The Gerontologist Advance Access published May 28, 2012

The Gerontologist © The Author 2012. Published by Oxford University Press on behalf of The Gerontological Society of America.
Cite journal as: The Gerontologist Vol. 0, No. 0, 1–13 All rights reserved. For permissions, please e-mail: [email protected].
doi:10.1093/geront/gns071

Development and Validation of Criterion-

Referenced Clinically Relevant Fitness
Standards for Maintaining Physical
Independence in Later Years
Roberta E. Rikli, PhD*,1 and C. Jessie Jones, PhD2

Downloaded from http://gerontologist.oxfordjournals.org/ at University of Arizona on June 25, 2012

1
Department of Kinesiology, College of Health and Human Development, California State University, Fullerton.
2
Department of Health Science, California State University, Fullerton.

*Address correspondence to Roberta E. Rikli, PhD, College of Health and Human Development, California State University,
Fullerton, EC-646, 800 N. State College Blvd., Fullerton, CA 92834. E-mail: [email protected]

Received February 28, 2012; Accepted April 20, 2012

Decision Editor: Rachel Pruchno, PhD

Purpose: To develop and validate criterion-referenced unavailable methods for evaluating physical capacity
fitness standards for older adults that predict the in older adults relative to that associated with physi-
level of capacity needed for maintaining physical cal independence. Most importantly, the standards
independence into later life. The proposed standards can be used in planning interventions that target spe-
were developed for use with a previously validated test cific areas of weakness, thus reducing risk for prema-
battery for older adults—the Senior Fitness Test (Rikli, ture loss of mobility and independence.
R. E., & Jones, C. J. (2001). Development and valida- Key Words: Assessment, Strength, Aerobic endurance,
tion of a functional fitness test for community-residing Agility/dynamic balance, Mobility, Physical fitness
older adults. Journal of Aging and Physical Activity,
6, 127–159; Rikli, R. E., & Jones, C. J. (1999a).
Senior fitness test manual. Champaign, IL: Human With the projected increase in the number and
Kinetics.). Methods: A criterion measure to assess percentage of older adults throughout much of the
physical independence was identified. Next, scores world, it is critical for both economic and personal
from a subset of 2,140 “moderate-functioning” older reasons that this large segment of the population
adults from a larger cross-sectional database, together remains healthy and independent for as long as
with findings from longitudinal research on physical possible. A key factor in preserving mobility and
capacity and aging, were used as the basis for propos- independence in later years is maintaining the fit-
ing fitness standards (performance cut points) associ- ness capacity (e.g., strength, endurance, agility,
ated with having the ability to function independently. and balance) needed to perform normal everyday
Validity and reliability analyses were conducted to test activities—to do simple housework, climb steps,
the standards for their accuracy and consistency as lift and carry objects, get in and out of chairs or
predictors of physical independence. Results: Perfor- transportation vehicles, and walk far enough in
mance standards are presented for men and women and around stores, buildings, and parking lots to
ages 60–94 indicating the level of fitness associated do one’s own shopping and errands (Macaluso &
with remaining physically independent until late in life. De Vito, 2004; Morey, Pieper, & Cornoni-Huntley,
Reliability and validity indicators for the standards 1998; Paterson & Warburton, 2010).
ranged between .79 and .97. Implications: The Unfortunately, limited information is available
proposed standards provide easy-to-use, previously regarding the fitness level needed for maintaining

1
physical independence. The few studies published performance standards based on a nation-wide
regarding threshold requirements for independent study of 7,183 older Americans aged 60–94 years.
living primarily have involved laboratory-based Functional fitness was defined as “having the
measures, such as maximum oxygen uptake, peak physiologic capacity to perform normal everyday
oxygen consumption, or maximum muscle torque activities safely and independently without undue
(Cress & Meyer, 2003; Fleg et al., 2005; Goodpaster fatigue” (1999a, p. 133).
et al., 2006), measures that provide important As briefly described in Table 1, the test battery
information for the scientific community but which includes measures of strength, aerobic endurance,
are not well understood or easily interpreted by flexibility, and agility/dynamic balance. Each item
most health professionals, program leaders, or by was developed and validated as a means of assess-
older adults themselves. ing the underlying physical attributes that support
The purpose of this research was to establish functional mobility. Test–retest reliability for SFT
reliable and valid criterion fitness standards (per- items ranged from .80 to .98. Validity was estab-
formance cut points) for five items in a previously lished through various types of content and crite-
validated easy-to-use field test of functional fitness for rion analyses, including comparing SFT scores

Downloaded from http://gerontologist.oxfordjournals.org/ at University of Arizona on June 25, 2012

older adults—the Senior Fitness Test (SFT; Rikli & with other “gold standard” measures, such as
Jones, 1999a, 2001, in press), standards that treadmill VO2 testing and one repetition maximum
indicate the strength, endurance, agility, and strength testing. The test battery, subsequently
dynamic balance associated with maintaining phys- published as the SFT (Rikli & Jones, 2001, in
ical independence into later life. Criterion stan- press), has been widely used throughout the United
dards are not being proposed at this time for two States and in numerous other countries, with mate-
flexibility items on the SFT as there is insufficient rials reproduced in several languages including
evidence documenting the relationship between Chinese, Danish, Korean, Japanese, Portuguese,
measures of flexibility and improved functional and Spanish.
ability (Fiatarone Singh, 2002; Paterson, Jones, & Because of its strong psychometric properties
Rice, 2007). and ease of use, the SFT seemed especially well
To our knowledge, this is the first attempt to suited to serve as the basis for developing criterion
develop criterion standards for a comprehensive standards of performance for older adults. The
fitness test battery for older adults, standards that SFT utilizes continuous-scale scoring protocols
address the key physiological variables needed for that make it possible to assess gradual changes
independent functioning. Although mobility and over time (improvement or decline) across a wide
physical independence can be attained in a variety range of ability levels. Other popular field test
of ways (through use of assistive technologies, measures, such as the single-item gait speed test
public transportation, etc.) and is influenced by and the Short Physical Performance Battery (SPPB)
multiple factors—cognitive, psychosocial, physical, have been highly effective as predictors of disabil-
environmental, and financial (Webber, Porter, & ity risk, nursing home admittance, and survival
Menec, 2010), the focus of this research is on rates in older adults (Cesari, 2011; Guralnik et al.,
physiological capacity. Specifically, physical inde- 1994, 2000; Studenski et al., 2011), but they do
pendence is defined as having the physical capacity not provide the kind of detailed information
needed to perform common everyday activities on needed for evaluating specific aspects of physical
one’s own without additional assistance, activities fitness, information that is critical in developing
such as simple housework, lifting and carrying interventions that target isolated areas of weak-
objects, negotiating steps, and walking far enough ness. The SPPB, for example, utilizes an ordinal
to do one’s own shopping and errands. ranking system rather than continuous-scale scor-
ing which limits its ability to detect gradual changes
Background Information in individual performance. It also contains items
that have been found to be too easy (side-by-side
Senior Fitness Test balance task) or too difficult (5-times chair stand)
In response to the need for valid field-based to be effective performance discriminators for up
(nonlaboratory) measurement tools for assessing to 20%–50% of community-residing older adults
fitness parameters in older adults, Rikli and Jones (Guralnik et al., 1994; Seeman et al., 1994) and
(1999a, 1999b) developed a comprehensive func- for as much as 75% of assisted living/residential
tional fitness test battery that included normative care patients (Giuliani et al., 2008).

