The overall objective of this application is to identify modifiable factors in older adults associated with functional decline following major surgery. An estimated 4.5 million older adults undergo major surgery each year with nearly one-third experiencing functional decline. The unifying hypothesis is that poor preoperative exercise tolerance and physical performance, potentially modifiable factors, are crucial in predicting postoperative functional decline. The objectives of this application are to: 1) quantify the degree of functional decline in older adults associated with nursing home placement following surgery, 2) define the contribution of preoperative exercise tolerance and physical performance in predicting postoperative functional decline, and 3) examine interactions between physical performance, age, comorbid disease, and prior disability. Older adults undergoing major abdominal surgery will be followed prospectively with variables of interest recorded) preoperatively. The Stanford Health Assessment Questionnaire will measure incident functional decline by; comparing baseline to postoperative values. Identified modifiable factors will direct future interventions in older adults at highest risk for functional decline following surgery.