title: 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.
abstract: OBJECTIVE
  To compare the ability of the Short Physical Performance Battery (SPPB), 4-m walk test (4mWT), 6-minute walk test (6MWT), and handgrip strength to predict mortality, incident disability, worsening mobility, and falls in older community dwellers.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  Population-based.
  
  
  METHODS
  Individuals aged 65 and older n = 561) without prevalent basic activity of daily living (ADL) disability participating.
  
  
  METHODS
  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 ADLs, 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 (ORs) 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 4mWT, 0.74 (95% CI = 0.61-0.89) for SPPB, and 0.993 (95% CI = 0.988-0.997) for 6MWT. Handgrip strength (OR = 0.88, 95% CI = 0.83-0.93), 4mWT (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 6MWT (HR = 0.997, 95% CI = 0.995-0.999) predicted death.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Research Unit of Medicine of Aging, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Starbene SrL Rehabilitation Centre, Cerreto Guidi, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Minneci
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Mello
authors.forename: Enrico
authors.initials: E
authors.lastname: Mossello
authors.forename: Samuele
authors.initials: S
authors.lastname: Baldasseroni
authors.forename: Loredana
authors.initials: L
authors.lastname: Macchi
authors.forename: Stefano
authors.initials: S
authors.lastname: Cipolletti
authors.forename: Niccolò
authors.initials: N
authors.lastname: Marchionni
authors.forename: Mauro
authors.initials: M
authors.lastname: Di Bari
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000203:Activities of Daily Living; D000368:Aged; D004185:Disability Evaluation; D005260:Female; D015577:Geriatric Assessment; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D007558:Italy; D008297:Male; D051346:Mobility Limitation; D011237:Predictive Value of Tests; D016138:Walking / Q000502:physiology
keywords: cohort studies; performance tests; predictive value