2 The Gerontologist
 Table 1. Brief Descriptions of Senior Fitness Test Items

Assessment category Test item Test description

Lower body strength 30-s chair stand Number of full stands in 30 s with
arms folded across chest
Upper body strength 30-s arm curl Number of bicep curls in 30 s holding
hand weight (women 5 lb; men 8 lb)
Aerobic endurance 6-min walk or Number of yards walked in 6 min
around 50-yard course
2-min step test (alternate aerobic test) Number of full steps completed in 2 min,
raising each knee to point midway between
patella and iliac crest (score is number
of times right knee reaches target)
Lower body flexibility Chair sit-and-reach From sitting position at front of chair,
with leg extended and hands reaching
toward toes, number of inches (+or −) from
extended fingers to tip of toe

Downloaded from http://gerontologist.oxfordjournals.org/ at University of Arizona on June 25, 2012

Upper body flexibility Back scratch With one hand reaching over shoulder
and one up middle of back,
number of inches between
extended middle fingers (+ or −)
Agility/dynamic balance 8-foot up-and-go Number of seconds required to get up
from seated position, walk 8 foot, turn,
and return to seated position on chair
Note: Full description of Senior Fitness Test items, formerly described as the Fullerton Functional Fitness Test, can be found
in Rikli and Jones (1999a, 2001, in press).

Normative Versus Criterion-Referenced Performance More specifically, criterion-referenced standards,

Standards which are typically more subjective and more com-
The normative fitness standards (percentile tables) plex to develop than norm-referenced standards,
previously developed for the SFT make it possible are those that connect a specific attribute such as
for individuals to compare their performance with lower body strength to that which is required to
peers of their same age and gender. A 75-year-old meet a particular performance goal, such as
male, for example, who receives a score of 15 on a remaining physically independent (i.e., being able
particular test item, such as the chair stand test for to perform normal everyday activities).
lower body strength, could look at the percentile Because of the complexity involved with estab-
tables and see how he compared with others in his lishing criterion-referenced standards for perfor-
age group and know whether he had scored better mance tests, as becomes evident when reviewing
or worse than any given percentage of his peers. the published work in this area much of which has
What is not possible to determine, though, from centered on the nation’s youth fitness testing pro-
normative standards is the level of fitness needed grams (Cureton & Warren, 1990; Mahar & Rowe,
on an attribute (such as lower body strength) to 2008; Welk & Meredith, 2008), the process is usu-
maintain sufficient physical capacity to avoid being ally an evolving one that extends over time. Once
“at risk” for losing independence in later years. an initial set of standards are proposed, typically
Although normative standards can be of personal based on a combination of data-based statistics,
interest to older adults, criterion standards are literature review, and subjective reasoning, addi-
those of most use in providing researchers and tional studies are needed to further confirm and
practitioners with the kind of clinical information refine the accuracy and appropriateness of the
they need to evaluate fitness level relative to that original standards.
required for maintaining physical independence.
Per Safrit and Wood (1995), “A criterion- Methods
referenced test is defined as a test with a predeter- The processes followed in establishing criterion-
mined standard of performance, with the standard referenced fitness standards for older adults are
tied to a specified domain of behavior” (p. 175). consistent with previously published well-defined

3
procedures (Baumgartner, Jackson, Mahar, & Rowe, (which is the purpose of the SFT) but also the
2007; Cureton & Warren, 1990; Mahar & Rowe, ultimate behavioral goal—ability to perform the
2008; Morrow, Jackson, Disch, & Mood, 2011; everyday activities needed for maintaining physical
Safrit & Wood, 1995), procedures that involve independence. In this study, having the physical
three major steps—(a) identifying an appropriate ability needed to live independently was assessed
criterion measure to asses the goal of interest through self-report using the Composite Physical
(physical independence, in this case), (b) setting the Function (CPF) scale, one that was developed based
performance standards (fitness cut-point scores), on an adaptation and extension of other previously
and (c) testing the validity and reliability of the published scales by Siu, Reuben, and Hays (1990),
standards as predictors of the criterion goal (phys- by Rosow and Breslau (1966), and with items also
ical independence). taken from the National Health Interview Survey
(National Center for Health Statistics, 1991). The
resulting 12-item CPF scale described in Table 2 is
Step 1—Identifying an Appropriate Criterion capable of assessing physical function across a wide
Measure to Assess Physical Independence range of abilities—from those associated with basic

Downloaded from http://gerontologist.oxfordjournals.org/ at University of Arizona on June 25, 2012

In establishing criterion-referenced fitness stan- activities of daily living (ADLs such as dressing
dards for older adults, it is important to have a and bathing oneself) to instrumental or intermedi-
suitable method for assessing not only fitness level ate ADLs (such as housework and shopping) to

Table 2. Composite Physical Function (CPF) Scale

Instructions: Indicate your ability to do each of the following by circling appropriate response. Your response should indicate
whether you “can do” these activities, not if you actually “do” the activities

Can do on own without help Can do with help Cannot do

a. Take care of own personal needs—like dressing yourself 2 1 0
b. Bathe yourself, using tub or shower 2 1 0
c. Walk outside (1–2 blocks) 2 1 0
d. Do light household chores—like cooking, 2 1 0
dusting, washing dishes, and sweeping a walkway
e. Climb up and down a flight of stairs 2 1 0
f. Do own shopping/errands 2 1 0
(walk approximately 3–4 blocks; 400 yards)
g. Lift and carry 10 pounds (bag of groceries) 2 1 0
h. Walk 1/2 mile (6–7 blocks) 2 1 0
i. Walk 1 mile (12–14 blocks) 2 1 0
j. Lift and carry 25 pounds (medium to large suitcase) 2 1 0
k. Do heavy household activities—like scrubbing, 2 1 0
floors, vacuuming, and raking leaves
l. Do strenuous activities—like hiking, 2 1 0
digging in garden, moving heavy objects,
bicycling, aerobic dance activities,
strenuous calisthenics, etc.
Notes: CPF Rating Scale: High (advanced) functioning: those able to perform all 12 activities without assistance (CPF score
of 24); Moderate functioning: those with current ability to perform at least seven activities (score of 14) without assistance, thus
meeting commonly recognized requirements for physical independence–able to take care of personal needs, do light housework,
walk three to four blocks, negotiate steps, do own shopping, etc.; and Low functioning (at risk): those unable to meet require-
ments for moderate functioning, thus indicating a person may be “at risk” for losing physical independence.
a
Moderate functioning, “age-adjusted” scoring: Ages 90 and above: CPF score of 14 (able to perform at least seven activities
without assistance), Ages 80–89: CPF score of 16 (able to perform at least eight activities without assistance), Ages 70–79: CPF
score of 18 (able to perform at least nine activities without assistance), and Ages 60–69: CPF score of 20 (able to perform at least
10 activities without assistance). The age-adjusted (higher) scoring requirements for a moderate rating for those younger than 90
years are to allow for an anticipated decline in functional ability that is similar to the 10–15% commonly reported rate of
physiological decline per decade in older adults, thus creating a standard for “moderate” functioning that reflects “projected”
ability for independent functioning in later years (90+), rather than current ability to function independently. Table adapted from
Rikli and Jones (1998).

