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Functional Fitness of Older AdultsLinda D. Wilkin a & Bryan L. Haddock aa Department of Kinesiology , California State University , SanBernardino, CAPublished online: 20 Sep 2011.

To cite this article: Linda D. Wilkin & Bryan L. Haddock (2011) Functional Fitness of Older Adults,Activities, Adaptation & Aging, 35:3, 197-209, DOI: 10.1080/01924788.2011.596759

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Activities, Adaptation & Aging, 35:197–209, 2011Copyright © Taylor & Francis Group, LLCISSN: 0192-4788 print/1544-4368 onlineDOI: 10.1080/01924788.2011.596759

Functional Fitness of Older Adults

LINDA D. WILKIN and BRYAN L. HADDOCKDepartment of Kinesiology, California State University, San Bernardino,

San Bernardino, CA

The purpose of this study is to compare differences in the functionalfitness of a group of older adults to determine if they are aging suc-cessfully, to analyze the differences in functional fitness betweenfemales and males, and to determine differences in four cate-gories by sex. Participants were placed into four categories basedon senior fitness test (SFT) scores. More than 50% of the partici-pants had scores that placed them in the average or above averagecategories. The most common variables affecting scores for femaleswere age and medications, and for males the most common vari-able was depression. In conclusion, older adults with average andabove average functional fitness appear to age successfully.

KEYWORDS aging, senior fitness test, depression

It is well established that the population in the United States is aging dra-matically. According to the Centers for Disease Control and Prevention andThe Merck Company Foundation (2007) in The State of Aging and Healthin America 2007 , by 2030 there will be 71 million older adults in America,representing roughly 20% of the total population. There will be many chal-lenges associated with this increasing number of older adults, one of whichwill be to find ways to help people age successfully. Although successfulaging is not clearly defined in the literature, Wagner (1997) defined it asthe maintenance of a high-quality, independent life. Likewise, the WorldHealth Organization (WHO; 1996) expands on this idea of successful aging

Received 7 June 2010; accepted 11 May 2011.This study was supported in part by the Community University Partnership Group of

California State University, San Bernardino, CA.Address correspondence to Linda D. Wilkin, Department of Kinesiology, California State

University, San Bernardino, 5500 University Parkway, San Bernardino, CA 92407. E-mail:lwilkin@csusb.edu

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in their release of the Heidelberg Guidelines for Promoting Physical ActivityAmong Older Persons, expressing the importance of physical activity amongaging adults as a means of maintaining functional abilities and identifyingroutine physical activity as an essential ingredient of healthy and successfulaging.

Both the WHO (2001) and Alan Walker (2002), in his work “A Strategyfor Active Ageing,” define active aging as “the process of optimizing oppor-tunities for physical, social, and mental well-being throughout the life coursein order to extend healthy life expectancy, productivity and quality of life inolder age” (p. 17). Walker suggests that active aging is sometimes just a slo-gan and not a coherent strategy; however, he outlines seven key principlesthat should be part of the concept. According to Walker, the principles ofactive aging include activity that should: (a) contribute to the well-being ofthe individual and not be concerned only with the activity of paid employ-ment, (b) encompass all older people including the frail and dependent, (c)be a preventive concept, (d) include intergenerational solidarity, (e) includeboth rights and obligations,(f) be participative and empowering, and (g)respect national and cultural diversity.

Most of the research investigating functional fitness or disability associ-ated with increasing age measures functional fitness or disability throughthe use of basic activities of daily living (BADL or ADL) or the instru-mental activities of daily living (IADL). A systematic review of the recenttrends in disability and functioning among older adults in the United States(Freedman, Martin, & Schoeni, 2002) defined physical disability “as theinability to carry out independently specific roles, or activities within a givenenvironment” (p. 3138). As shown by reviews from Freedman et al. (2002)and Manton, Lamb, and Gu (2007), the most prevalent method of assessingdisability in older adults seems to be ADLs and/or IADLs.

