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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
Author(s) -
Minneci Cristina,
Mello Anna Maria,
Mossello Enrico,
Baldasseroni Samuele,
Macchi Loredana,
Cipolletti Stefano,
Marchionni Niccolò,
Di Bari Mauro
Publication year - 2015
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.13195
Subject(s) - medicine , hazard ratio , confidence interval , proportional hazards model , odds ratio , activities of daily living , logistic regression , population , grip strength , physical therapy , gerontology , demography , environmental health , sociology
Objectives To compare the ability of the Short Physical Performance Battery ( SPPB ), 4‐m walk test (4m WT ), 6‐minute walk test (6 MWT ), 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 ADL s, 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 ( OR s) 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 4m WT , 0.74 (95% CI = 0.61–0.89) for SPPB , and 0.993 (95% CI = 0.988–0.997) for 6 MWT . Handgrip strength ( OR = 0.88, 95% CI = 0.83–0.93), 4m WT ( 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 6 MWT ( 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.