June 28 - 29, 2007 Advisory Committee Meeting Minutes

Functional Health

Dr. Nelson indicated functional health affects all ages, sexes and different socio-economic subgroups. The review of issues around functional health were discussed mainly around different age groups but with an emphasis on older adults as impairment disproportionately affects this age group and they are the least active and the fastest growing age group.

For the Committee's purposes it will be difficult to define an older adult. The American College of Sports Medicine and American Heart Association completed a process that used the approach that anyone 65 and older is an older adult. However, there are adults that are in their 50's that have impairments that make them seem older.

Another issue that will be challenging will include defining functional health. For older adults there is incongruity between what older adults think they can achieve physically and what they actually can achieve. Also, because many older adults have a low baseline for normal physical activity, doses of low activity must be interpreted differently in this age group.

Regarding other age groups, functional health may be a central issue at earlier ages because of the overall absolute lack of physical fitness.

Discussion following Dr. Nelson's presentation centered around the question of focusing on fitness as a health outcome and its role in the Committee's report. Additionally, the question of fitness as an exposure variable as well as the relationship between fitness and clinical outcomes were raised. The Committee discussed the importance of addressing functional health as it relates to persons with disabilities. Balance training was also mentioned as something to include with fitness parameters. It was verified that the initial database treats fitness as an exposure and fitness as an outcome should be flagged for Phase B.

The definition of older adult was again raised. It was noted other agencies have definitions of an older adult and that the Committee should not contradict those definitions as it is important the government speak with one voice.

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