In another paper published by Freedman and Martin (1998), the authorspresent a suggestion that some of the problems associated with determin-ing the trends in functional limitations of older adults include the issues ofmeasurement. In his book Understanding Health Care Outcomes Research,Robert L. Kane (2006, p. 87) addresses the specific measurement issues withADL/IADL scales, stating that because of the number of scales available andthe variance with which they are scored, administered, and interpreted, thesescales are not likely to produce consistent results or be easily comparable.Once again, most of the work in this area is completed utilizing the ADLsand IADLs, and some random measures of lower- and upper-body strengthand flexibility.

In order to more completely assess functional fitness compared withassessment utilizing ADLs and/or IADLs, the senior fitness test (SFT) waschosen for this study. Rikli and Jones (1999a) developed the SFT to assessthe functional fitness of older adults. The SFT is a set of six tests that are

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economical, comprehensive, and easy to administer and include measuresof lower-body strength (30-second chair stand), upper-body strength (30-second arm curl), aerobic endurance (2-minute step-in-place), lower-bodyflexibility (sit-and-reach), upper-body flexibility (back scratch), and agility/

dynamic balance (8-foot up-and-go). Rikli and Jones (1999a) developed theSFT to evaluate and monitor the physical fitness of older adults with thegoal of identifying and treating limitations in functional fitness. As definedby Rikli and Jones (2001), “functional fitness is having the physical capac-ity to perform normal everyday activities safely and independently withoutundue fatigue” (p. 2). In addition, Rikli and Jones (2001) generated “cri-terion performance scores” based on the data from their national study(Rikli & Jones, 1999b). These scores place females and males into fourcategories: above average, average, below average, and at risk for loss offunctional mobility based on their scores on the six functional tests. Thecategories are defined as: above average is >75th percentile, average is75th–25th percentile, below average is <25th percentile, and at risk for lossof functional mobility is based on scores associated with low functionalability.

The purpose of this study was to compare the differences in the func-tional fitness of a group of older females and males to determine if theyare aging successfully based on several physiological and psychological fac-tors typically associated with aging, and to assess the number of participantsat risk for loss of functional mobility using the SFT. An additional purposewas to analyze the differences in functional fitness between females andmales and to determine differences in the four categories (defined as aboveaverage, average, below average, and at risk for loss of functional mobility)according to Rikli and Jones (2001) by sex and the health-related variablesmeasured.

METHOD

Participants

A convenience sample of 108 older adults was recruited from senior centers,senior apartment complexes, and retirement communities in the surroundingarea. Participants were recruited through the presentation of informationaltalks provided by the principal investigator on physical activity and aging,focusing on the many benefits of being physically active. All participantswere self-reported as apparently healthy (absence of debilitating disease)and participation was voluntary. In addition, all participants lived indepen-dently, scored ≥20 on the Mini-Mental State Exam (MMSE; Folstein, Folstein,& McHugh, 1975), and signed an informed consent. All procedures wereapproved by the university’s Institutional Review Board.

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Procedures

After providing a release from their personal physician, all participants wereinterviewed by the principal investigator for consistency of data collection,and the participants provided answers to a variety of health-related ques-tionnaires. The Physical Activity Scale for the Elderly (PASE; Washburn,Smith, Jette, & Janney, 1993) was used to assess physical activity level.The questionnaire includes a recall of 10 items related to activities com-monly undertaken by older adults for the past 7 days. The items includequestions related to sitting activities; walking activities; light, moderate, andstrenuous sport and recreational activities; strength and endurance activi-ties; and common household activities. Each item is assigned a weightedvalue according to the level of exertion, with the amount of time spentmultiplied by the predetermined weighted value. The PASE has a test-retest reliability coefficient of .75 (Washburn et al., 1993). The constructvalidity of the PASE was established by correlating the scores with bothhealth status and several physiologic measures. During the developmentof the PASE, scores positively correlated with grip strength, static balance,and leg strength with r values of .25–.37, and the scores negatively cor-related with resting heart rate, age, and perceived health status and anoverall sickness impact profile score of r = −.13 to −.42 (Washburn et al.,1993).

The MMSE (Folstein et al., 1975) was used to assess cognitive state. Thetest-retest reliability coefficient of the MMSE is .89 and the concurrent validitycoefficient is .78 for MMSE verses verbal IQ and .66 for MMSE versus perfor-mance IQ (Folstein et al., 1975). The MMSE is a scored form that includes11 questions and requires from 5 to 10 minutes to administer. A score of 18or greater indicates no cognitive impairment.

