had not been diagnosed with dementia, and participated in tests on walking speed and cognitive capacity at a research centre. Measures: Cognitive capacity was measured with three validated psychometric tests that were from the Wechsler Adult Intelligence Scale, Wechsler Memory Scale and Schaie- Thurstone Adult Mental Abilities Test. Mobility was measured with walking speed over a 10-m distance. Exclusive distribution based study groups were formed with cut-offs at the lowest third as follows: no limitation, solely mobility limitation, solely cognitive deficits, and combined mobility limitation and cognitive deficits. Cox proportional hazards model was used to determine the relative risks of institutionalization for the study groups. Results: Eleven percent of the participants were institutionalized during the 10-year surveillance. The risk for institutionalization was 4.9 times greater (95% confidence interval: 2.1–11.2) for those who had co-existing mobility limitations and cognitive deficits than for those with no limitations. Conclusions: The findings show that the accumulation of limitations in physical and cognitive performance substantially decreases the possibility for a person remaining at home. This might be due to a decreased reserve capacity and ineffective compensatory strategies. Therefore, interventions targeted to improve even one limitation, or prevent accumulation of these risk factors, could significantly reduce the risk of institutionalization.

Gait speed is a measure of health and functioning. Physical and cognitive determinants of gait are amenable to interventions, but best practices remain unclear. We investigated the effects of a 12‐month physical and cognitive training (PTCT) on gait speed, dual‐task cost in gait speed, and executive functions (EFs) compared with physical training (PT) (ISRCTN52388040). Community‐dwelling older adults, who did not meet physical activity recommendations, were recruited (n = 314). PT included supervised walking/balance (once weekly) and resistance/balance training (once weekly), home exercises (2–3 times weekly), and moderate aerobic activity 150 min/week in bouts of >10 min. PTCT included the PT and computer training (CT) on EFs 15–20 min, 3–4 times weekly. The primary outcome was gait speed. Secondary outcomes were 6‐min walking distance, dual‐task cost in gait speed, and EF (Stroop and Trail Making B‐A). The trial was completed by 93% of the participants (age 74.5 [SD3.8] years; 60% women). Mean adherence to supervised sessions was 59%–72% in PT and 62%–77% in PTCT. Home exercises and CT were performed on average 1.9 times/week. Weekly minutes spent in aerobic activities were 188 (median 169) in PT and 207 (median 180) in PTCT. No significant interactions were observed for gait speed (PTCT‐PT, 0.02; 95%CI −0.03, 0.08), walking distance (−3.8; −16.9, 9.3) or dual‐task cost (−0.22; −1.74, 1.30). Stroop improvement was greater after PTCT than PT (−6.9; −13.0, −0.8). Complementing physical training with EFs training is not essential for promotion of gait speed. For EF’s, complementing physical training with targeted cognitive training provides additional benefit.