4 The Gerontologist
advanced activities, such as strenuous sport, house- 70s, and even 80s) have more stringent criteria
hold, and exercise activities. Evidence supporting than those in their 90s for being assessed as “mod-
the test–retest reliability (R = .94) and validity of erate” functioning, criteria that are set high enough
the CPF (Rikli & Jones, 1998) is consistent with to allow younger older adults to experience nor-
other findings suggesting that self-report measures mal age-related declines and not progress below
of functional ability generally are reliable and valid the functional ability requirements for indepen-
(Guralnik, Reuben, Buchner, & Ferrucci, 1995; dent living at age 90. Therefore, knowing that
Hoeymans, Wouters, Feskens, van den Bos, & age-related declines in physical capacity after the
Kromhout, 1997). age of 50 or 60 are commonly reported to be at
The CPF scale can be used to categorize indi- least 10%–15% per decade and that declines in
viduals as “high (advanced) functioning,” “mod- physical capacity are associated with declines in
erate functioning,” or as “low functioning” and functional ability (Macaluso & De Vito, 2004; Morey
“at risk” for loss of independence. High function- et al., 1998; Paterson et al., 2007; Vandervoort,
ing are those who indicate that they can perform 2002), it may be reasonable to assume (in the
all 12 items on their own without assistance, thus absence of better data) that performance on the

Downloaded from http://gerontologist.oxfordjournals.org/ at University of Arizona on June 25, 2012

receiving a perfect score of 24. Moderate function- CPF scale could likely decline at a somewhat simi-
ing are those who can do, or depending on their lar 10%–15% rate per decade rate as does physi-
age group, have the projected ability to do in later cal capacity. Based on this assumption, the
life a minimum of seven items on the CPF scale age-adjusted scoring option for defining moderate
without assistance, thus meeting the usual require- functioning, as described in Table 2, was used in
ments for physical independence (see additional this study. Whereas a score of 14 (ability to per-
discussion later). Low functioning individuals are form a minimum of seven CPF activities without
those who do not meet the requirements for a rat- assistance) is required for a rating of moderate for
ing of moderate, meaning that they have functional those aged 90 years and older, higher scores of
limitations in common everyday activities that 20, 18, and 16, respectively, are needed in order
may put them at risk for a possible loss of the abil- for those in their 60s, 70s, and 80s to be rated as
ity to live independently in later life. For the pur- moderate functioning. Thus, both the definition
poses of this study, “later in life” was defined as of moderate functioning and its interpretation are
age 90+, which seemed logical considering that adjusted for age. For those under the age of 90 years,
average life expectancy at birth is nearing 80 years a rating of moderate reflects projected ability for
of age and close to 84 years for those who reach the physical independence at age 90 rather than current
age of 65 years (Administration on Aging, 2010). ability to function independently. Those in their
Defining physical independence as having the 60s, 70s, and 80s, then, who fail to achieve the
ability to perform at least seven CPF activities appropriate age-adjusted requirement for a rating
without assistance is consistent with information of moderate would be rated as “low functioning”
reported elsewhere. It is commonly suggested that for their age and may be at risk for loss of mobility
living independently requires such attributes as and independence prior to age 90.
being able to dress and bathe oneself, do simple
housework, negotiate steps, lift and carry 10 lbs,
and walk at least three to four blocks (approxi- Step 2—Setting the Criterion Performance
mately 400 yards, far enough to walk from a Standards (Cut-Point Scores) for SFT Test Items
parking area to stores and buildings as needed to As is typical in initially establishing criterion-
do one’s own shopping and errands; Cress, Petrella, based standards, a combination of processes involv-
Moore, & Schenkman, 2005; Siu et al., 1990; U.S. ing subjective reasoning, data-based statistics, and
Department of Health and Human Services, 2006), literature review were utilized in arriving at the
with these being the kinds of activities that would recommended fitness standards (cut-point scores)
have to be “checked-off” on the CPF scale in order for the SFT test items, that is, fitness scores that
to meet the minimum requirement for independent would predict ability to function independently in
functioning. later years. Stage 1 of the process involved making
However, with the goal being to develop criterion the decision to use scores from the previously pub-
fitness standards that project one’s ability to live lished SFT normative data set as the initial starting
independently until later life (age 90+), it is impor- point for setting the standards, particularly the
tant that younger age groups (those in their 60s, fitness scores obtained by the 2,140 participants

5
who met the age-adjusted criteria for having mod- there was no evidence that the type of fitness mea-
erate functional ability as defined by the CPF. The sure (e.g., strength vs. aerobic) or gender (women vs.
normative SFT data set seemed especially appro- men) were factors in influencing the rate of decline
priate for use in developing criterion performance when performance was measured longitudinally
standards for this population because it is, to our versus cross-sectionally, 1.25 was considered an
knowledge, the largest data set of its kind reflect- appropriate conversion factor on all test items for
ing comprehensive measures of fitness for older both men and women. Again, it was important
adults and because it is based on a well-defined that fitness standards be set sufficiently high for
population of community-residing older adults. younger older adults so that the normal age-related
Demographic characteristics and SFT scores for declines will not cause them to progress below the
normative study participants are described in level of fitness needed for independent functioning
Rikli and Jones (1999b). Table 3 presents the at age 90.
average fitness scores achieved by the 2,140 subset As such, the ultimately “proposed fitness stan-
of moderate-functioning participants, scores that dards” presented in Table 4 reflect an average
served as the initial basis for the ultimately pro- anticipated decline in performance of 40.1% over