The Center for Epidemiologic Studies Depression Scale (CES-D; Radloff,1977) was used to assess depressive symptoms. The test-retest reliabilitycoefficients by time interval ranged from .51 to .67, and the validity of thetest suggests that the instrument is sensitive to levels of severity of depressivesymptomatology (Radloff, 1977). The CES-D is a short self-report series of20 questions. A score of 22 or higher may indicate major depression. Ascore between 15 and 21 may indicate mild to moderate depression. A scorebelow 15 may indicate no depression.

The IADL (Lawton & Brody, 1969) was used to assess the ability toperform the activities of daily living. The test-retest reliability coefficient is.85 and the IADL was correlated with four scales that measured domainsof functional status with all correlations significant at the .01 or .05 level(Lawton & Brody, 1969). The highest possible score is 8 on 8 differentquestions related to activities of daily living, such as telephone use, mealpreparation, and such.

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The Mini Nutritional Assessment (MNA; Guigoz, Vellas, & Garry, 1994)was used to assess nutritional status. The test-retest reliability coefficient is.89. The validity of the MNA compared with other nutritional parametersdemonstrated sensitivity at 96% (ability to detect malnutrition), specificity at98% (ability to classify well-nourished correctly), and predictive value at 97%(Bleda, Bolibar, Parés, & Salva, 2002). The MNA is a series of 18 noninvasiveitems related to food consumption. The highest possible score is 30.

In addition, self-reported socioeconomic status data and self-reportedmedical history data were collected. Socioeconomic status data was col-lected because it is consistently associated with health outcomes (Adler et al.,1994). All testing and interviews were completed in one session with eachparticipant.

Following the verbal assessments, the functional fitness of all partici-pants was assessed, utilizing the SFT. The SFT was administered accordingto guidelines established by Rikli and Jones (2001), with each evaluationconducted by the principal investigator to ensure accuracy and consistency.The SFT includes the following: (a) a chair-stand test to assess lower bodystrength, (b) an arm-curl test to assess upper body strength, (c) a 2-minutestep test to assess aerobic endurance, (d) a chair sit-and-reach test to assesslower body flexibility, (e) a back scratch test to assess upper body flexibility,and (f) an 8-foot up-and-go test to assess agility/dynamic balance. A full testdescription can be found in Rikli and Jones (1999a). In the original work ofRikli and Jones (1999a) the six tests of the SFT had reliability coefficients ofr ≥ .80 and criterion validity of r ≥ .70. The 30-second chair stand was cor-related with the one repetition maximum (1RM) leg press (r = .77) (Jones& Rikli, 1999). The 30-second arm curl was correlated with the 1RM chestpress, biceps, and upper back (r = .81 for males and r = .78 for females)(James, Rikli, & Jones, 1998). The 2-minute step-in-place was correlated withthe 1-mile walk time (r = .73) and time on a treadmill to 85% of maximumheart rate (r = 74) (Dugas, 1996). The chair sit-and-reach was correlatedto goniometer-measured hamstring flexibility (r = .83) (Jones, Rikli, Max,& Guillermo, 1998). The back scratch was unable to be correlated becausethere is no single criterion available, but it is suggested to be the best mea-sure of upper body flexibility (Gross, Fetto, & Rosen, 1996; Hoppenfeld,1976; Starkey & Ryan, 1996). The 8-foot up-and-go also was unable to becorrelated because there is no single criterion, but it is a valid and reliabletest that would correlate with balance, gait speed, and functional capacityaccording to Podsiadlo and Richardson (1991).

All questionnaires and the SFT were administered in the homes of theparticipants for their convenience and to encourage participation. Therewere four participants who chose to come to the university to answer thequestionnaires and to participate in the SFT.

