Added value of physical performance measures in predicting adverse health-related events: results from the Health, Aging And Body Composition Study.
OBJECTIVE
To determine how three different physical performance measures (PPMs) combine for added utility in predicting adverse health events in elders.


METHODS
Prospective cohort study.


METHODS
Health, Aging and Body Composition Study.


METHODS
Three thousand twenty-four well-functioning older persons (mean age 73.6).


METHODS
Timed gait, repeated chair stands, and balance (semi- and full-tandem, and single leg stands each held for 30 seconds) tests were administered at baseline. Usual gait speed was categorized to distinguish high- and low-risk participants using the previously established 1-m/s cutpoint. The same population-percentile (21.3%) was used to identify cutpoints for the repeated chair stands (17.1 seconds) and balance (53.0 seconds) tests. Cox proportional hazard analyses were performed to evaluate the added value of PPMs in predicting mortality, hospitalization, and (severe) mobility limitation events over 6.9 years of follow-up.


RESULTS
Risk estimates for developing adverse health-related events were similarly large for each of the three high-risk groups considered separately. Having more PPM scores at the high-risk level was associated with a greater risk of developing adverse health-related events. When all three PPMs were considered, having only one poor performance was sufficient to indicate a highly significantly higher risk of (severe) lower extremity and mortality events.


CONCLUSIONS
Although gait speed is considered to be the most important predictor of adverse health events, these findings demonstrate that poor performance on other tests of lower extremity function are equally prognostic. This suggests that chair stand and standing balance performance may be adequate substitutes when gait speed is unavailable.
Cesari
Matteo
M
Department of Aging and Geriatric Reseach, Institute on Aging, University of Florida, Gainesville, 32611, USA. macesari@gmail.com
Kritchevsky
Stephen B
SB
Newman
Anne B
AB
Simonsick
Eleanor M
EM
Harris
Tamara B
TB
Penninx
Brenda W
BW
Brach
Jennifer S
JS
Tylavsky
Frances A
FA
Satterfield
Suzanne
S
Bauer
Doug C
DC
Rubin
Susan M
SM
Visser
Marjolein
M
Pahor
Marco
M
D000368:Aged; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D007866:Leg / Q000502:physiology*; D008297:Male; D051346:Mobility Limitation; D009026:Mortality; D009043:Motor Activity; D004856:Postural Balance / Q000502:physiology; D011187:Posture / Q000502:physiology; D011446:Prospective Studies; D012680:Sensitivity and Specificity