Background: Muscle mass, strength and fitness play a role in lower-extremity physical function (LEPF) in older adults; however, the relationships remain inadequately characterized. Objective: This study aimed to examine the relationships between leg mineral free lean mass (MFLMLEG), leg muscle quality (leg strength normalized for MFLMLEG), adiposity, aerobic fitness and LEPF in community-dwelling healthy elderly subjects. Methods: Fifty-five older adults (69.3 ± 5.5 years, 36 females, 19 males) were assessed for leg strength using an isokinetic dynamometer, body composition by dual energy X-ray absorptiometry and aerobic fitness via a treadmill maximal oxygen consumption test. LEPF was assessed using computerized dynamic posturography and stair ascent/descent, a timed up-and-go task and a 7-meter walk with and without an obstacle. Results: Muscle strength, muscle quality and aerobic fitness were similarly correlated with static LEPF tests (r range 0.27–0.40, p < 0.05); however, the strength of the independent predictors was not robust with explained variance ranging from 9 to 16%. Muscle quality was the strongest correlate of all dynamic LEPF tests (r range 0.54–0.65, p < 0.001). Using stepwise linear regression analysis, muscle quality was the strongest independent predictor of dynamic physical function explaining 29–42% of the variance (p < 0.001), whereas aerobic fitness or body fat mass explained 5–6% of the variance (p < 0.05) depending on performance measure. Conclusions: Muscle quality is the most important predictor, and aerobic fitness and fat mass are secondary predictors of LEPF in community-dwelling older adults. These findings support the importance of exercise, especially strength training, for optimal body composition, and maintenance of strength and physical function in older adults.

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