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202 L. D. Wilkin and B. L. Haddock

Statistical Analyses

Data were examined through the use of the Statistical Package for theSocial Sciences (SPSS) Version 16.0 (SPSS Inc., Chicago, IL). Descriptivestatistics including the mean (±SD) of the variables were calculated alongwith the percentage of participants that fell within the various performancecategories for each test. A multivariate analysis of variance (MANOVA) wasutilized to determine the differences among the four categories for all of thehealth-related variables examined. Subsequently, least significant difference(LSD) post hoc tests were run to determine where the variables differed bycategory. An alpha level of 0.05 was set to determine statistical significance.

RESULTS

Descriptive data are presented in Table 1. Seventy-three females and35 males completed all questionnaires and the SFT. The females had greaterlower- and upper-body flexibility. The males had a higher level of physi-cal activity, greater lower- and upper-body strength, and faster times on the8-foot up-and-go test. In addition, the males had higher incomes. No sexdifferences on all other variables were assessed.

TABLE 1 Descriptive Data (Mean ±SD)

Variable Females (n = 73) Min.–Max Males (n = 35) Min.–Max

Age (years) 78.55 (±5.58) 70–94 77.74 (±5.79) 70–91BMI (kg • m−2) 26.26 (±4.94) 18–41 25.57 (±3.53) 20–33Years of education 14.87 (±2.69) 10–23 15.63 (±2.81) 12–22Incomea 2.24 (±1.45) 0–5 3.29 (±1.36)∗ 1–5PASE 107.60 (±44.13) 26.0–232.0 141.04 (±65.41)∗ 22.5–302.0MMSE (max score = 30) 28.23 (±1.98) 20–30 28.31 (±2.05) 22–30CES-D (max score = 60) 6.70 (±7.94) 0–47 6.08 (±6.62) 0–28IADL (max score = 8) 7.96 (±0.20) 7–8 8.00 (±0.00) 8–8MNA (max score = 30) 27.42 (±1.83) 20–30 28.07 (±1.36) 24–30Diagnosed diseases (#) 2.60 (±1.84) 0–8 2.20 (±1.75) 0–6Prescription medications (#) 3.08 (±2.30) 0–10 2.77 (±2.58) 0–8Chair stand test (#) 10.22 (±4.14) 0–21 12.28 (±4.74)∗ 0–23Arm curl test (#) 14.94 (±4.25) 0–26 17.37 (±5.04)∗ 8–312-minute step test (#) 69.11 (±20.08) 0–119 77.51 (±25.12) 0–124Chair sit-and-reach test (in.) −1.29 (±4.73)∗ −13.5–12.5 −6.09 (±4.38) −17.0–1.0Back scratch test (in.) −2.80 (±4.21)∗ −21.0–5.0 −5.31 (±4.01) −18.0–1.58-foot up-and-go test (s) 7.72 (±2.46) 4.09–17.95 6.34 (±2.39)∗ 0–14.64

∗p ≤ 0.05.aYearly income is defined as: 0 = <$10,000; 1 = $10,001–$20,000; 2 = $20,001–$30,000; 3 = $30,001–$40,000; 4 = $40,001–$50,000; 5 = >$50,000.PASE = Physical Activity Scale for the Elderly; MMSE = Mini-Mental State Exam; CES-D = Center forEpidemiologic Studies Depression Scale; IADL = Instrumental Activities of Daily Living; MNA = Mini-Nutritional Analysis.

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There were significant differences among the four categories (aboveaverage, average, below average, and at risk for loss of functional mobility)by sex and health-related variables for each of the six SFTs. The results areas follows, listed by each individual SFT.

Chair Stand

The females with scores that placed them in the below average categorywere younger than those in the other three categories (p = .000, p = .025,p = .040). Those with scores that placed them in the at risk for loss offunctional mobility category took more prescription medications than thosein the above average category (p = .027). For males, body mass index (BMI)was lower in the above average category than the at risk for loss of functionalmobility and below average categories (p = .013, p = .006). In addition, formales, depression was greater in the at risk for loss of functional mobilitycategory than the other three categories (p = .017, p = .001, p = .003).

Arm Curl

There was a difference in age for females; however, there was only oneperson in the below average category that prohibited the performance ofa post hoc test (p = .037). The males in the below average category hada higher score on the CES-D than those in the average and above averagecategories (p = .009, p = .003) with the at risk for loss of functional mobilitycategory approaching significance with a p value of .058.