Downloaded from http://gerontologist.oxfordjournals.org/ at University of Arizona on June 25, 2012

posed criterion performance standards. the 30-year period from 60–64 to 90–94 compared
Stage 2 of the standards-setting process involved with the average 32.2% decline seen in the norma-
converting the obtained scores from the normative tive scores presented in Table 3, an increase that
database described earlier to recommended fitness approximates the 1.25 times greater rate of decline
standards, with adjustments made as appropriate observed in past studies when performance changes
to reflect other relevant information from the lit- were tracked over time as opposed to being mea-
erature such as data indicating that a faster rate of sured cross-sectionally.
physical decline is observed when performance is Only for the 90–94 age group were the pro-
tracked over time from one age period to the next posed criterion standards based directly (without
(i.e., measured longitudinally) versus when data are adjustment) on the scores achieved in the norma-
collected cross-sectionally (on different age groups tive database, a decision which seemed logical con-
at the same time). Thus, with the normative study sidering that the goal of maintaining independent
data having been collected from cross-sectional age functioning until late in life had already been met
groups, adjustments were needed in converting by these participants. For all other age groups, the
these scores to recommended fitness standards, proposed standards were set higher than the norma-
standards that would be set high enough to take tive scores in order to allow for the greater amount
into account the greater rate of decline expected of physical decline expected when performance is
when performance is tracked over time. tracked longitudinally versus cross-sectionally.
In past studies where both cross-sectional fitness Because there is no evidence in the literature
data (baseline comparisons across age groups) and suggesting that thresholds for maintaining physical
longitudinal data (scores collected over a period of independence should be different for men than for
time) were available on the same participants using women, the fitness standards proposed for those
the same measurement protocols, it was found over 90 on each test item are the same for both
that the average rate of physical decline measured sexes. Interestingly, as seen in Table 3, the actual
longitudinally was approximately 1.25 times as scores obtained by the 90-to 94- year-old men and
great as when measured cross-sectionally (Bassey & women in the normative database were nearly
Harries, 1993; Goodpaster et al., 2006; Hollenberg, identical on all fitness measures except upper body
Yang, Haight, & Tager, 2006; Jackson, Sui, Bebert, strength, despite the fact that men scored better
Church, & Blair, 2009; Kallman, Plato, & Tobin, than women on all test items at younger ages (e.g.,
1990; Rantanen et al., 1998; Stathokostas, Jacob- at ages 60–64). This pattern of age-related decline
Johnson, Petrella, & Paterson, 2004; Winegard, where fitness scores of men are higher than those
Hicks, Sale, & Vandervoort, 1996). Thus, in utiliz- of women in younger age groups but then tend to
ing data from the SFT normative study to propose converge and become more similar in later years
recommended fitness standards for various age due to a more rapid rate of physiologic decline in
groups, it was important to make adjustments that certain key areas (e.g., muscle mass and aerobic
reflected the approximate 1.25 times greater rate capacity) is consistent with findings reported else-
of decline expected when performance is to be where (Doherty, 2003; Goodpaster et al., 2006;
tracked over time. Because, in the studies reviewed, V. A. Hughes et al., 2001; Paterson et al., 2007).

6 The Gerontologist
 Table 3. Fitness Means and SD (in Parentheses) for the Subset (N = 2,140) of Normative Study Participants (Rikli & Jones, 1999b) Who Were Rated as Moderate Functioning
as Determined by Age-Adjusted Scores on the Composite Physical Function Scalea

Age groups
% Of decline
60–64 (n = 144) 65–69 (n = 369) 70–74 (n = 538) 75–79 (n = 515) 80–84 (n = 306) 85–89 (n = 180) 90–94 (n = 88) over 30 years
Lower body strength
(number of chair
stands in 30 s)
Women 13.8 (3.6) 13.7 (3.5) 12.8 (3.1) 12.5 (3.6) 11.9 (5.2) 10.7 (4.1) 9.2 (4.3) 33.3
Men 14.8 (4.7) 14.0 (4.5) 13.0 (4.0) 12.9 (3.6) 12.4 (3.6) 10.1 (4.6) 9.4 (3.6) 36.4
Upper body strength
(number of arm
curls in 30 s)
Women 15.4 (4.1) 14.8 (3.8) 14.1 (4.0) 13.9 (4.0) 13.4 (4.0) 12.5 (3.2) 11.0 (3.9)) 28.6
Men 18.0 (5.0) 17.2 (5.1) 17.3 (5.1) 15.5 (3.9) 15.6 (3.8) 13.4 (3.2) 12.3 (3.4) 31.9
Aerobic endurance

7
(yards walked
in 6 min)
Women 578 (81) 550 (102) 539 (87) 503 (100) 484 (83) 456 (98) 407 (125) 29.6
Men 610 (89) 597 (92) 568 (100) 500 (142) 505 (99) 443 (126) 404 (131) 33.8
Alternate aerobic
endurance
(number of steps
in 2 min)
Women 85.9 (24.5) 85.1 (24.2) 83.5 (21.9) 83.1 (23.0) 78.5 (19.7) 74.2 (18.4) 60.4 (22.1) 29.7
Men 92.6 (20.8) 89.3 (25.1) 92.5 (20.6) 90.1 (27.0) 81.2 (27.1) 75.5 (28.5) 60.0 (22.1) 35.2
Agility/dynamic balance
(8-foot up-and-go, s)
Women 5.4 (1.2) 5.6 (1.0) 6.0 (1.3) 6.3 (1.2) 6.6 (1.4) 7.2 (1.6) 7.8 (1.6) 30.8b
Men 5.2 (1.6) 5.6 (1.3) 6.2 (2.5) 6.2 (1.9) 6.4 (1.4) 7.4 (3.1) 7.7 (2.0) 32.5b
Notes: aSee Table 2 for a definition of moderate functional ability. Mean decline = 32.2%.
b
The percent of change in performance for the 8-foot up-and-go was calculated by dividing the amount of change by the higher score, so that the proportion of change would
be calculated in a manner comparable to other test items.

Downloaded from http://gerontologist.oxfordjournals.org/ at University of Arizona on June 25, 2012

 Table 4. Criterion-Referenced Fitness Standards for Maintaining Physical Independence in Older Adults

Age groups % Of decline

reflected over
60–64 65–69 70–74 75–79 80–84 85–89 90–94 30 years
Lower body strength
(number of chair
stands in 30 s)
Women 15 15 14 13 12 11 9 40.0
Men 17 16 15 14 13 11 9 47.1
Upper body strength
(number of arm curls in 30 s)
Women 17 17 16 15 14 13 11 35.3
Men 19 18 17 16 15 13 11 42.1
Aerobic endurance
(yards walked in 6 min)
Women 625 605 580 550 510 460 400 36.0

Downloaded from http://gerontologist.oxfordjournals.org/ at University of Arizona on June 25, 2012

Men 680 650 620 580 530 470 400 41.2
Alternate aerobic endurance
(number of steps in 2 min)
Women 97 93 89 84 78 70 60 38.1
Men 106 101 95 88 80 71 60 43.4
Agility/dynamic balance
(8-foot up-and-go, s)
Women 5.0 5.3 5.6 6.0 6.5 7.1 8.0 37.5
Men 4.8 5.1 5.5 5.9 6.4 7.1 8.0 40.0
Mean decline = 40.1
Note: The proposed fitness standards were developed for use with the Senior Fitness Test (SFT) battery (Rikli & Jones, 2001,
in press). The standards are based on actual SFT scores obtained by moderate-functioning older adults in a previously published
cross-sectional database (Rikli & Jones, 1999b), with scores adjusted as appropriate to reflect other relevant information in the
literature including an increased rate of decline over the years when performance is tracked longitudinally versus cross-sectionally.

