This nationwide cohort study in Taiwan evaluated associations between objectively measured physical fitness across 4 domains (cardiorespiratory fitness, muscular strength, flexibility, balance/agility) and all-cause mortality in 13,423 community-dwelling adults aged ≥65 years, with up to ~7 years of follow-up (2015–2022).
12.2% of participants died over median 7.0 years. Compared to the lowest quintile, the highest quintile had significantly lower mortality: 8-foot up-and-go (AHR 0.41), 1-leg stance (AHR 0.50), 30-second chair stand (AHR 0.55), and 2-minute step test (AHR 0.58). A composite fitness index showed the strongest protection (AHR 0.39, 95% CI 0.32–0.48).
- Single-country cohort (Taiwan) limits generalizability to other populations. - Self-reported physical activity was used as a covariate, introducing potential recall bias. - Fitness was measured only at baseline; changes in fitness over time were not captured.
Routine objective fitness testing — especially balance, agility, and lower-body strength — can meaningfully stratify mortality risk in older adults beyond comorbidity burden alone. Clinicians should consider integrating simple tests like the 8-foot up-and-go and 1-leg stance into geriatric assessments to guide function-oriented interventions.
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