Associations Between Self-Reported Physical Activity and Physical Performance Measures Over Time in Postmenopausal Women: The Women's Health Initiative

Low physical function following cancer diagnosis is associated with higher mortality risk in postmenopausal women

BACKGROUND

Postmenopausal women with cancer experience an accelerated physical dysfunction beyond what is expected through aging alone due to cancer and its treatments. The aim of this study was to determine whether declines in physical function after cancer diagnosis are associated with all-cause mortality and cancer-specific mortality.

METHODS

This prospective cohort study included 8068 postmenopausal women enrolled in the Women's Health Initiative with a cancer diagnosis and who had physical function assessed within 1 year of that diagnosis. Self-reported physical function was measured using the 10-item physical function subscale of the 36-Item Short Form Health Survey. Cause of death was determined by medical record review, with central adjudication and linkage to the National Death Index. Death was adjudicated through February 2022.

RESULTS

Over a median follow-up of 7.7 years from cancer diagnosis, 3316 (41.1%) women died. Our results showed that for every 10% difference in the physical function score after cancer diagnosis versus pre-diagnosis, all-cause mortality and cancer-specific mortality were reduced by 12% (hazard ratio [HR] = 0.88, 95% confidence interval  [95% CI] = 0.87 to 0.89 and HR = 0.88, 95% CI = 0.86 to 0.91, respectively). Further categorical analyses showed a significant dose-response relationship between postdiagnosis physical function categories and mortality outcomes (P < .001 for trend), where the median survival time for women in the lowest physical function quartile was 9.1 years (Interquartile range [IQR] = 8.6-10.6 years) compared with 18.4 years (IQR = 15.8-22.0 years) for women in the highest physical function quartile.

CONCLUSION

Postmenopausal women with low physical function after cancer diagnosis may be at higher risk of mortality from all causes and cancer-related mortality.

Physical Activity Changes From Before to During the First Wave of the COVID-19 Pandemic Among Community-Dwelling Older Adults in Finland

This study aimed to compare community-dwelling older adults' physical activity (PA) during the COVID-19 restrictions in 2020 to their PA levels 2 years before and investigate associations between earlier physical performance and PA levels over the follow-up. Participants' (n = 809, initial age 75-85 years) self-reported PA was assessed at baseline in 2017-2018 and May/June 2020 as total weekly minutes of walking and vigorous PA. Physical performance was assessed at baseline using the maximal handgrip strength and Short Physical Performance Battery tests. During the first wave of the COVID-19 pandemic, a median change in total weekly minutes of walking and vigorous PA among all participants was + 20.0 (interquartile range: -60.0 to 120.0, p < .001) min per week compared with 2 years earlier. Higher baseline Short Physical Performance Battery total scores were associated with higher total weekly minutes of walking and vigorous PA over the follow-up in men and women, and better handgrip strength in women.

Relationship of psychotropic medication use with physical function among postmenopausal women

To examine cross-sectional and longitudinal relationships of psychotropic medications with physical function after menopause. Analyses involved 4557 Women's Health Initiative Long Life Study (WHI-LLS) participants (mean age at WHI enrollment (1993-1998): 62.8 years). Antidepressant, anxiolytic, and sedative/hypnotic medications were evaluated at WHI enrollment and 3-year follow-up visits. Performance-based physical function [Short Physical Performance Battery (SPPB)] was assessed at the 2012-2013 WHI-LLS visit. Self-reported physical function [RAND-36] was examined at WHI enrollment and the last available follow-up visit-an average of 22 [±2.8] (range: 12-27) years post-enrollment. Multivariable regression models controlled for socio-demographic, lifestyle, and health characteristics. Anxiolytics were not related to physical function. At WHI enrollment, antidepressant use was cross-sectionally related to worse self-reported physical function defined as a continuous (β = -6.27, 95% confidence interval [CI]: -8.48, -4.07) or as a categorical (< 78 vs. ≥ 78) (odds ratio [OR] = 2.10, 95% CI: 1.48, 2.98) outcome. Antidepressant use at WHI enrollment was also associated with worse performance-based physical function (SPPB) [< 10 vs. ≥ 10] (OR = 1.53, 95% CI: 1.05, 2.21) at the 2012-2013 WHI-LLS visit. Compared to non-users, those using sedative/hypnotics at WHI enrollment but not at the 3-year follow-up visit reported a faster decline in physical function between WHI enrollment and follow-up visits. Among postmenopausal women, antidepressant use was cross-sectionally related to worse self-reported physical function, and with worse performance-based physical function after > 20 years of follow-up. Complex relationships found for hypnotic/sedatives were unexpected and necessitate further investigation.