Once fitness standards were established for the body strength (Paterson et al., 2007; Vandervoort,
oldest age group (90–94 years) and were proposed 2002).
for the youngest group (60–64 years) based on the The ultimately proposed standards of fitness for
rate of projected rate of decline that needed to be all age groups reflect “rounded off” numbers to
considered over the 30-year age span from 60–64 make them consistent with SFT scoring procedures
to 90–94, standards were then proposed for the and to make them more user-friendly. As seen in
remaining age groups based on additional age- and Table 4, to be consistent with SFT scoring instruc-
gender-related considerations, especially on the tions, all standards for the chair stand, arm curl,
“curvilinear” nature of physical decline during and step test are reported in whole numbers, with
aging that has been observed in almost all age- standards for the 6-min walk presented in 5-yard
related research involving cardiovascular and neu- increments. It is important to keep in mind that the
romuscular functioning (American College of recommended fitness standards are intended to be
Sports Medicine, 2009; Doherty, 2003; Macaluso & used as “guidelines” for evaluating fitness and for
De Vito, 2004; Paterson et al., 2007; Vandervoort, planning exercise interventions for older adults
2002). Typically, the rate of decline accelerates rather than as precise data points that have been
across decades from the 6th to the 7th and from calculated to smallest unit of measurement possible.
the 7th to the 8th, with even greater declines seen Additional information on administering the
from the 8th to the 9th decade. Therefore, as seen SFT items and on converting test protocols and
in Table 4, the proposed standards reflect a some- performance tables to metric units are presented in
what lesser rate of decline during the earlier the SFT Manual (Rikli & Jones, 2001, in press).
years and a greater rate in later years. In propos- Also included is additional information on how to
ing the standards, consideration was also given use the performance tables to interpret test results
to previous findings indicating that lower body and plan appropriate exercise interventions. As an
strength tends to decline at a faster rate than upper example, if a 73-year-old male scores 19 on the

8 The Gerontologist
chair stand test, 18 on the arm curl, and covers being used (the SFT and CPF) but also the validity
500 yards on 6-min walk test, one sees by looking and reliability of the proposed standards them-
at Table 4 that he met (or surpassed) recommended selves as predictors of the intended goal (physical
fitness standards on the strength items (chair stand independence in this case), a process that has been
and arm curl) but not on the aerobic endurance well defined elsewhere (Baumgartner et al., 2007;
test (6-min walk). Thus, an appropriate exercise Cureton & Warren, 1990; Morrow et al., 2011;
prescription for this person would include addi- Safrit & Wood, 1995).
tional emphasis on endurance types of activities. To estimate the validity and reliability of the
The third stage of the standards development proposed fitness standards, data were analyzed on
involved seeking input at various times during the a sample of 82 community-residing older adults
process from members of a panel of experts in the (48 women and 34 men, mean age = 70.2; SD = 5.7)
fields of gerontological health, exercise, and mea- who were ambulatory without the use of assistive
surement, a panel which included well-known devices and were not to have been advised by their
scholars in their respective areas as well as pro- physician to refrain from exercise.
gram leaders/practitioners who had considerable The validity of a criterion-referenced test

Downloaded from http://gerontologist.oxfordjournals.org/ at University of Arizona on June 25, 2012

“hands-on” experience in working with older addresses the question of consistency in properly
adults. The major overriding feedback from panel classifying individuals as having met (or not met)
members was that the methods followed in pro- the established standard on both the predictor test
posing the criterion “cut points” were logical, were and the criterion test. In the present study, for
based on the best data available, and that the example, a given fitness test standard would be
resulting criterion performance standards were considered valid if there were a high percent of par-
viable and would make a significant contribution ticipants who were consistent in meeting (or not
to the field of gerontology and to the quality of meeting) the established standard for their age
older adult programs. Panel members also helped group on both the SFT item and the CPF scale.
to identify various limitations of the study, which The validity coefficients (c values) reported in
are acknowledged in the section on Study Strengths Table 5 reflect the proportion of individuals who
and Limitations, and provided important recom- were accurately classified as having met or not met
mendations for the manuscript itself. the proposed standards on both test items—the SFT
item and the CPF measure of physical indepen-
dence. As indicated, all values were quite high,
Step 3—Determining the Validity and Reliability approaching or exceeding the recommended thresh-
of the Proposed Fitness Standards old of .80 (Safrit & Wood, 1995), meaning that SFT
Once fitness standards (cut-point scores) were standards generally had better than an 80% success
proposed, their accuracy was evaluated by testing rate in predicting functional ability and physical
their validity and reliability as predictors of the independence as measured by the CPF. Phi coeffi-
intended goal (ability to function independently as cients (ϕ), which indicate the correlation between
measured by the CPF). In developing criterion dichotomous variables, were also reported as
standards, it is important to document not only the another recommended method for assessing clas-
validity and reliability of the measurement tools sification consistency (Baumgartner et al., 2007).

Table 5. Validity of Criterion-Referenced Standards for Senior Fitness Test (SFT) Items

Total Women Men

Test item c ϕ n c ϕ n c ϕ n
30-s chair stand .87 .70 75 .86 .74 45 .86 .71 30
30-s arm curl .83 .66 69 .83 .52 40 .86 .72 29
6-min walk .91 .67 78 .88 .44 48 .97 .97 30
2-min step test .91 .79 68 .92 .81 40 .89 .76 28
8-foot up-and-go .79 .56 73 .80 .60 44 .79 .58 29
Note: c = validity coefficient, proportion of consistent classifications in having met or not met the standard on both measures—
the SFT field measure and the Composite Physical Function (CPF) criterion measure for functional independence. ϕ = phi coeffi-
cient, indicates correlation between the classifications on each variable (SFT and CPF), another indication of classification
consistency.