2-Minute Step

The females in the below average category were more active than those inthe other three categories according to the PASE score (p = .003, p = .007,p = .010). For males, those in the at risk for loss of functional mobilitycategory were older than those in the below average and average categories(p = .006, p = .014).

Chair Sit-and-Reach

There were no differences between the categories for females. However,for males, those in the at risk for loss of functional mobility category had alower score on the MNA than those in the average category (p = .018).

Back Scratch

The females in the above average category had a lower BMI than those inthe average and at risk for loss of functional mobility categories (p = .003,

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p = .021). Also, the females in the above average category took fewerprescription medications than those in the average and at risk for loss offunctional mobility categories (p = .016, p = .005). For the males, therewere no differences between the categories.

8-Foot Up-and-Go

The females in the at risk for loss of functional mobility category wereolder than those in the below average and average categories (p = .015,p = .011, respectively). The females in the above average category had alower BMI than those in the other three categories (p = .005, p = .010,p = .033). Females in the at risk for loss of functional mobility categoryscored lower on the IADL than those in the other three categories (p = .001,p = .000, p = .003). Females in the above average category took fewermedications than those in the other three categories (p = .020, p = .008,p = .045). For males, those in the at risk for loss of functional mobilitycategory had a higher score on the CES-D than those in the average orabove average categories (p = .009, p = .042). Also, the males in the belowaverage category had a higher score on the MNA than those in the at riskfor loss of functional mobility or the above average categories (p = .006,p = .019).

When placed into the four categories (above average, average, belowaverage, and at risk for loss of functional mobility) as defined by Rikli and

TABLE 2 Percentage of Participants in Each Category by SFT

SFT

At Risk (lowfunctional

ability)

Below Average(below 25thpercentile)

Average(75th–25thpercentile)

Above Average(>75th

percentile)

Chair standFemale 23.3 13.7 46.6 16.4Male 8.6 20.0 54.3 17.1

Arm curlFemale 11.0 1.4 53.4 34.2Male 5.7 8.6 48.6 37.1

2-minute stepFemale 42.5 2.7 45.2 9.6Male 22.9 25.7 40.0 11.4

Chair sit-and-reachFemale 35.6 1.4 46.6 16.4Male 57.1 0.0 34.3 8.6

Back scratchFemale 28.8 2.8 47.9 20.5Male 17.1 0.0 62.9 20.0

8-foot up-and-goFemale 16.4 16.4 56.2 11.0Male 8.6 17.1 51.4 22.9

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Jones (2001), Table 2 provides the percentage of participants in each cat-egory listed by functional test and sex. The score on each of the six SFTsdetermines the category for each participant, indicating their functional abil-ity. As demonstrated in Table 2, more than 50% of the participants had scoresthat placed them in the average and above average categories based on theSFT scores, except for the sit-and-reach test for males.

DISCUSSION

The majority of the participants in this study seem to be aging successfullybased on the data that demonstrated they were above average in socioe-conomic status (based on income level and education), cognitively sound(based on the scores on the MMSE), nutritionally sound (based on the scoreson the MNA), mostly not depressed (based on the scores on the CES-D), hadfewer than three diagnosed diseases and were taking no more than threeprescription medications, and had no problems with ADL (based on thescores on the IADL). When examining the number of participants that werein the four categories (above average, average, below average, at risk forloss functional mobility) based on their SFT scores, the largest percentage ofparticipants were in the average and above average categories. More than50% of the 73 female participants were in these two categories for all sixSFTs, demonstrating that the majority of the females in this population haveat least average or above average functional fitness. More than 50% of the35 male participants were in these two categories for five of the six SFT, butnot for the chair sit-and-reach test, where only 42.9% of the 35 males werein the average and above average categories. This again demonstrated thatthe males in this population were at least average or above average in themajority of the functional fitness tests.

