Lower-limb power and gait speed as early markers of functional decline in middle-aged women

This study examined whether lower-limb power and gait speed act as early markers of functional decline in middle-aged women compared with older women. In a cross-sectional design, 31 community-dwelling women were assessed and divided into two groups: 40-59 years (n=12) and ≥60 years (n=19). Primary outcomes were lower-limb muscle power estimated from the 30- and 60-second sit-to-stand tests (STS-30/60), six-minute walk test (6MWT) distance and habitual gait speed. Secondary outcomes included handgrip strength and frailty status (FRAIL scale and Fried phenotype). Between-group comparisons used Mann-Whitney tests with Hedges’ g and effect size r, and p values for primary outcomes were adjusted using the Holm-Bonferroni method. Middle-aged women showed better performance in STS-30/60, 6MWT distance and gait speed than women ≥60 years, with statistically significant differences and moderate-to-large effect sizes, whereas handgrip strength was similar between groups. Sit-to-stand-derived power was positively associated with gait speed. Frailty-related measures indicated a burden of prefrailty/frailty across the sample, with a numerically greater vulnerability in the ≥60 group and evidence of non-robust profiles already present among some middle-aged women. These findings suggest that simple tests of lower-limb power and gait speed may serve as practical early markers of functional decline in women, supporting their use for screening and exercise prescription from midlife onwards.