<p>The longitudinal relationship between fatigue and physical deterioration is least explored. The aim of the study was to investigate the physical performance transitions and the relationship with adverse outcomes over 3-years in older people with or without fatigue. This 3-year longitudinal study included 456 community-dwelling older adults (mean age: 73.5 ± 7.5 years; female 43.0%). Physical performance was assessed using the Short Physical Performance Battery (SPPB). Fatigue was assessed by a single-item question “Have you felt tired or fatigued on at least 3 or 4 days each week?” At follow-up, both groups showed a trend towards lower physical performance levels, with the fatigue group exhibiting a significantly more pronounced decline. After adjusting for covariates, new-onset sarcopenia(OR = 3.08, 95%CI = 2.18–5.45) and malnutrition(OR = 2.70, 95%CI = 1.38–5.57) were the significant adverse events associated with physical performance deterioration in individuals with fatigue at 3-year follow-up. While for non-fatigue older adults, cognitive impairment (OR = 1.81,95%CI = 1.52–3.84) and sarcopenia(OR = 1.83, 95%CI = 1.50–5.33) were the significant adverse events associated with physical performance deterioration. The characteristics of older individuals with and without fatigue are distinct while considering longitudinal physical performance transitions. Fatigue is a significant risk factor associated with geriatric syndromes such as sarcopenia and malnutrition in individuals who have poor physical performance.</p><p><b>Clinical trial number: ChiCTR2100051397.</b></p>