<p><b><i>Background:</i></b> Early identification of people at risk of functional decline is essential for delivering targeted preventive interventions. <b><i>Objective:</i></b>
The aim of this study is to identify and predict trajectories of
functional decline over 9 years in males and females aged 60-70 years. <b><i>Methods:</i></b>
We included 403 community-dwelling participants from the InCHIANTI
study and 395 from the LASA study aged 60-70 years at baseline, of whom
the majority reported no functional decline at baseline (median 0,
interquartile range 0-1). Participants were included if they reported
data on ≥2 measurements of functional ability during a 9-year follow-up.
Functional ability was scored with 6 self-reported items on activities
of daily living. We performed latent class growth analysis to identify
trajectories of functional decline and applied multinomial regression
models to develop prediction models of identified trajectories. Analyses
were stratified for sex. <b><i>Results:</i></b> Three distinct
trajectories were identified: no/little decline (219 males, 241
females), intermediate decline (114 males, 158 females), and severe
decline (36 males, 30 females). Higher gait speed showed decreased risk
of functional limitations in males (intermediate limitations, odds ratio
[OR] 0.74, 95% CI 0.57-0.97; severe limitations, OR 0.42, 95% CI
0.26-0.66). The final model in males further included the predictors
fear of falling and alcohol intake (no/little decline, area under the
receiver operating curve [AUC] 0.68, 95% CI 0.62-0.73; intermediate
decline, AUC 0.63, 95% CI 0.56-0.69; severe decline, AUC 0.79, 95% CI
0.71-0.87). In females, higher gait speed showed a decreased risk of
intermediate limitations (OR 0.51, 95% CI 0.38-0.68) and severe
limitations (OR 0.18, 95% CI 0.07-0.44). Other predictors in females
were age, living alone, economic satisfaction, balance, physical
activity, BMI, and cardiovascular disease (no/little decline, AUC 0.80,
95% CI 0.75-0.85; intermediate decline, AUC 0.74, 95% CI 0.69-0.79;
severe decline, AUC 0.95, 95% CI 0.91-0.99). <b><i>Conclusion:</i></b>
Already in people aged 60-70 years, 3 distinct trajectories of
functional decline were identified in these cohorts over a 9-year
follow-up. Predictors of trajectories differed between males and
females, except for gait speed. Identification of people at risk is the
basis for targeting interventions.</p
