Objective:To determine the usefulness of timed manual performance measurements (TMP) as predictors of health outcomes, hospitalization, and mortality in a large, heterogeneous sample of elderly people living in the community.Design:Prospective cohort study.Setting:Central North Carolina.Participants:1,286 community‐dwelling older people.Measurements:Demographic background, health problems, number of prescribed medications, perceived health, quality of life, and the TMP, a 27‐item test that has been shown to predict functional dependency and need of health‐care services in older people.Results:During the 2‐year follow‐up period, 127 people died and 200 were hospitalized. Scores for those who were able to complete the original TMP, as well as scores for two shorter versions of the TMP, predicted mortality and, to a lesser extent, hospitalization within 2 years. For both original and shorter versions of the TMP, relative risk of death was approximately 2.5 times greater for those in the poorest performance quartile, as compared with the best performing quartile, when adjusted for age, gender, race, and number of prescribed medications. TMP tests and an index of IADL were independent predictors of death.Conclusions:TMP scores may be useful in the clinical setting as a vital sign of functioning, providing a means of targeting those individuals at increased risk of mortality.J Am Geriatr Soc 42:2