Is a composite score of physical performance measures more useful than usual gait speed alone in assessing functional status?

2012 ◽  
Vol 55 (2) ◽  
pp. 392-398 ◽  
Author(s):  
Satoshi Seino ◽  
Mi-ji Kim ◽  
Noriko Yabushita ◽  
Miyuki Nemoto ◽  
Songee Jung ◽  
...  
Keyword(s):  
Functional Status ◽  
Physical Performance ◽  
Performance Measures ◽  
Gait Speed ◽  
Composite Score ◽  
Usual Gait Speed

scholarly journals Relationship Between Perceived Physical and Mental Fatigability and Physical Performance in Very Old Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 178-178
Author(s):  
Yixin Hu ◽  
Zhuangzhuang Zhang ◽  
Woei-Nan Bair ◽  
Anying Bai ◽  
Li Fan
Keyword(s):  
Grip Strength ◽  
Physical Performance ◽  
Performance Measures ◽  
Gait Speed ◽  
Clinical Importance ◽  
Community Dwelling ◽  
Very Old ◽  
Chair Stand ◽  
Old Adults ◽  
Usual Gait Speed

Abstract To investigate the relationship between perceived physical and mental fatigability and physical performance in community-dwelling very old adults (≥80 years). We examined the association in one retired community in Beijing including 404 very old adults. Pittsburgh Fatigability Scale (PFS), Chinese version, was used to assess perceived fatigability in physical domain (PFS-P) and mental domain (PFS-M). High fatigability is defined as PFS-P ≥ 15, and PFS-M ≥ 13. Physical performance measures include grip strength, usual gait speed, chair stand and Short Physical Performance Battery (SPPB) test. Women have higher PFS scores (both PFS-P & PFS-M) and higher prevalence of high fatigability than men. After adjusting for sex, usual gait speed and SPPB scores were significantly associated with PFS-P & PFS-M, while grip strength and chair stand performance were significantly associated with PFS-P only. After multivariable adjustment, usual gait speed (B=-3.745, P=0.021) and chair stand performance (B=0.335, P=0.005) were significantly associated with PFS-P, while usual gait speed (B=-2.656, P=0.006) and SPPB scores (B=-0.214, P=0.029) were significantly associated with PFS-M. Perceived physical and mental fatigability is highly prevalent in very older adults and they differ by sex. The significant associations between PFS scores and performance measures suggest that PFS is of potential clinical importance, especially when testing performance measures are not feasible. Utilization of PFS score can assist in identifying target populations who are at risk of reduced physical functions, such as older with depression, older women. Interventions to improve usual gait speed are likely to reduce both perceived physical and mental fatigability.

scholarly journals Detectable Changes in Physical Performance Measures in Elderly African Americans

2010 ◽  
Vol 90 (6) ◽  
pp. 921-927 ◽  
Author(s):  
Kathleen Kline Mangione ◽  
Rebecca L. Craik ◽  
Alyson A. McCormick ◽  
Heather L. Blevins ◽  
Meaghan B. White ◽  
...  
Keyword(s):  
Older Adults ◽  
African American ◽  
Physical Performance ◽  
Performance Measures ◽  
Gait Speed ◽  
Intraclass Correlation ◽  
Assistive Device ◽  
Minimal Detectable Change ◽  
6Mwt Distance ◽  
African American Older Adults

Background African American older adults have higher rates of self-reported disability and lower physical performance scores compared with white older adults. Measures of physical performance are used to predict future morbidity and to determine the effect of exercise. Characteristics of performance measures are not known for African American older adults. Objective The purpose of this study was to estimate the standard error of measurement (SEM) and minimal detectable change (MDC) for the Short Physical Performance Battery (SPPB), Timed “Up & Go” Test (TUG) time, free gait speed, fast gait speed, and Six-Minute Walk Test (6MWT) distance in frail African American adults. Design This observational measurement study used a test-retest design. Methods Individuals were tested 2 times over a 1-week period. Demographic data collected included height, weight, number of medications, assistive device use, and Mini-Mental Status Examination (MMSE) scores. Participants then completed the 5 physical performance tests. Results Fifty-two participants (mean age=78 years) completed the study. The average MMSE score was 25 points, and the average body mass index was 29.4 kg/m2. On average, participants took 7 medications, and the majority used assistive devices. Intraclass correlation coefficients (ICC [2,1]) were greater than .90, except for the SPPB score (ICC=.81). The SEMs were 1.2 points for the SPPB, 1.7 seconds for the TUG, 0.08 m/s for free gait speed, 0.09 m/s for fast gait speed, and 28 m for 6MWT distance. The MDC values were 2.9 points for the SPPB, 4 seconds for the TUG, 0.19 m/s for free gait speed, 0.21 m/s for fast gait speed, and 65 m for 6MWT distance. Limitations The entire sample was from an urban area. Conclusions The SEMs were similar to previously reported values and can be used when working with African American and white older adults. Estimates of MDC were calculated to assist in clinical interpretation.