Examining the factors associated with functional capacity of community-dwelling older adults using the ICF framework: a cross-sectional study from the Frailty in Brazilian Older Adults Study (FIBRA)

BACKGROUND

There are many factors associated with functioning and disability in older adults and these relationships are not clear.

OBJECTIVE

To explore the factors associated with functional capacity of older adults using the framework of the International Classification of Functioning, Disability, and Health (ICF).

METHODS

This is a cross-sectional study with a dataset from a survey of 1 377 community-dwelling older adults (≥ 65 years) in a middle-income country. Three functional outcomes were selected to represent the functioning domains: 1) muscle strength for body function; 2) walking speed for activity; and 3) advanced activities of daily living (ADL) for participation. Demographic, clinical, and social information was selected to represent the domains of health conditions and contextual factors (i.e. personal and environmental factors). Multivariate models tested the impact of these factors on each outcome.

RESULTS

Depressive symptoms, age, and physical activity were associated with the three outcomes. Muscle strength was also associated with urinary incontinence, visual deficits, female sex, and employment. Walking speed was also associated with urinary incontinence, obesity, fractures due to falls, female sex, health professionals' visits, and walking aid devices. Advanced ADL were also associated with stroke, visual deficits, education, employment, health perception, social support, and walking aid devices.

CONCLUSION

Functional capacity of older adults is associated with some non-modifiable factors, such as age and sex. The modifiable factors must be addressed by health professionals and policymakers in the geriatric area, especially depression, obesity, physical inactivity, and social support.

Combined Aerobic and Strength Training Improves Dynamic Stability and can Prevent against Static Stability Decline in Postmenopausal Women: A Randomized Clinical Trial

OBJECTIVE

 To analyze the effect of combined training (CT) in postural control and gait parameters in postmenopausal women.

METHODS

 A parallel-group, randomized, control study was conducted with 16 weeks of combined training (n = 16) versus a non-training control group (n = 12) in postmenopausal women (aged 59.3 ± 8.0). Pre and postintervention assessments included postural control (using an AMTI force platform - Advanced Mechanical Technology, Inc., Watertown, MA, USA) and gait impairments (using baropodometry). In addition, the upper limb strength and abdominal tests, as well as aerobic capacity, assessed functional indicators.

RESULTS

 The CT intervention in postmenopausal women resulted in improved gait (stride length (p = 0.006); speed (p = 0.013); double support time (p = 0.045); and improved postural control (displacement area of postural sway in a normal base of support with eyes open (p = 0.006). Combined training increased functional indicators (abdominal - p = 0.031; aerobic capacity - p = 0.002).

CONCLUSION

 In conclusion, combined aerobic plus strength training effectively improved gait and balance control in older women. The postmenopausal women from the CT group walked faster and with bigger steps after the intervention than the control group. In addition, they presented decreased postural sway in standing and decreased the percentage of double support time while walking, which means improved static and dynamic balance control and functional indicators.

Factors associated with changes in the objectively measured physical activity among Japanese adults: A longitudinal and dynamic panel data analysis

Factors associated with dynamic changes in the objectively measured physical activity have not been well understood. We aimed to 1) evaluate the longitudinal change in the physical activity trajectory according to sex which is associated with age and to 2) determine the factors associated with the dynamic change in physical activity-related variables across a wide age range among Japanese adults. This longitudinal prospective study included 689 Japanese adults (3914 measurements) aged 26-85 years, whose physical activity data in at least two surveys were available. Physical activity-related variables, such as intensity (inactive, light [LPA; 1.5 to 2.9 metabolic equivalents (METs)], moderate-to-vigorous [MVPA; ≥3.0 METs]), total energy expenditure (TEE), physical activity level (PAL), and step count, were evaluated using a validated triaxial accelerometer. Statistical analysis involved the latent growth curve models and random-effect panel data multivariate regression analysis. During a mean follow-up period of 6.8 years, physical activity was assessed an average of 5.1 times in men and 5.9 times in women. The profiles for the inactive time, LPA (only men), MVPA, step count, PAL, and TEE showed clear curvature, indicating an accelerated rate of change around the age of 70. In contrast, other variables exhibited minimal or no curvature over the age span. The MVPA trajectory was positively associated with alcohol consumption, hand grips, leg power, and trunk flexibility and negatively associated with age, local area, body mass index (BMI), comorbidity score, and heart rate over time. Our results indicated that the physical activity trajectory revealed clear curvature, accelerated rate of change around the age of 70, and determined physical health and fitness and BMI as dynamic factors associated with physical activity changes. These findings may be useful to help support populations to achieve and maintain the recommended level of physical activity.

