A multidimensional assessment of physical performance for older Japanese people with community-based long-term care needs.
OBJECTIVE
A multidimensional assessment representing overall lower- and upper-extremity performance is necessary to identify functional decline among older adults. The aim of this study was to develop and validate a physical performance scale (PPS) using both cross-sectional and observational approaches in older adults with and without community-based long-term care (LTC) needs in Japan.


METHODS
A total of 416 community-living adults aged 75 years and over. The 7 items of the PPS include a range of physiological challenges, such as assessment of upper-extremity strength, lower-extremity strength, balance, and walking ability. Concurrent validity [correlating the PPS with self-reported functional status in activities of daily living (ADLs), instrumental ADLs, and Physical Function subscale of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36PF)] and discriminative validity were assessed. Sensitivity to changes was evaluated with a 12-week exercise program.


RESULTS
Total PPS score was significantly correlated with self-reported functional status such as ADLs, instrumental ADLs (IADLs), and SF-36PF (r = 0.53-0.62) and demonstrated no floor effect and minimal ceiling effect (8.7 %). The total PPS score showed large areas under the curve (AUC = 0.89; 95 % confidence interval, 0.86-0.92) with regard to discrimination between individuals with and without LTC needs. In observational analysis, total PPS score demonstrated small meaningful change in high-risk individuals requiring care (effect size 0.34).


CONCLUSIONS
The PPS may be a useful tool for identifying functional status decline and improvement in older adults requiring community-based LTC.
Research Team for Promoting Independence of the Elderly, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan, mijiak@tmig.or.jp.
Miji
M
Kim
Kiyoji
K
Tanaka
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D044466:Asian People; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment; D018737:Hand Strength; D006801:Humans; D007564:Japan; D008134:Long-Term Care; D008297:Male; D004856:Postural Balance; D057566:Self Report