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Physical performance transition and the risk of adverse health outcomes among community-dwelling older adults with or without fatigue
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  • Published: 04 February 2026

Physical performance transition and the risk of adverse health outcomes among community-dwelling older adults with or without fatigue

  • Dan Su  ORCID: orcid.org/0000-0002-6090-59901,2 na1,
  • Yanling Su  ORCID: orcid.org/0000-0003-4894-58071,
  • Xiaojun Zhang  ORCID: orcid.org/0000-0002-6317-42222,
  • Jagadish K. Chhetri  ORCID: orcid.org/0000-0002-8053-44292 na1 &
  • …
  • Piu Chan  ORCID: orcid.org/0000-0003-1346-881X2 

Scientific Reports , Article number:  (2026) Cite this article

We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Subjects

  • Diseases
  • Health care
  • Medical research
  • Risk factors

Abstract

The longitudinal relationship between fatigue and physical deterioration is least explored. The aim of the study was to investigate the physical performance transitions and the relationship with adverse outcomes over 3-years in older people with or without fatigue. This 3-year longitudinal study included 456 community-dwelling older adults (mean age: 73.5 ± 7.5 years; female 43.0%). Physical performance was assessed using the Short Physical Performance Battery (SPPB). Fatigue was assessed by a single-item question “Have you felt tired or fatigued on at least 3 or 4 days each week?” At follow-up, both groups showed a trend towards lower physical performance levels, with the fatigue group exhibiting a significantly more pronounced decline. After adjusting for covariates, new-onset sarcopenia(OR = 3.08, 95%CI = 2.18–5.45) and malnutrition(OR = 2.70, 95%CI = 1.38–5.57) were the significant adverse events associated with physical performance deterioration in individuals with fatigue at 3-year follow-up. While for non-fatigue older adults, cognitive impairment (OR = 1.81,95%CI = 1.52–3.84) and sarcopenia(OR = 1.83, 95%CI = 1.50–5.33) were the significant adverse events associated with physical performance deterioration. The characteristics of older individuals with and without fatigue are distinct while considering longitudinal physical performance transitions. Fatigue is a significant risk factor associated with geriatric syndromes such as sarcopenia and malnutrition in individuals who have poor physical performance.

Clinical trial number: ChiCTR2100051397.

Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Beard, J. R. et al. The world report on ageing and health: a policy framework for healthy ageing. Lancet 387, 2145–2154 (2016).

    Google Scholar 

  2. World Health Organization. Ageing and health. https://www.who.int/news-room/fact-sheets/detail/ageing-and-health (2022).

  3. Zhou, Y. & Ma, L. Intrinsic capacity in older adults: recent advances. Aging Disease. 13, 353–359 (2022).

    Google Scholar 

  4. Bautmans, I. et al. WHO working definition of vitality capacity for healthy longevity monitoring. Lancet Healthy Longev. 3, e789–e796 (2022).

    Google Scholar 

  5. Zengarini, E. et al. Fatigue: relevance and implications in the aging population. Exp. Gerontol. 70, 78–83 (2015).

    Google Scholar 

  6. Loy, B. D., Cameron, M. H. & O’Connor, P. J. Perceived fatigue and energy are independent unipolar states: supporting evidence. Med. Hypotheses. 113, 46–51 (2018).

    Google Scholar 

  7. Ehrenkranz, R. et al. Functional correlates of self-reported energy levels in the Health, aging and body composition study. Aging Clin. Exp. Res. 33, 2787–2795 (2021).

    Google Scholar 

  8. Menting, J. et al. Is fatigue a disease-specific or generic symptom in chronic medical conditions? Health Psychol. 37, 530–543 (2018).

    Google Scholar 

  9. Reyes-Gibby, C. C. et al. Pain and fatigue in community-dwelling adults. Pain Med. 4, 231–237 (2003).

    Google Scholar 

  10. Wijeratne, C., Hickie, I. & Brodaty, H. The characteristics of fatigue in an older primary care sample. J. Psychosom. Res. 62, 153–158 (2007).

    Google Scholar 

  11. Knoop, V. et al. Fatigue and the prediction of negative health outcomes: A systematic review with meta-analysis. Ageing Res. Rev. 67, 101261 (2021).

    Google Scholar 

  12. Norton, S. A. et al. Inflammation is associated with pain and fatigue in older adults. Brain Behav. Immun. – Health. 52, 101020 (2024).

    Google Scholar 

  13. Cappola, A. R. et al. Thyroid and adrenal function and the geriatric syndrome of fatigue. J. Clin. Endocrinol. Metabol.. 94, 1656–1662 (2009).

    Google Scholar 

  14. D’Antona, G. & S. Dioguardi, F. Fatigue in older persons: the role of nutrition. Proc. Nutr. Soc. 82, 189–199 (2023).

    Google Scholar 

  15. Egerton, T. et al. Fatigue May contribute to reduced physical activity among older people: an observational study. J. Gerontol. Ser. A. 71, 670–676 (2016).

    Google Scholar 

  16. Egerton, T. et al. Fatigue alters the pattern of physical activity behavior in older adults: observational analysis of data from the generation 100 study. J. Aging Phys. Act. 24, 633–641 (2016).

