Physical Performance, Muscle Strength, and Frailty: Differential Associations with Health-Related Quality of Life in Peri-Urban Older Adults

Introduction: Population aging highlights the need to identify functional factors related to the health and quality of life of older adults. Frailty, physical performance, and muscle strength are relevant indicators of functional status, although their relationship with health-related quality of life (HRQoL) may vary depending on the component being assessed. Objective: To analyze the differential associations between physical performance, muscle strength, and frailty status with health-related quality of life in older adults in Montería, Colombia. Methods: An observational, cross-sectional study was conducted with 155 adults aged 60 years and older. Physical performance was assessed using the Short Physical Performance Battery (SPPB), muscle strength using a handgrip dynamometer, and frailty using the Fried phenotype. Quality of life was assessed using the Short Form-36 Health Survey (SF-36). Correlation analyses, multiple linear regression, and multinomial logistic regression were performed, adjusted for sociodemographic and clinical variables. Results: The mean age was 71.94 years, and 81.9% of the participants were women. Pre-frailty had a prevalence of 82.6%, while 9.0% were classified as robust and 8.4% as frail. Handgrip strength and the SPPB were not significantly associated with the study-specific mean of the SF-36 domain scores. However, handgrip strength showed an independent association with the physical functioning domain. Furthermore, a higher study-specific mean of the SF-36 domain scores was associated with a higher probability of being in the robust group and a lower probability of frailty. Conclusions: Quality of life is differentially associated with muscle strength and frailty status. Early identification of pre-frailty and a comprehensive assessment of physical function can help guide preventive strategies in older adults.