9
 Test–retest reliability of the standards was other relevant information from the literature,
determined by administering the SFT on two dif- especially that indicating a greater rate of decline
ferent occasions so that comparisons can be made when performance is tracked longitudinally versus
regarding the consistency of the classifications on cross-sectionally. It was important that standards
Day 1 compared with Day 2. Standards are consid- be set high enough so that a person’s level of fitness
ered to have good reliability when a large number would not decline below the level needed for inde-
of participants who meet (or do not meet) the pendent functioning in spite of normal age-related
established standard on Test Day 1 are consistent changes.
in also meeting (or not meeting) the standard on For the 90–94 age group only, actual observed
Day 2. scores (rather than adjusted scores) were proposed
As indicated in Table 6, the test–retest reliability as the recommended fitness standards, as this
of the standards (represented by Pa, proportion group already had demonstrated that they had
of agreement) was quite high for all test items, retained sufficient fitness to perform the activities
with most values being in the .80 to .97 range. The needed for living independently. Previous studies
Pa values in this study, which can be interpreted as suggest that the standards for 90–94 years old, even

Downloaded from http://gerontologist.oxfordjournals.org/ at University of Arizona on June 25, 2012

percentages, means that there generally was well though based on a relatively small proportion of
over 80% consistency in participant classifications participants, are reasonable and in line with other
from one test day to the next, thus suggesting that findings concerning the level of fitness needed for
the proposed standards are reliable and stable. independent functioning. The proposed 400-yard
Kappa values (kq) were also presented as an aide standard for 90–94 years old on the 6-min walk is
in interpreting the chance factor in determining within range of the 360–600 m (329–589 yards) pre-
degree of agreement, with values above .50 being viously reported recommendation for the minimum
desirable (Looney, 1989; Mahar & Rowe, 2008). walking distance needed to function indepen-
dently—that is, to be able to navigate within the
community to do one’s own shopping and errands
Results, Summary, and Discussion (Cohen, Sveen, Walker, & Brummel-Smith,
The purpose of this research was to develop and 1987; Lerner-Frankiel, Vargas, Brown, Krusell, &
validate criterion standards that estimate the level Schoneberger, 1986). The 400-yard standard on
of fitness needed by older adults to remain physi- the 6-min walk is also similar to the ¼ mile (440
cally independent into later life. The major study yards) criteria used by Medicare as a cut-point for
results are the proposed fitness standards for each defining mobility limitation and disability (U.S.
SFT item as presented in Table 4. The proposed Department of Health and Human Services, 2006).
standards are based on actual fitness scores obtained On the 8-foot up-and-go, the proposed standard
by a subset of 2,140 moderate-functioning women of 8.0 s for 90–94 years old to complete the test is
and men, ages 60–94, who were part of a larger similar to but appropriately faster than the 8.5 s
previously published study to establish normative cut-point that has been identified as a predictor of
standards for older Americans. In converting actu- falling (Rose, Jones, & Lucchese, 2002). Performing
ally observed scores to recommended standards, below (better than) the 8.5 cut-point for predicting
adjustments were made as appropriate to reflect falls is an especially important consideration, given

Table 6. Test–Retest Reliability of Criterion-Referenced Standards for Senior Fitness Test (SFT) Items

Total Women Men

Test Item Pa kq n Pa kq n Pa kq n
30-s chair stand .89 .79 73 .89 .78 42 .90 .80 31
30-s arm curl .80 .60 71 .79 .58 39 .81 .62 32
6-min walk .93 .86 73 .91 .82 44 .97 .94 29
2-min step test .88 .76 69 .90 .80 39 .87 .74 30
8-foot up-and-go .90 .80 71 .88 .76 40 .94 .88 31
Note: Pa = proportion of agreement in participants being consistently classified as having met or not met the SFT performance
standard on both Day 1 and Day 2. kq = modified kappa, provides a correction for chance in reporting classification consistency
(Looney, 1989).

10 The Gerontologist
that falls and fall-related injuries are a major cause nonexperimental untested predictions. Longitudinal
of loss of independence and escalating health care intervention studies will be required to test the
costs (Centers for Disease Control and Prevention, ultimate accuracy of the standards relative to their
2011). In addition, when comparing the newly ability to predict the level of fitness needed at vari-
proposed criterion standards with the previously ous ages to retain independent functioning in later
published SFT normative percentile tables, it was in life.
found that all 70 of the proposed standards (five Additional research is also needed to address
test items across seven age groups for both men the potential limitation associated with use of self-
and women) fell at or above the 40th percentile report to assess functional ability level, particu-
rank. This means that at least 40% of the norma- larly as measured by the CPF. Although evidence
tive population would not have met the fitness exists to support the reliability and validity of the
standard associated with independent functioning, CPF (Rikli & Jones, 1998) and of other self-report
an observation that is reasonably consistent with measures of physical ability (Guralnik, et al., 1995;
statistics reported elsewhere indicating that 40%– Hoeymans et al., 1997), additional studies are
50% of the over 65 population have difficulty with needed to confirm the effectiveness of the CPF for

Downloaded from http://gerontologist.oxfordjournals.org/ at University of Arizona on June 25, 2012

common activities needed for daily living and, thus, use in criterion standards development and also to
may be at risk for loss of independence (Federal clarify the relationship between rate of physical
Interagency Forum on Aging-Related Statistics, decline and decline in functional ability.
2010; Webber et al., 2010). Finally, with the baseline data for this research
collected on mostly white (89.1%), relatively well-
educated American (M = 14.5 years of education;
Study Strengths and Limitations
Rikli & Jones, 1999b), additional studies are needed
An important strength of this research is that to determine the degree to which results can be
the proposed fitness standards are based on actual generalized to other populations. With this research
data collected from a large geographically representa- being, to our knowledge, the first attempt at set-
tive study of over 7,000 community-residing older ting criterion-referenced fitness standards for older
Americans, with a special focus on scores of the adults, there clearly is a need for additional studies
2,140 subset of participants who met the age- to further confirm, clarify, and expand this initial
adjusted criteria for a rating of moderate function- work.
ing. The ultimately proposed standards also reflect
well-documented information from the literature Conclusion and Implications
(both longitudinal and cross-sectional) about pat-
terns of age- and gender-related declines in perfor- In conclusion, the criterion standards as proposed
mance and are based on easy-to-use measurement appear to have sufficiently strong empirical and
tools with strong psychometric properties. rational support to justify their use by both
The newly proposed fitness standards should researchers and practitioners as reasonable esti-
also have value as a complement to the national mates of the level of fitness associated with remain-
Physical Activity Guidelines for Americans (2008) ing physically mobile and independent in later life.
and similar documents developed in other countries. The SFT battery of test items with its accompany-
Although much research has gone into the prepara- ing criterion standards provides a unique and pre-
tion of these guidelines, experts in the field of aging viously unavailable method for evaluating physical
and physical activity report that confusion still fitness in older adults and for planning exercise
exists regarding their application to older adults, interventions that target areas of weakness. The
particularly regarding the threshold requirements criterion standards also provide the first of their
“to remain healthy and independent” (S. L. Hughes type, easy to interpret reference points to indicate
et al., 2011, p. 828). Thus, the fitness standards when fitness capacity indices in older adults may be
proposed in this research should help add clarity at a level that could put them at risk for premature
about the level of fitness and physical activity loss of physical independence.
needed to remain independent.
The major limitations in this research are similar Acknowledgments
to those in other studies involving the initial devel- Appreciation is extended to an advisory panel of experts, both scien-
tists and practitioners, who provided valuable input and feedback during
opment of criterion-referenced standards of perfor- various phases of this project. Members of the scientific review panel were
mance in that there is, by necessity, a reliance on Wojtek Chodzko-Zajko, Professor and Head, Department of Kinesiology