Profiles of Physical Activity and Physical Performance in Matched Religious Vegetarian and Nonvegetarian Women: A Preliminary Observational Study in Taiwan

Religious vegetarianism has become more popular with women and increases with age. However, concerns have been raised that vegetarians are less productive than nonvegetarians. Thus, we aimed to compare the characteristics of physical activity and physical performance in properly matched religious vegetarian and nonvegetarian women aged ≥ 45 years. Participants (n = 160) were recruited via convenience sampling in the community of Hualien, Taiwan, and matched by demographic and cognitive characteristics. Physical activity was assessed using the International Physical Activity Questionnaire-Short Form (IPAQ-SF). Physical performance was assessed with handgrip strength, five-times-sit-to-stand, gait speed, timed up-and-go, and functional reach tests (FRT). Overall, 90% of religious vegetarians practiced lacto-ovo-vegetarianism. The proportions of those with low physical activity levels and poor physical performance did not significantly differ between religious vegetarians and nonvegetarians. Additionally, there were no significant between-group differences in IPAQ-SF scores and physical performance, except for FRT performance (mean 24.5 cm vs. 19.7 cm, p < 0.001). Exhaustion after work, busyness, and a lack of interest were three main reasons for low physical activity levels, and none of these had significant between-group differences (p = 0.936). Our results show a similar profile of physical activity and physical performance in religious vegetarian and nonvegetarian women.

Physical Activity Levels and Self-perception of Fitness in COVID-19-Recovered Individuals

Background: The preventative measures to reduce the incidence of coronavirus disease 2019 (COVID-19) have reduced the physical activity level (PAL) that might also affect physical and mental health. Objectives: The present study investigated the relationship between self-perception of fitness (SPF) and PAL in COVID-19-recovered individuals (CRI). Methods: The population of this descriptive-analytical study included all CRI (men and women, in the age range of 20 to 70 years) in Kermanshah. In the present study, 890 volunteers (438 men and 452 women) were sampled using a multistage cluster sampling method. The International Physical Activity Questionnaire (IPAQ-SF) was used to assess the PAL and the Delignières et al. questionnaire to assess the SPF. The Pearson correlation coefficient test and independent t-test were used to analyze the data using SPSS version 24 software. Results: The results showed low PAL (men: 876.11 ± 40.23; women: 739.27 ± 8.02) and poor SPF (men: 6.64 ± 1.62; women: 5.27 ± 1.39) in CRI. Also, there was a significant positive relationship between high and moderate PAL and SPF in men (r = 0.67, P = 0.032; r = 0.77, P = 0.018, respectively) and women (R = 0.56, P = 0.041; r = 0.66, P = 0.035, respectively), while there was a significant inverse relationship between low PAL and SPF among men (r = -0.85, P = 0.001) and women (r = -0.89, P = 0.001). Conclusions: Based on the results, wrong SPF in individuals with low PAL might be one reason for being insufficiently active. Thus, a proper understanding of PAL could be the first step of a regular physical activity schedule to enhance the immune system.

Associations of physical activity participation trajectories with subsequent motor function declines and incident frailty: A population-based cohort study

BACKGROUND

Maintaining physical function and delaying frailty are of significant importance in both quality of life and health longevity for successful aging. The objective of this study is to investigate whether different trajectories of long-term physical activity (PA) participation are associated with subsequent motor function declines and incident frailty in middle-aged and elderly adults.

MATERIALS AND METHODS

Data from 8,227 aged ≥ 50 years adults enrolled in the English Longitudinal Study of Aging were analyzed. Long-term PA participation trajectories were assessed using group-based trajectory modeling over the first 6-year period from wave 1 (2002-2003) to wave 4 (2008-2009). The longitudinal associations of PA trajectories with motor function declines and incident frailty were evaluated by a linear mixed model and Cox regression model, respectively, with follow-up of 10 years from wave 4 to wave 9 (2018-2019).