In support of the participants in this study having an acceptable levelof physical activity, Washburn et al. (1993) established that the mean PASEscores for females 70–75 years of age and for females 76–100 years of agewere 89.1 and 62.3, respectively. The mean PASE score for the 73 femalesin this study was 107.60 (±44.13) and their mean age was 78.55 (±5.58)years. According to Washburn et al. (1993), the mean PASE scores for males70–75 years of age and for males 76–100 years of age were 102.4 and 101.8,respectively. The mean PASE score for the 35 males in this study was 141.04(±65.41) and their mean age was 77.74 (±5.79). This comparison suggeststhat the females and males in this study were more active than the 222participants of similar ages in the Washburn study.

The results of this study suggest that females have greater upper- andlower-body flexibility while males have higher levels of physical activity,greater upper- and lower-body strength, and are able to perform the 8-foot up-and-go test more quickly than the females. These findings are in

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agreement with the findings from Wood et al. (2005), which examinedthe physical function and quality-of-life differences between the sexes. Thefemales and males in the Wood et al. (2005) study were of similar agesto the current study (current study: females 78.55 [±5.58] years and males77.74 [±5.79] years; Wood et al. [2005]: females 77.9 [±8.3] years and males76.6 [±7.7] years). Wood et al. also found the males to have greater upper-and lower-body strength. There was, however, no difference in upper-bodyflexibility between the females and the males in the Wood et al. (2005) study.

A study examining skeletal muscle mass in older adults (Janssen,Heymsfield, & Ross, 2002) found reduced skeletal muscle mass to be acommon occurrence among older adults and that this loss is significantlyrelated to functional impairment and disability. Janssen et al. (2002) foundthe association of this loss of skeletal muscle mass, functional impairment,and disability to be more prevalent in older females. This work would sup-port our finding that males have significantly greater upper- and lower-bodystrength than females, likely because of greater skeletal muscle mass.

A novel finding in this study, when examining the data for each cate-gory by SFT, was a difference in depression level for males in three of thefunctional tests. A CES-D score of 16 is the most commonly used cutoff forthe classification of depression. For the chair stand test, the males in theat risk for loss of functional mobility category had a CES-D score of 17.33(±5.77). For the arm curl test, the males in the below average category hada CES-D score of 16.33 (±10.69). For the 8-foot up-and-go test, the malesin the at risk for loss of functional mobility category had a CES-D score of12.67 (±2.31). While the 8-foot up-and-go test did not reach the score thatdefines the classification of depression, there was a difference in the depres-sion scores between categories for the 8-foot up-and-go test. Therefore, themales in the at risk for loss of functional mobility and below average cate-gories on two of the six SFT had scores on the CES-D higher than the cutoffscore for the classification of depression. In agreement with this study, moststudies that have examined depression and physical function in older adultshave found that those who are depressed (CES-D score >16) have a lowerlevel of physical function. In contrast to this study, most research has shownthat older females are more depressed than older males (Everson-Rose et al.,2005; Heikkinen & Kauppinen, 2004; Jiang, Tang, Futatsuka, & Zhang, 2004;Lenze et al., 2001; Penninx et al., 1998; Russo et al., 2007).

According to the Centers for Disease Control and Prevention NationalCenter for Injury Prevention and Control’s (2008) Suicide Facts at a Glance,males ages 75 years and older have the highest rate of suicide. The rate is37.97 per 100,000 people for males older than 75 compared with the overallrate of 11.01 suicides per 100,000 people. Crandall (1991) suggests that malesfind the loss of physical independence more intolerable than females, andthat very old males become more socially isolated than very old females. Thisdata, coupled with previous work suggesting that depression is correlated

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with lower levels of physical activity, agrees with the novel finding in thisstudy. Our data demonstrates that males who had scores on the chair standand arm curl that placed them in the at risk for loss of functional mobilityor below average categories had higher CES-D scores (17.33 [±5.77], 16.33[±10.69], respectively) than those in the other two categories.

Even though the results of this study suggest that many people areachieving “active aging” and are avoiding a loss of functional mobility, therewere limitations to this work. First and foremost, the results are not able tobe generalized to the entire population of adults age 70 and older. Thereis a great deal of diversity in the surrounding community, but it is difficultto recruit all segments of the population. The results of the study may havebeen different if the recruitment of a more diverse participant pool hadbeen successful. Another limitation of the study was the number of maleparticipants. The low number of males in the study may have resulted inthe unusual finding of depression as the difference between the categoriesfor males. Once again, along with the difficulty of recruiting diversity, it isdifficult to recruit older male participants.