11
and Community Health, University of Illinois, Urbana-Champaign; Guralnik, J. M., Reuben, D. B., Buchner, D. M., & Ferrucci, L. (1995).
Matthew Mahar, Professor of Kinesiology, East Carolina University, Performance measures of physical function in comprehensive geriatric
Greenville; Miriam Morey, Professor of Medicine, Duke University; James assessment. In L. Z. Rubenstein, D. Wieland, & R. Bernabei. (Eds.), Geri-
R. Morrow, Jr., Regents Professor of Kinesiology, University of North atric assessment technology: The state of the art (pp. 59–74). Milan, Italy:
Texas, Denton; Naoko Muramatsu, Associate Professor of Community Editrice Kurtis.
Health Sciences, University of Illinois, Chicago; Donald Paterson, Research Guralnik, J. M., Simonsick, E. M., Ferrucci, L., Glynn, R. J., Berkman, L. F.,
Director, Canadian Centre for Activity and Aging, University of Western Blazer, D. G., et al. (1994). A short physical performance battery
Ontario; Debra Rose, Director, Center for Successful Aging, California assessing lower extremity function: Association with self-reported
State University, Fullerton; and Dawn Skelton, Professor, Aging and Health, disability and prediction of mortality and nursing home admission.
Glasgow Caledonian University, Glasgow. Program leader/practitioner Journal of Gerontology: Medical Sciences, 49, 85–94.
panel members were Jordan Aquino, Assistant Director, Pain Management Hoeymans, N., Wouters, E., Feskens, E., van den Bos, G., & Kromhout, D.
Center, California State University, Fullerton (CSUF); Jeana Miller, (1997). Reproducibility of performance-based and self-reported mea-
Operations Manager, CSUF Center for Successful Aging; Jan Montague, sures of functional status. Journal of Gerontology: Medical Sciences,
President, Whole Person Wellness Solutions Inc., Cincinnati; and Karen 52a(6), M363–M368. doi:10.1093/gerona/52A.6.M363
Schlieter, Assistant Director, FallProof Balance and Mobility Instructor Hollenberg, M., Yang, J., Haight, T. J., & Tiger, I. B. (2006). Longitudinal
Certificate Program, CSUF. changes in aerobic capacity: Implications for concepts of aging. Journal
of Gerontology: Medical Sciences, 61A, 851–858.
Hughes, S. L., Leith, K. H., Marquez, D. X., Moni, G., Nguyen, H. Q.,
Desai, P., et al. (2011). Physical activity and older adults: Expert con-
References
sensus for a new research agenda. The Gerontologist, 51, 822–832.
Administration on Aging. (2010). A profile of older Americans: 2010. doi:10.1093/geront/gnr106
Washington, DC: A report of the Administration on Aging, U.S.

Downloaded from http://gerontologist.oxfordjournals.org/ at University of Arizona on June 25, 2012

Hughes, V. A., Frontera, W. R., Wood, M., Evans, W. J., Dallal, G. E.,
Department of Health and Human Services. Roubenoff, R., et al. (2001). Longitudinal muscle strength changes in
American College of Sports Medicine. (2009). ACSM position stand: older adults: Influence of muscle mass, physical activity, and health.
Exercise and physical activity for older adults. Medicine and Science in Journal of Gerontology: Biological Sciences, 56A, B209–B217.
Sports and Exercise, 41, 1510–1530. doi:10.1249/MSS.0b013e3 doi:10.1093/gerona/56.5.B209
181a0c95c Jackson, A. S., Sui, X., Hebert, J. R., Church, T. S., & Blair, S. N. (2009).
Bassey, E. J., & Harries, U. J. (1993). Normal values for handgrip strength Role of lifestyle and aging on the longitudinal change in cardiorespiratory
in 920 men and women over 65 years, and longitudinal changes over fitness. Archives of Internal Medicine, 169, 1781–1787. doi:10.1001/
4 years in 620 survivors. Clinical Science, 84, 331–337. archinternalmed.2009.312
Baumgartner, T. A., Jackson, A. S., Mahar, M. T., & Rowe, D. A. (2007). Kallman, D. A., Plato, C. C., & Tobin, J. D. (1990). The role of muscle
Measurement for evaluation in physical education and exercise science loss in the age-related decline of grip strength: Cross-sectional and
(8th ed.). Boston: McGraw-Hill. longitudinal perspectives. Journal of Gerontology: Medical Sciences, 45,
Centers for Disease Control and Prevention. (2011). Costs of falls among 82–88.
older adults. Retrieved from http://www.cdc.gov/ncipc/factsheets/ Lerner-Frankiel, M. B., Vargas, S., Brown, M., Krusell, L., &
fallcost.htm Schoneberger, W. (1986). Functional community ambulation: What
Cesari, M. (2011). Role of gait speed in the assessment of older patients. are your criteria? Clinical Management in Physical Therapy, 6(2),
Journal of the American Medical Association, 305, 93–94. doi:10.1001/ 12–15.
jama.2010.1970 Looney, M. A. (1989). Criterion-referenced measurement: Reliability. In
Cohen, J. J., Sveen, J. D., Walker, J. M., & Brummel-Smith, K. (1987). M. J. Safrit & T. M. Woods (Eds.), Measurement concepts in physical
Establishing criteria for community ambulation. Topics in Geriatric education and exercise science (pp. 137–152). Champaign, IL: Human
Rehabilitation, 3(1), 71–77. Kinetics.
Cress, M. E., & Meyer, M. (2003). Maximal voluntary and functional Macaluso, A., & De Vito, G. (2004). Muscle strength, power and adapta-
performance levels needed for independence in adults ages 65 to 97 years. tions to resistance training in older people. European Journal of
Physical Therapy, 83, 37–48. Applied Physiology, 91, 450–472.
Cress, M. E., Petrella, J. K., Moore, T. L., & Schenkman, M. L. (2005). Mahar, M. R., & Rowe, D. A. (2008). Practical guidelines for valid and
Continuous-scale physical functional performance test: Validity, reli- reliable youth fitness testing. Measurement in Physical Education
ability, and sensitivity of data for the short version. Physical Therapy, and Exercise Science, 12(3), 126–145. doi:10.1080/1091367080
85, 323–335. 2216106
Cureton, K. J., & Warren, G. L. (1990). Criterion-referenced standards Morey, M. C., Pieper, C. F., & Cornoni-Huntley, J. (1998). Physical fitness
for youth health-related fitness tests: A tutorial. Research Quarterly and functional limitations in community-dwelling older adults.
for Exercise and Sport, 61, 7–19. Medicine & Science in Sports & Exercise, 30, 715–723.
Doherty, T. J. (2003). Invited review: Aging and sarcopenia. Journal of Applied Morrow, J. R., Jr., Jackson, A. W., Disch, J. G., & Mood, D. P. (2011).
Physiology, 95, 1717–1727. doi:10.1152/japplphysiol.00347.2003 Measurement and evaluation in human performance (4th ed.).
Federal Interagency Forum on Aging-Related Statistics. (2010). Older Champaign, IL: Human Kinetics.
Americans 2010: Key indicators of well-being. Washington, DC: U.S. National Center for Health Statistics. (1991). National Health Inter-
Government Printing Office. view Survey 1991(10): Vital Health Statistics. Washington, DC:
Fiatarone Singh, M. S. (2002). Exercise to prevent and treat functional Author.
disability. Clinics in Geriatric Medicine, 18, 431–462. Paterson, D. H., Jones, G. R., & Rice, C. L. (2007). Ageing and physical
Fleg, J. L., Morrell, C. H., Bos, A. G., Brant, L. J., Talbot, L. A., Wright, J. G., activity: Evidence to develop exercise recommendations for older
et al. (2005). Accelerated longitudinal decline of aerobic capacity in adults. Applied Physiology, Nutrition, and Metabolism, 32(Suppl. 2E),
health older adults. Circulation, 112, 674–682. doi:10.1161/CIRCU- S69–S108. doi:10.1139/H07-111
LATIONAHA.105.545459 Paterson, D. H., & Warburton, D. E. R. (2010). Physical activity and
Giuliani, C. A., Gruber-Baldini, A. L., Park, N. S., Schrodt, L. A., Rokoske, F., functional limitations in older adults: A systematic review related to
Sloane, P. D., et al. (2008). Physical performance characteristics Canada’s Physical Activity Guidelines. International Journal of
of assisted living residents and risk for adverse health outcomes. The Behavioral Nutrition and Physical Activity, 7, 1–22. doi:10.1186/1479-
Gerontologist, 48, 203–212. doi:10.1093/geront/48.2.203 5868-7-38
Goodpaster, B. H., Park, S. W., Harris, T. B., Kritchevsky, S. B., Nevitt, M., Physical Activity Guidelines for Americans. (2008). U.S. department
Schwartz, A. V., et al. (2006). The loss of skeletal muscle strength, of health and human services. Retrieved from www.health.gov/
mass, and quality in older adults: The health, aging, and body composi- paguidelines
tion study. Journal of Gerontology: Medical Sciences, 61A, 1059–1064. Rantanen, T., Masaki, K., Foley, D., Izmirlian, G., White, L., & Guralnik, J. M.
Guralnik, J. M., Ferrucci, L., Pieper, C. F., Leveille, S. G., Markides, K. S., (1998). Grip strength changes over 27 yr in Japanese-American men.
Ostir, G. V., et al. (2000). Lower extremity function and subsequent Journal of Applied Physiology, 85(6), 2047–2053.
disability: Consistency across studies, predictive models, and value of gait Rikli, R. E., & Jones, C. J. (1998). The reliability and validity of a 6-minute
speed alone compared with the Short Physical Performance Battery. walk test as a measure of physical endurance in older adults. Journal of
Journal of Gerontology: Medical Sciences, 55A, 221–231. Aging and Physical Activity, 6, 363–375.

