The predictive validity for mortality of the index of mobility-related limitation--results from the EPESE study.
BACKGROUND
self-reported disability reflects physical, environmental and attitudinal factors. We have previously reported the empirical identification of three simple tests to provide an index of (ambulatory) mobility-related physiological limitations (MOBLI). Evidence of the MOBLI 's responsiveness over time has been presented. Evidence of the predictive validity of the index is needed.


OBJECTIVE
we aimed to measure the predictive validity for future mortality of the MOBLI and of self-reported mobility disability in a longitudinal cohort study.


METHODS
data are from the sixth annual interview for two sites in the Established Populations for Epidemiologic Studies of the Elderly study. Included were 3,040 people, with information about self-reported walking difficulties, walking speed, time to complete five chair stands and peak expiratory flow. Age- and sex-adjusted death rates over a 4-year follow-up were computed, and proportional hazards regression models were used in the analysis.


RESULTS
the MOBLI score is associated with subsequent mortality over 4 years, with evidence of a 'dose-response' relationship. The predictive value for mortality of the MOBLI score is similar to that of self-reported mobility disability in the studied population.


CONCLUSIONS
the 'objective' MOBLI index has predictive validity as a continuous or dichotomised measure of the physiological component of mobility limitation in older populations. Given its empirical basis and face validity, predictive validity and responsiveness to change, MOBLI should be considered for local validation and use in epidemiological comparisons of older populations across countries or over longer periods of time.
Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK. dm214@medschl.cam.ac.uk
David
D
Melzer
Tzuo-Yun
TY
Lan
Jack M
JM
Guralnik
D000203:Activities of Daily Living / Q000145:classification*; D000368:Aged; D000369:Aged, 80 and over; D001900:Boston; D015331:Cohort Studies; D003237:Connecticut; D004185:Disability Evaluation; D005260:Female; D015577:Geriatric Assessment / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009140:Musculoskeletal Diseases / Q000401:mortality*; D016016:Proportional Hazards Models; D015203:Reproducibility of Results; D016019:Survival Analysis; D016138:Walking