RESULTS

Five distinct trajectories of long-term PA participation were identified in the aging cohort, including persistently low-active trajectory (N = 2,039), increasing active trajectory (N = 1,711), declining active trajectory (N = 216), persistently moderate-active trajectory (N = 2,254), and persistently high-active trajectory (N = 2,007). Compared with the persistently low-active group, the participants in persistently moderate- and high-active groups experienced significantly decelerated grip strength decline, decreased gait speed decline, and faster chair rises after multiple-adjustment. Similarly, participants maintaining moderate- and high-active PA were also associated with a lower risk of incident frailty (multiple-adjusted hazard ratio: 0.70, 95% confidence interval: 0.62-0.80, and 0.42, 95% CI: 0.36-0.49, respectively), compared with those with persistently low PA. Notably, the participants with the increasing active trajectory got similar health benefits as those with persistently moderate and high levels of PA.

CONCLUSION

In addition to persistent PA, increasing PA was linked to a slower decline in motor function and lower risk of incident frailty in the cohort. Our findings suggest that regular PA is never too late.

Mediating effect of muscle power on the relationship of physical activity with physical fitness and physical function in older women

OBJECTIVE

This study analyzed if the associations of physical activity with physical fitness and physical function in older women are mediated by muscle power.

METHODS

Participants were 54 older women (age 73.5 ± 6.8 yrs). Moderate-to-vigorous intensity physical activity (min day^-1) was measured by accelerometry. Lower limb muscle power (W/kg) was estimated from a single two-leg countermovement jump performed on a force platform. Physical fitness (lower body strength, agility/dynamic balance, and aerobic endurance) was objectively assessed through the Senior Fitness Test Battery, respectively: 30s chair stand (repetitions), 8-ft up-and-go (s), and 6-min walk test (m). Physical function was subjectively evaluated via the 12-item Composite Physical Function Scale Questionnaire (score). Mediation effects were estimated using bootstrapped 95% confidence intervals and were deemed significant if 0 was not included in the intervals.

RESULTS

Mediation analysis controlling to age revealed an indirect effect of moderate-to-vigorous intensity physical activity through muscle power on all physical fitness components, specifically lower body strength (B = 0.048, 95% BootCI [0.013, 0.114]), agility/dynamic balance (B = -0.009, 95% BootCI [-0.024, -0.002]) and aerobic endurance (B = 0.656, 95% BootCI [0.142, 1.597]) and on physical function global score (B = 0.040 95% BootCI [0.009, 0.094]).

CONCLUSIONS

These results suggest that physical activity of at least moderate intensity is relevant to daily functional competence, by promoting the maintenance or improvement of muscle power.

Physical Activity Trajectories and Associated Changes in Physical Performance in Older Men: The MrOS Study

BACKGROUND

Physical activity (PA) is important to maintaining functional independence. It is not clear how patterns of change in late-life PA are associated with contemporaneous changes in physical performance measures.

METHODS

Self-reported PA, gait speed, grip strength, timed chair stand, and leg power were assessed in 3,865 men aged ≥ 65 years at baseline (2000-2002) and Year 7 (2007-2009). Group-based trajectory modeling, using up to four PA measures over this period, identified PA trajectories. Multivariate linear regression models (adjusted least square mean [95% confidence interval {CI}]) described associations between-PA trajectories and concurrent changes in performance.

RESULTS

Three discrete PA patterns were identified, all with declining PA. Linear declines in each performance measure (baseline to Year 7) were observed across all three PA groups, but there was some variability in the rate of decline. Multivariate models assessing the graded response by PA trajectory showed a trend where the high-activity group had the smallest declines in performance while the low-activity group had the largest (p-for trend < .03). Changes in the high-activity group were the following: gait speed (-0.10 m/s [-0.12, -0.08]), grip strength (-3.79 kg [-4.35, -3.23]), and chair stands (-0.38 [-0.50, -0.25]), whereas changes in the low-activity group were the following: gait speed (-0.16 [-0.17, -0.14]), grip strength (-4.83 kg [-5.10, -4.55]), and chair stands (-0.53 [-0.59, -0.46]). Between-group differences in leg power trajectories across PA patterns were not significant.

CONCLUSIONS

Declines in functional performance were higher among those with lower PA trajectories, providing further evidence for the interrelationship between changes in PA and performance during old age.

