title: Performance measures predict onset of activity of daily living difficulty in community-dwelling older adults.
abstract: OBJECTIVE
  To assess the predictive value of five performance-based measures for the onset of difficulty in activities of daily living (ADLs).
  
  
  METHODS
  A prospective cohort study; home visits every 6 months for 18 months.
  
  
  METHODS
  Community-based.
  
  
  METHODS
  Community-dwelling older adults, n=110, (mean age 80.3+/-7.0; range 67-98) who reported no difficulty in basic ADLs.
  
  
  METHODS
  The Short Physical Performance Battery (SPPB), gait speed, Berg Balance Scale (BBS), grip strength, and Timed Up and Go Test (TUG) were evaluated at baseline. Seven ADL items were assessed at baseline and 6, 12, and 18 months. The onset of ADL disability was self-report of difficulty in any of the seven ADL items. Logistic regression models were fitted for each of the physical performance measures to predict onset of ADL difficulty at 6, 12, and 18 months.
  
  
  RESULTS
  After controlling for age, comorbid conditions, and sex, the BBS was the most consistent and best predictor for the onset of ADL difficulty over an 18-month period (6 months, c-statistic=0.725, (95% confidence interval (CI)=0.60-0.85; 12 months, c-statistic=0.840 95% CI=0.75, 0.93; 18 months, c-statistic=0.821, 95% CI=0.71, 0.93). The SPPB showed excellent predictive value for the onset of difficulty at 12 months. Ninety-five, 89, and 75 older adults completed the 6, 12, and 18-month follow-up visits, respectively.
  
  
  CONCLUSIONS
  BBS, followed by SPPB, TUG, gait speed, and grip strength, were predictive of the onset of ADL difficulty over an 18-month period in community-dwelling older adults. Screening nondisabled older adults with simple performance tests could allow clinicians to identify those at risk for ADL difficulty and may help to detect early functional decline.
authors.affiliation: Department of Physical Therapy, I-Shou University, Kaohsiung, Taiwan. hwennie@isu.edu.tw
authors.forename: Wen-Ni
authors.initials: WN
authors.lastname: Wennie Huang
authors.forename: Subashan
authors.initials: S
authors.lastname: Perera
authors.forename: Jessie
authors.initials: J
authors.lastname: VanSwearingen
authors.forename: Stephanie
authors.initials: S
authors.lastname: Studenski
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D005684:Gait; D018737:Hand Strength; D006801:Humans; D057187:Independent Living; D008297:Male; D009068:Movement / Q000502:physiology; D004856:Postural Balance; D011446:Prospective Studies; D012044:Regression Analysis; D012737:Sex Factors
references.citation: J Gerontol A Biol Sci Med Sci. 2000 Apr;55(4):M221-31
references.pmid: 10811152
references.citation: Age Ageing. 1999 May;28(3):283-8
references.pmid: 10475865
references.citation: Age Ageing. 2000 Sep;29(5):441-6
references.pmid: 11108417
references.citation: Neurorehabil Neural Repair. 2001;15(3):239-44
references.pmid: 11944746
references.citation: Phys Ther. 1995 Jun;75(6):462-9
references.pmid: 7770493
references.citation: Cochrane Database Syst Rev. 2000;(2):CD000340
references.pmid: 10796348
references.citation: Am J Med. 2004 Oct 1;117(7):484-91
references.pmid: 15464705
references.citation: Arch Phys Med Rehabil. 2005 Apr;86(4):789-92
references.pmid: 15827933
references.citation: Arch Phys Med Rehabil. 1992 Nov;73(11):1073-80
references.pmid: 1444775
references.citation: Soc Sci Med. 1994 Apr;38(7):937-42
references.pmid: 8202742
references.citation: J Gerontol A Biol Sci Med Sci. 1998 Jul;53(4):M295-300
references.pmid: 18314569
references.citation: J Am Geriatr Soc. 2004 Sep;52(9):1560-6
references.pmid: 15341562
references.citation: N Engl J Med. 1995 Mar 2;332(9):556-61
references.pmid: 7838189
references.citation: J Am Geriatr Soc. 1995 Jun;43(6):603-9
references.pmid: 7775716
references.citation: Percept Mot Skills. 1997 Jun;84(3 Pt 1):831-4
references.pmid: 9172190
references.citation: Clin Rehabil. 2002 Jun;16(4):420-8
references.pmid: 12061477
references.citation: Soc Sci Med. 1999 Feb;48(4):445-69
references.pmid: 10075171
references.citation: JAMA. 1963 Sep 21;185:914-9
references.pmid: 14044222
references.citation: J Am Geriatr Soc. 1991 Feb;39(2):142-8
references.pmid: 1991946
references.citation: J Clin Epidemiol. 2005 Nov;58(11):1180-7
references.pmid: 16223662
references.citation: J Gerontol A Biol Sci Med Sci. 1995 Sep;50(5):M235-41
references.pmid: 7671024
references.citation: Aging Clin Exp Res. 2003 Aug;15(4):315-20
references.pmid: 14661823
references.citation: Arch Phys Med Rehabil. 2007 Dec;88(12):1649-57
references.pmid: 18047881
references.citation: J Am Geriatr Soc. 2000 Feb;48(2):170-8
references.pmid: 10682946
references.citation: J Gerontol. 1994 Mar;49(2):M85-94
references.pmid: 8126356
references.citation: J Health Soc Policy. 2001;13(3):1-15
references.pmid: 11212621
references.citation: Vital Health Stat 1. 1987 Jun;(21):1-115
references.pmid: 3672938
references.citation: Can J Public Health. 1992 Jul-Aug;83 Suppl 2:S7-11
references.pmid: 1468055
references.citation: JAMA. 1999 Feb 10;281(6):558-60
references.pmid: 10022113
references.citation: J Gerontol A Biol Sci Med Sci. 1999 Jan;54(1):M3-6
references.pmid: 10026655
references.citation: J Am Geriatr Soc. 2003 Mar;51(3):314-22
references.pmid: 12588574
references.citation: J Am Geriatr Soc. 2000 Nov;48(11):1424-9
references.pmid: 11083318
references.citation: Arch Phys Med Rehabil. 1986 Jun;67(6):387-9
references.pmid: 3487300