As the findings of this study suggest that several areas of functional fit-ness correlated with depression in older males, depression in older malesshould be investigated more thoroughly. A training intervention to improvefunctional fitness of older adults utilizing the SFT as the measurementtool for functional fitness would be another area that warrants furtherinvestigation.

In summary, with regard to successful aging as defined by Wagner(1997), the participants in this study seem to be optimizing their opportuni-ties for physical, social, and mental well-being, leading to successful aging.Most participants in this study were categorized as having average or aboveaverage functional fitness, and were physically active, nutritionally sound,cognitively sound, and were avoiding depression based on all assessments.

REFERENCES

Adler, N. E., Boyce, T., Chesney, M. A., Cohen, S., Folkman, S., Kahn, R. L., & Syme,S. L. (1994). Socioeconomic status and health. American Psychologist, 49(1),15–24.

Bleda, M. J., Bolibar, I., Parés, R., & Salva, A. (2002). Reliability of the Mini NutritionalAssessment (MNA) in institutionalized elderly people. The Journal of Nutrition,Health, & Aging, 6(2), 134–137.

Centers for Disease Control and Prevention National Center for InjuryPrevention and Control. (2008). Suicide facts at a glance. Retrieved fromwww.cdc.gov/injury.

Centers for Disease Control and Prevention & The Merck Company Foundation.(2007). The state of aging and health in America 2007 . Whitehouse Station, NJ:The Merck Company Foundation.

Dow

nloa

ded

by [

Bas

kent

Uni

vers

itesi

] at

02:

01 2

0 D

ecem

ber

2014

208 L. D. Wilkin and B. L. Haddock

Crandall, R. C. (1991). Gerontology: A behavioral science approach. New York:McGraw-Hill.

Dugas, E. W. (1996). The development and validation of a 2-minute step test to esti-mate aerobic endurance in older adults. Unpublished master’s thesis, CaliforniaState University, Fullerton, Fullerton, CA.

Everson-Rose, S. A., Skarupski, K. A., Bienias, J. L., Wilson, R. S., Evans, D. A., &Mendes de Leon, C. F. (2005). Do depressive symptoms predict declinesin physical performance in an elderly, biracial population? PsychosomaticMedicine, 67 , 609–615.

Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). “Mini-Mental State”: A practicalmethod for grading the cognitive state of patients for the clinician. Journal ofPsychiatric Research, 12, 189–198.

Freedman, V. A., & Martin, L. G. (1998). Understanding trends in functionallimitations among older Americans. American Journal of Public Health, 88,1457–1462.

Freedman, V. A., Martin, L. G., & Schoeni, R. F. (2002). Recent trends in disability andfunctioning among older adults in the United States. Journal of the AmericanMedical Association, 288(24), 3137–3146.

Gross, J., Fetto, J., & Rosen, E. (1996). Musculoskeletal examination. Cambridge:Blackwell Science.

Guigoz, Y., Vellas, B. J., & Garry, P. J. (1994). Mini Nutritional Assessment: A practicalassessment tool for grading the nutritional state of elderly patients. Facts andResearch in Gerontology, 2, 15–59.

Heikkinen, R., & Kauppinen, M. (2004). Depressive symptoms in late life: A 10-yearfollow-up. Archives of Gerontology and Geriatrics, 38, 239–250.

Hoppenfeld, S. (1976). Physical examination of the spine and extremities. Norwalk,CT: Appleton & Lange.

James, T., Rikli, R. E., & Jones, C. J. (1998, November). The reliability and validityof a 30-second arm curl as a measure of upper body strength in older adults.Paper presented at the Southwest Chapter of the American College of SportsMedicine, Las Vegas, NV.

Janssen, I., Heymsfield, S. B., & Ross, R. (2002). Low relative skeletal muscle mass(Sarcopenia) in older persons is associated with functional impairment andphysical disability. Journal of American Geriatric Society, 50, 889–896.