    Google Scholar 

  17. Brahms, M. et al. The acute effects of mental fatigue on balance performance in healthy young and older adults - A systematic review and meta-analysis. Acta. Psychol. 225, 103540 (2022).

    Google Scholar 

  18. Ehrenkranz, R. et al. Longitudinal associations between higher Self-Reported Energy, gait Speed, and cognition in older adults with fatigue. Journals Gerontology: Ser. A. 78, 2407–2414 (2023).

    Google Scholar 

  19. Kerber, K. A. et al. Trajectories in physical performance and fall prediction in older adults: A longitudinal population-based study. J. Am. Geriatr. Soc. 70, 3413–3423 (2022).

    Google Scholar 

  20. Carroll, C. P. & Brandow, A. M. Chronic pain: prevalence and management. Hematol. Oncol. Clin. N. Am. 36, 1151–1165 (2022).

    Google Scholar 

  21. van Marwijk, H. W. et al. Evaluation of the feasibility, reliability and diagnostic value of shortened versions of the geriatric depression scale. Br. J. Gen. Pract. 45, 195–199 (1995).

    Google Scholar 

  22. Folstein, M. F., Folstein, S. E. & McHugh, P. R. Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. J. Psychiatr. Res. 12, 189–198 (1975).

    Google Scholar 

  23. Vellas, B. et al. The mini nutritional assessment (MNA) and its use in grading the nutritional state of elderly patients. Nutrition 15, 116–122 (1999).

    Google Scholar 

  24. Chen, L. K. et al. Sarcopenia in asia: consensus report of the Asian working group for sarcopenia. J. Am. Med. Dir. Assoc. 15, 95–101 (2014).

    Google Scholar 

  25. Mahoney, F. I. & Barthel, D. W. FUNCTIONAL EVALUATION: THE BARTHEL INDEX. Maryland State Med. J. 14, 61–65 (1965).

    Google Scholar 

  26. Su, D., Chang, J. & Chan, P. Exposure to ambient air pollution and falls risk in a community-dwelling adult population. Maturitas 202, 108712 (2025).

    Google Scholar 

  27. Abd-Elfattah, H. M., Abdelazeim, F. H. & Elshennawy, S. Physical and cognitive consequences of fatigue: A review. J. Adv. Res. 6, 351–358 (2015).

    Google Scholar 

  28. Marcora, S. M., Staiano, W. & Manning, V. Mental fatigue impairs physical performance in humans. J. Appl. Physiol. 106, 857–864 (2009).

    Google Scholar 

  29. Ament, W. & Verkerke, G. J. Exercise and fatigue. Sports Med. 39, 389–422 (2009).

    Google Scholar 

  30. Tolea, M. I. & Galvin, J. E. Sarcopenia and impairment in cognitive and physical performance. Clin. Interv. Aging. 10, 663–671 (2015).

    Google Scholar 

  31. Cesari, M. et al. Sarcopenia and physical frailty: two sides of the same coin. Front. Aging Neurosci. 6, 192 (2014).

    Google Scholar 

  32. Ramsey, K. A. et al. Malnutrition is associated with dynamic physical performance. Aging Clin. Exp. Res. 32, 1085–1092 (2020).

    Google Scholar 

  33. Kramer, C. S. et al. The association between malnutrition and physical performance in older adults: A systematic review and Meta-Analysis of observational studies. Curr. Devel. Opments Nutr. 6, nzac007 (2022).

    Google Scholar 

  34. Gray, M. et al. Cognitive decline negatively impacts physical function. Exp. Gerontol. 143, 111164 (2021).

    Google Scholar 

  35. Best, J. R. et al. Long term changes in time spent walking and subsequent cognitive and structural brain changes in older adults. Neurobiol. Aging. 57, 153–161 (2017).

    Google Scholar 

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Acknowledgements

We thank all participants of the study.

Author information

Author notes
  1. These authors contributed equally to this work: Dan Su and Jagadish K Chhetri.

Authors and Affiliations

  1. Department of Geriatrics, Liangxiang Hospital of Beijing Fangshan District, Beijing, 102400, China

    Dan Su & Yanling Su

  2. National Clinical Research Center for Geriatric Diseases, Department of Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China

    Dan Su, Xiaojun Zhang, Jagadish K. Chhetri & Piu Chan

Authors
  1. Dan Su
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  2. Yanling Su
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  3. Xiaojun Zhang
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  4. Jagadish K. Chhetri
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  5. Piu Chan
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Contributions

Conceptualization: Piu Chan and Jagadish K Chhetri; Data curation: Zhang Xiao Juan and Su Dan; Funding acquisition: PC. Methodology and data analysis: Su Yanling, SD, ZXJ; Manuscript Drafting: SD; Review & editing: PC, JKC.

Corresponding authors

Correspondence to Jagadish K. Chhetri or Piu Chan.

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The authors declare no competing interests.

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Cite this article

Su, D., Su, Y., Zhang, X. et al. Physical performance transition and the risk of adverse health outcomes among community-dwelling older adults with or without fatigue. Sci Rep (2026). https://doi.org/10.1038/s41598-026-37997-8

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  • Received: 09 July 2025

  • Accepted: 28 January 2026

  • Published: 04 February 2026

  • DOI: https://doi.org/10.1038/s41598-026-37997-8

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Keywords

  • Physical decline
  • Aging
  • Exhaustion
  • Healthy ageing
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