Comparative Study of Four Physical Performance Measures as Predictors of Death, Incident Disability, and Falls in Unselected Older Persons: The Insufficienza Cardiaca negli Anziani Residenti a Dicomano Study

Comparative Study of Four Physical Performance Measures as Predictors of Death, Incident Disability, and Falls in Unselected Older Persons: The Insufficienza Cardiaca negli Anziani Residenti a Dicomano Study

Objectives To compare the ability of the Short Physical Performance Battery (SPPB), 4‐m walk test (4mWT), 6‐minute walk test (6MWT), and handgrip strength to predict mortality, incident disability, worsening mobility, and falls in older community dwellers. Design Cohort study. Setting Population‐bas...

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Bibliographic Details
Published in:Journal of the American Geriatrics Society (JAGS) Vol. 63; no. 1; pp. 136 - 141
Main Authors: Minneci, Cristina, Mello, Anna Maria, Mossello, Enrico, Baldasseroni, Samuele, Macchi, Loredana, Cipolletti, Stefano, Marchionni, Niccolò, Di Bari, Mauro
Format: Journal Article
Language:English
Published: United States Blackwell Publishing Ltd 01-01-2015
Wiley Subscription Services, Inc
Subjects:
Accidental Falls - statistics & numerical data
Activities of Daily Living
Aged
cohort studies
Disability
Disability Evaluation
Falls
Female
Geriatric Assessment
Geriatrics
Hand Strength - physiology
Humans
Italy
Male
Mobility Limitation
Mortality
Motor ability
performance tests
predictive value
Predictive Value of Tests
Walking - physiology
Italy
cohort studies
performance tests
predictive value
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Summary:Objectives To compare the ability of the Short Physical Performance Battery (SPPB), 4‐m walk test (4mWT), 6‐minute walk test (6MWT), and handgrip strength to predict mortality, incident disability, worsening mobility, and falls in older community dwellers. Design Cohort study. Setting Population‐based. Participants Individuals aged 65 and older n = 561) without prevalent basic activity of daily living (ADL) disability participating. Measurements Separate logistic regression models were developed to predict incident ADL disability, worsening mobility, and falls in 3 years, and Cox regression models were used to assess 7‐year risk of death as a function of the four tests, adjusting for covariates. Results Performance tests were reciprocally correlated at baseline. After 3 years, 33 (7.3%) of 453 participants reexamined were disabled in ADLs, 87 (20%) had worsening mobility, and 99 (22%) reported falls. Of the 561 baseline participants, 141 (25%) died over the 7 years. All measures predicted incident ADL disability, with adjusted odds ratios (ORs) per unit increase of 0.85 (95% confidence interval (CI) = 0.77–0.93) for handgrip strength, 0.08 (95% CI = 0.02–0.36) for 4mWT, 0.74 (95% CI = 0.61–0.89) for SPPB, and 0.993 (95% CI = 0.988–0.997) for 6MWT. Handgrip strength (OR = 0.88, 95% CI = 0.83–0.93), 4mWT (OR = 0.33, 95% CI = 0.11–0.94), and SPPB (OR = 0.81, 95%CI = 0.71–0.93) predicted worsening mobility. No measure predicted falls; only SPPB (hazard ratio (HR) = 0.92, 95% CI = 0.85–0.997) and 6MWT (HR = 0.997, 95% CI = 0.995–0.999) predicted death. Conclusion Performance measures are independent predictors of relevant health outcomes, with the exception of falls. Because SPPB is easily applied and is the only measure predicting incident ADL disability, worsening mobility, and death, it is preferable to the other tests.
Bibliography:istex:797E24D349EA4B69237A9FB0DC5102D45C6A3048
ArticleID:JGS13195
ark:/67375/WNG-SWL1NRXZ-L
ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:0002-8614
1532-5415
DOI:10.1111/jgs.13195