Jiang, J., Tang, Z., Futatsuka, M., & Zhang, K. (2004). Exploring the influence ofdepressive symptoms on physical disability: A cohort study of elderly in Beijing,China. Quality of Life Research, 13, 1337–1346.

Jones, C. J., & Rikli, R. E. (1999). A 30-s chair-stand test as a measure of lower bodystrength in community-residing older adults. Research Quarterly for Exercise &Sport, 70(2), 113–117.

Jones, C. J., Rikli, R. E., Max, J., & Guillermo, G. (1998). The reliability and validityof a chair sit-and-reach test as a measure of hamstring flexibility in older adults.Research Quarterly for Exercise and Sport, 69, 338–343.

Kane, R. L. (2006). Understanding health care outcomes research (2nd ed.).Burlington, MA: Jones and Bartlett.

Lawton, M. P., & Brody, E. M. (1969). Assessment of older people: Self-maintainingand instrumental activities of daily living. Gerontologist, 9, 179–186.

Dow

nloa

ded

by [

Bas

kent

Uni

vers

itesi

] at

02:

01 2

0 D

ecem

ber

2014

Functional Fitness 209

Lenze, E. J., Rogers, J. C., Martire, L. M., Mulsant, B. H., Rollman, B. L., Dew, M. A.,. . . Reynolds, C. F. (2001). The association of late-life depression and anxietywith physical disability. American Journal of Geriatric Psychiatry, 9, 113–135.

Manton, K. G., Lamb, V. L., & Gu, X. (2007). Medicare cost effects of recent U.S.disability trends in the elderly. Journal of Aging and Health, 19(3), 359–381.

Penninx, B. W. J. H., Guralnik, J. M., Ferrucci, L., Simonsick, E. M., Deeg, D. J. H., &Wallace, R. B. (1998). Depressive symptoms and physical decline in community-dwelling older persons. Journal of the American Medical Association, 279,1720–1726.

Podsiadlo, D., & Richardson, S. (1991). The timed “up & go”: A test of basic func-tional mobility for frail elderly persons. Journal of American Geriatric Society,39, 142–148.

Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research ingeneral population. Applied Psychological Measurement, 1(3), 385–401.

Rikli, R. E., & Jones, C. J. (1999a). Development and validation of a functional fitnesstest for community-residing older adults. Journal of Aging and Physical Activity,7 , 129–161.

Rikli, R. E., & Jones, C. J. (1999b). Functional fitness normative scores forcommunity-residing older adults, ages 60–94. Journal of Aging and PhysicalActivity, 7 , 162–181.

Rikli, R. E., & Jones C. J. (2001). Senior fitness test manual. Champaign, IL: HumanKinetics.

Russo, A., Cesari, M., Onder, G., Zamboni, V., Barillaro, C., Pahor, M., . . .Landi, F. (2007). Depression and physical function: Results from the Agingand Longevity Study in Sirente Geographic Area (ilSirente Study). Journal ofPsychiatry Neurology, 20, 131–137.

Starkey, C., & Ryan, J. L. (1996). Evaluation of orthopedic and athletic injuries.Philadelphia: F.A. Davis.

Wagner, E. H. (1997). Preventing decline in function: Evidence from randomizedtrials around the world. Western Journal of Medicine, 167 , 295–298.

Walker, A. (2002). A strategy for active ageing. International Social Security Review,55, 121–139.

Washburn, R. A., Smith, K. W., Jette, A. M., & Janney, C. A. (1993). The PhysicalActivity Scale for the Elderly (PASE): Development and evaluation. Journal ofClinical Epidemiology, 46(2), 153–162.

Wood, R. H., Gardner, R. E., Ferachi, K. A., King, C., Ermolao, A., Cherry, K. E., . . .Jazwinsky, S. M. (2005). Physical function and quality of life in older adults: Sexdifferences. Southern Medical Journal, 98(5), 504–512.

World Health Organization. (1996). The Heidelberg guidelines for promoting physicalactivity among older persons. Geneva, Switzerland: World Health Organization.

World Health Organization. (2001). Health and ageing: A discussion paper. Geneva27, Switzerland: World Health Organization.

Dow

nloa

ded

by [

Bas

kent

Uni

vers

itesi

] at

02:

01 2

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