High-Intensity Interval Circuit Training Versus Moderate-Intensity Continuous Training on Cardiorespiratory Fitness in Middle-Aged and Older Women: A Randomized Controlled Trial

High-intensity interval training (HIIT) has similar or better effects than moderate-intensity continuous training (MICT) in increasing peak oxygen consumption (VO_2max), however, it has not been studied when HIIT is applied in a circuit (HIICT). The aim of this study was to compare the effects of a HIICT versus MICT on VO_2max estimated (VO_2max-ES), heart rate (HR) and blood pressure (BP) of middle-aged and older women. A quasi-experimental randomized controlled trial was used. Fifty-four women (67.8 ± 6.2 years) were randomized to either HIICT (n = 18), MICT (n = 18) or non-exercise control group (CG; n = 18) for 18 weeks. Participants in HIICT and MICT trained two days/week (one hour/session). Forty-one participants were assessed (HIICT; n = 17, MICT; n = 12, CG; n = 12). Five adverse events were reported. Cardiorespiratory fitness, HR and BP were measured. The tests were performed before and after the exercise intervention programs. VO_2max-ES showed significant training x group interaction, in which HIICT and MICT were statistically superior to CG. Moreover, HIICT and MICT were statistically better than CG in the diastolic blood pressure after exercise (DBP_ex) interaction. For the systolic blood pressure after exercise (SBP_ex), HIICT was statistically better than CG. In conclusion, both HIICT and MICT generated adaptations in VO_2max-ES and DBP_ex. Furthermore, only HIICT generated positive effects on the SBP_ex. Therefore, both training methods can be considered for use in exercise programs involving middle-aged and older women.

Efficacy of Physical Activity in Prevention of Muscle Weakness in Patients With Chronic Liver Disease

Background

Sarcopenia is a prognostic factor for patients with liver cirrhosis and hepatocellular carcinoma, and it affects the onset of hepatic encephalopathy. Therefore, the prevention of sarcopenia contributes to the improvement of the prognosis of patients with chronic liver disease (CLD). We focused on changes of hand grip strength (HGS), one of the indicators of sarcopenia. However, there are little data investigating the impact of physical activity (PA) on HGS in patients with CLD. This study aimed to clarify whether PA contributes to the prevention of muscle weakness in patients with CLD.

Methods

This was a prospective observational study. We examined the effect of PA on changes in HGS from the baseline to the endpoint in each group. Metabolic equivalents-hour/week (METs-h/w) was used to evaluate PA. In total, 183 outpatients with CLD were analyzed. We divided participants into four groups (low PA in younger patients (n = 20), high PA in younger patients (n = 33), low PA in elderly patients (n = 47), and high PA in elderly patients (n = 83)).

Results

Fifty-eight percent of patients were men, and the median (interquartile range) age was 69.0 (63.0, 75.0) years. The most common etiology of liver disease was hepatitis C (38%). The frequency of living alone and low exercise habit was significantly high, and sarcopenia was more obvious in elderly patients with low PA than in those with high PA. Additionally, the elderly with low PA showed significantly reduced HGS compared to that of the elderly with high PA (-1.00 (-2.27, 0.55) kg vs. 0.10 (-1.40, 1.10) kg, P < 0.05). However, changes in HGS in younger patients were not significant (-0.02 (1.83, 1.47) kg vs. 0.25 (-2.45, 2.05) kg, P = 0.96). Logistic regression analyses identified PA as the independent factor for prevention of decrease in HGS (odds ratio: 1.91, 95% confidence interval: 1.00 - 3.62, P = 0.049).

Conclusions

Young patients with low PA were characterized by a long sedentary time; however, there was no loss of HGS. In contrast, elderly patients with CLD and low PA had significantly reduced HGS compared to that in elderly patients with CLD and high PA.

Functional Fitness and Quality of Life among Women over 60 Years of Age Depending on Their Level of Objectively Measured Physical Activity

The aim of this study was to identify the differences in functional fitness and quality of life among women over 60 years of age depending on their level of objectively measured physical activity (PA) according to Global Recommendations on Physical Activity for health. The study used a cross-sectional design with 213 female volunteers over 60 years of age. Physical activity was monitored for 7 days of the week using an Actigraph Gt3X monitor. The Senior Fitness Test battery and hand-grip strength tests were performed to assess functional fitness. Quality of life was self-reported using a short version of the World Health Organization Quality of Life questionnaire WHOQOL-bref. Women who met the PA recommendations achieved slightly better results in most functional tests and in all domains of quality of life. Significant differences were found in the upper body strength, dynamic balance, and social relationships domains of quality of life. Physical activity programs developed on the basis of World Health Organization (WHO) recommendations have the potential to improve functional fitness and quality of life. However, further experimental studies in this area are required.

Impact of obesity and physical inactivity on the long-term change in grip strength among middle-aged and older European adults

BACKGROUND

Grip strength is a well-established predictor of various chronic conditions and all-cause mortality. Body weight and physical activity (PA) are considered potential determinants of muscle strength. This study aimed to investigate gender-specific associations of baseline obesity and physical inactivity with long-term changes in grip strength among middle-aged and older European adults.

