title: Lower limb function and 10-year survival in population aged 75 years and older.
abstract: BACKGROUND
  Scientific societies recommend assessing lower limb function in usual clinical practice. The Short Physical Performance Battery (SPPB) is one of the most validated tools to assess this, but its capacity to predict long-term mortality in very old population attending primary care has not been studied.
  
  
  OBJECTIVE
  To assess the ability of the SPPB to predict 10-year survival in individuals aged 75 and over.
  
  
  METHODS
  Prospective cohort study with a 10-year follow-up. A representative sample of people aged 75 years or older without severe dependence (Barthel Index > 20) treated at a Spanish primary care centre (n = 315). Baseline evaluation included geriatric assessment with most well-known death predictors. The three SPPB subtasks (standing balance, walking speed and chair stand tests) were administered. Kaplan-Meier curves and Cox proportional hazard models were calculated for all-cause mortality.
  
  
  RESULTS
  Mean age was 81.9 years (60.6% female). Ten-year survival of elders with SPPB score <7 and ≥7 was 0.23 and 0.37 (P < 0.001), respectively. This difference remained statistically significant in the Cox model adjusted by age, gender, number of drugs prescribed, cognitive status, body mass index and visual sharpness (adjusted hazard ratio = 1.37; 95% confidence interval: 1.01-1.86). Also, walking speed and chair stand subtasks were both individual-independent predictors of 10-year survival.
  
  
  CONCLUSIONS
  Our findings indicate that SPPB is an independent predictor of long-term survival. The chair stand subtask could be a predictor as useful as the full performance battery, becoming a good alternative for primary care where the burden of performing all three subtasks could be excessive.
authors.affiliation: Clinical Research Unit, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Barcelona, Programa de Doctorat en Salut Pública i Metodologia de La Recerca, Departament de Pediatria, d'Obstetrícia i Ginecologia i Medicina Preventiva, Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, aarnau@althaia.cat.
authors.forename: Anna
authors.initials: A
authors.lastname: Arnau
authors.affiliation: Servei de Geriatria i Cures Pal liatives, Hospital Universitari de Vic-Hospital Universitari de la Santa Creu, Vic, Barcelona.
authors.forename: Joan
authors.initials: J
authors.lastname: Espaulella
authors.affiliation: Servei de Geriatria i Cures Pal liatives, Hospital Universitari de Vic-Hospital Universitari de la Santa Creu, Vic, Barcelona.
authors.forename: Teresa
authors.initials: T
authors.lastname: Méndez
authors.affiliation: Equip d'Assitència Primària Vic, Primary Care Center El Remei, Vic, Barcelona.
authors.forename: Marta
authors.initials: M
authors.lastname: Serrarols
authors.affiliation: Equip d'Assitència Primària Vic, Primary Care Center El Remei, Vic, Barcelona.
authors.forename: Judit
authors.initials: J
authors.lastname: Canudas
authors.affiliation: Geriatric Unit, Internal Medicine Service, Hospital Universitari de Bellvitge, L'Hospitalet del Llobregat, Barcelona.
authors.forename: Francesc
authors.initials: F
authors.lastname: Formiga
authors.affiliation: Programa de Doctorat en Salut Pública i Metodologia de La Recerca, Departament de Pediatria, d'Obstetrícia i Ginecologia i Medicina Preventiva, Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona and CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Ferrer
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006801:Humans; D035002:Lower Extremity / Q000502:physiology / Q000503:physiopathology*; D008297:Male; D051346:Mobility Limitation; D010809:Physical Fitness / Q000502:physiology*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D015996:Survival Rate; D016138:Walking / Q000502:physiology*
keywords: Aged; cohort study; lower extremity function; physical performance; survival.