The relationship between age-associated change in body composition and physical disability is still unknown. Skeletal muscle mass declines with age in both sexes; however, since women have less muscle mass per unit of weight than men, these changes may be more debilitating in women. To evaluate the relationship between body composition and physical performance. A cross-sectional study. 144 women aged 68 to 75 were selected randomly from the general population of Verona. Body composition was evaluated using dual energy X-ray absorptiometry and bioimpedance. Physical performance was evaluated using a modified version of the Activities of Daily Living scale. Distance walked in 6 minutes was calculated, and isometric knee strength was tested. Normal women had a significantly lower body mass index (BMI) and percent body fat. These women also had a higher ratio of body cell mass (BCM) and total fat free mass (FFM) than women with physical impairments. After adjusting for BMI, women in the lowest tertile of muscle strength had significantly lower BCM than those in the highest tertile. These cross-sectional data show that although muscle strength is related to fat-free mass, disability in older women is associated with heavier BMI and with a higher percentage of body fat.