12 The Gerontologist
Rikli, R. E., & Jones, C. J. (1999a). Development and validation of a Siu, A. L., Reuben, D. B., & Hays, R. D. (1990). Hierarchical measures of
functional fitness test for community-residing older adults. Journal of physical function in ambulatory geriatrics. Journal of the American
Aging and Physical Activity, 6, 127–159. Geriatrics Society, 38, 1113–1119.
Rikli, R. E., & Jones, C. J. (1999b). Functional fitness normative scores for Stathokostas, L., Jacob-Johnson, S., Petrella, R. J., & Paterson, D. H. (2004).
community-residing adults, ages 60-94. Journal of Aging and Physical Longitudinal changes in aerobic power in older men and women. Journal
Activity, 6, 160–179. of Applied Physiology, 97, 781–789. doi:10.1152/japplphysiol.
Rikli, R. E., & Jones, C. J. (2001). Senior fitness test manual. Champaign, 00447.2003
IL: Human Kinetics. Studenski, S., Perera, S., Patel, K., Rosano, C., Faulkner, K., Inzitari, M., et al.
Rikli, R. E., & Jones, C. J. (in press). Senior fitness test manual (2nd ed.). (2011). Gait speed and survival in older adults. Journal of the American
Champaign, IL: Human Kinetics. Medical Association, 305, 50–58. doi:10.1001/jama.2010.1923
Rose, D. J., Jones, C. J., & Lucchese, N. (2002). Predicting the probability U.S. Department of Health and Human Services. (2006). Medicare Current
of falls in community-residing older adults using the 8-foot up-and-go: Beneficiary Survey (MCBS), Centers for Medicare and Medicaid
A new measure of functional mobility. Journal of Aging and Physical Services. Retrieved from http://www.cms.hhs.gov/MCBS
Activity, 10, 466–475. Vandervoort, A. A. (2002). Aging of the human neuromuscular system.
Rosow, I., & Breslau, N. (1966). A guttman health scale for the aged. Muscle & Nerve, 25, 17–25. doi:10.1002/mus.1215
Journal of Gerontology, 21, 556–559. Webber, S. C., Porter, M. M., & Menec, V. H. (2010). Mobility in older
Safrit, M. J., & Wood, T. M. (1995). Introduction to measurement in adults: A comprehensive framework. The Gerontologist, 50, 443–450.
physical education and exercise science (3rd ed.). St. Louis, MO: doi:10.1093/geront/gnq013
Mosby-Year Book, Inc. Welk, G. J. & Meredith, M. D. (Eds.). (2008). Fitnessgram/Activitygram
Seeman, T. E., Charpentier, P. A., Berkman, L. F., Tinetti, M. E., reference guide. Dallas, TX: The Cooper Institute.
Guralnik, J. M., Albert, M., et al. (1994). Predicting changes in physical Winegard, K. J., Hicks, A. L., Sale, D. G., & Vandervoort, A. A. (1996).
performance in a high-functioning elderly cohort: MacArthur Studies A 12-year follow-up study of ankle muscle function in older adults.

Downloaded from http://gerontologist.oxfordjournals.org/ at University of Arizona on June 25, 2012

of Successful Aging. Journal of Gerontology: Medical Sciences, 49, Journal of Gerontology: Biological Science, 51A, B202–B207.
97–108. doi:10.1093/gerona/51A.3.B202

13