METHODS

Data from the Survey of Health, Ageing and Retirement in Europe 2004-2015 which was conducted in 12 countries were analysed. Grip strength was repeatedly measured at five follow-up visits with average 2-year intervals. Obesity and physical inactivity at baseline were primary exposures. Generalised estimated equations stratified by gender were fitted.

RESULTS

This study included 8616 males and 10 088 females with a median follow-up of 9.42 years. Significant interactions between obesity and time with grip strength were identified in both males (χ² _interaction=16.65, p = 0.002) and females (χ² _interaction=10.80, p = 0.029). No significant interaction between physical inactivity and time with grip strength was identified in males (χ² _interaction=9.42, p = 0.051) or females (χ² _interaction=5.62, p = 0.230). Those who were less physically active at baseline had weaker grip strength from the beginning at baseline (β = -2.753, p < 0.001 for males and β = -1.529, p < 0.001 for females) to Visit 6 (β = -2.794, p < 0.001 for males and β = -1.550, p < 0.001 for females). Further combined analysis suggested a trend that exposure to both obesity and physical inactivity was related to the fastest decline rate of grip strength.

CONCLUSIONS

This study provides the additional evidence that PA and obesity prevention earlier in life play an important role in maintaining grip strength during ageing.

Associations of recommended food score and physical performance in Korean elderly

Background

A single nutrient or dietary pattern has been associated with physical performance. However, little is still known about the association of overall dietary quality with physical performance. This study aimed to investigate the link between the recommended food score (RFS), defined as an indicator of overall diet quality, and physical performance among the Korean elderly aged over 65 years.

Methods

The study subjects consisted of 622 participants (294 men and 328 women) aged over 65 years from the 2014–2015 National Fitness Award project.

Results

The mean value of RFS was higher in elderly women (30.7 ± 7.6) than elderly men (29.5 ± 8.8), but the difference was only marginally significant (P = 0.065). In elderly women, multiple regression linear models, adjusted for potential confounders, showed that RFS was positively related to absolute hand grip strength (kg) (ß = 0.066, 95% CI = 0.010 to 0.122) and relative hand grip strength (%) (ß =0.109, 95% CI = 0.016 to 0.201); other physical performance indicators did not show any association with RFS. In elderly men, none of the physical performance indexes were associated with RFS.

Conclusions

These results suggest that a better overall diet quality may be associated with improved grip strength among elderly women in Korea.

Body composition and physical function in the Women's Health Initiative Observational Study

Physical function is critical for mobility and quality of life. We hypothesized that higher total lean mass is associated with higher physical function, and body fat inversely associated, among postmenopausal women. Women's Health Initiative Observational Study participants at Pittsburgh, PA; Birmingham, AL; and Tucson-Phoenix, AZ (1993–1998) completed dual-energy X-ray absorptiometry scans and the Rand SF-36 questionnaire at baseline and 3 y (N = 4526). Associations between quartiles (Q1–4) of lean or fat mass and physical function were tested using linear regression, adjusted for demographics, lifestyle factors, medical history, and scanner serial number. At baseline, participants had a mean ± SD age of 63.4 ± 7.4 y and BMI of 27.4 ± 5.8 kg/m². Higher percent lean mass was positively associated with physical function at baseline (Q4, 83.6 ± 0.6 versus Q1, 74.6 ± 0.7; p < 0.001), while fat mass (kg and %) was inversely associated (e.g., Q4, 73.7 ± 0.7 versus Q1, 84.2 ± 0.7 kg; p_trend < 0.001). Physical function had declined across the cohort at 3 y; the highest relative lean mass quartile at baseline conferred a lesser decline in physical function than the lowest (Q4, −3.3 ± 0.6 versus Q1–7.0 ± 0.6; p_trend < 0.001), while the highest fat mass quartile (% and kg) conferred greater decline (ex. Kg Q4, −6.7 ± 0.7 versus Q1–2.8 ± 0.6; p_trend < 0.001). Increased fat mass (≥5%), but not lean mass, was associated with lower physical function at 3 y (p < 0.001). Adiposity, as well as lean mass, requires consideration in the prediction of physical function among postmenopausal women over time.

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Lean mass (%) is positively associated with physical function in menopause.

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Body fat is negatively associated with physical function in menopause.

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Decline in physical function is more rapid with gains in fat during menopause.

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Body composition influence on functional decline is more evident among women <65 y.