scholarly journals Distinct Trajectories of Individual Physical Performance Measures Across 9 Years in 60- to 70-Year-Old Adults

2020 ◽  
Vol 75 (10) ◽  
pp. 1951-1959
Author(s):  
Trynke Hoekstra ◽  
Anna Galina Maria Rojer ◽  
Natasja M van Schoor ◽  
Andrea Britta Maier ◽  
Mirjam Pijnappels
Keyword(s):  
Physical Performance ◽  
Performance Measures ◽  
Gait Speed ◽  
Successful Aging ◽  
Latent Class ◽  
Handgrip Strength ◽  
Optimal Number ◽  
Latent Class Models ◽  
Chair Stand ◽  
Longitudinal Aging Study Amsterdam

Abstract Background Physical performance is an important factor for successful aging. This study aimed to identify distinct trajectories of multiple physical performance measures over 9 years in individuals aged 60–70 years and to evaluate their characteristics and the overlap between measures. Methods Four physical performance measures were assessed in 440 participants of the Longitudinal Aging Study Amsterdam: tandem stand, gait speed, chair stand, and handgrip strength. Gender-specific latent class models were conducted to obtain distinct trajectories and their degree of overlap. Results Mean age at baseline was 67.9 (SD 1.7) years for males and 68.0 (SD 1.7) years for females. The optimal number of trajectories differed across measures. For tandem stand, no distinct trajectories were found (all 179 males, 198 females). For gait speed, three trajectories were identified, dependent on baseline speed: high-stable (47 males, 27 females), intermediate-stable (132 males, 130 females), and low-declining performance (6 males, 48 females). Two trajectories were identified for the chair stand: a stable (168 males, 150 females) and declining trajectory (10 males, 38 females). For handgrip strength, three declining trajectories were identified differing in baseline performance: high (55 males, 75 females), intermediate (111 males, 118 females), and low (17 males, 10 females). Overall, 11.9% of males and 5.7% of females were classified in similar trajectories across measures. Conclusions Trajectories of physical performance were heterogeneous, but showed similar patterns for males and females. Little overlap between measures was shown, suggesting different mechanisms for decline. This study emphasizes the use of multiple domains to assess physical performance.

Abstract P298: Associations Between Time-varying Physical Activity and Physical Performance Measures in Postmenopausal Women: the Women’s Health Initiative

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Deepika Laddu ◽  
Betsy C Wertheim ◽  
David O Garcia ◽  
Robert Brunner ◽  
Aladdin H Shadyab ◽  
...  
Keyword(s):  
Physical Activity ◽  
Functional Status ◽  
Women's Health ◽  
Grip Strength ◽  
Older Women ◽  
Physical Performance ◽  
Performance Measures ◽  
Time Varying ◽  
Health Initiative ◽  
The Women’S Health Initiative

Introduction: Maintaining regular physical activity (PA) may delay the onset of functional disability and preserve mobility later in life. Whereas many population-based studies have reported the prospective relationship of initial PA levels to later-life functional status, few studies have examined the longitudinal relationships between changes in PA to changes in physical functioning. This study examined associations between changes in PA and changes in standard physical performance measures (PPM) over 6-years in older women. Methods: Recreational PA was reported using the WHI questionnaire; gait speed, timed chair stand, and grip strength were assessed in clinic using standardized protocols. Exposures were assessed at baseline, years 1, 3 and 6 of the Women’s Health Initiative Clinical Trials (n=5092 women; mean age = 69.8 y). Mixed effects linear regression models were used to evaluate the association between time-varying PA and change in each PPM. Potential interactions between time-varying PA and race and age (<70 y; ≥70 y) were also tested. Results: At baseline, 23.0% women were categorized as sedentary (SED; <100 MET-min/wk), 30.4% as light PA level (100- <500 MET-min/wk), 27.5% as moderate (500- <1200 MET-min/wk); and 19.1% as high PA (≥ 1200 MET-min/wk). Significant, dose-response associations between PA and improvements in all PPMs were observed over the 6 y follow-up after adjusting for demographic, lifestyle, and clinical factors. Compared to SED, women in the high PA groups showed better grip strength (0.48 kg higher; P <0.01), more chair stands (0.35 more; P <0.001), and faster gait speeds (0.06 m/s faster ; P <0.001). Older women (≥70 y) benefited more from higher levels of PA than the younger women (P interaction for age =0.014), as reflected by their greater increase in chair stands ( P <0.001); however, interactions between PA and race were not significant. Conclusions: These findings provide evidence that, in post-menopausal women, maintaining higher PA levels over time is associated with benefits in lower extremity function, as compared to being sedentary. These data are consistent with the view that regular PA plays an important role in maintaining functional status during aging, particularly in older women.

scholarly journals Relationship between SHARE-FI Frailty Scores and Physical Performance Measures in Older Adult Medicaid Recipients

Geriatrics ◽  
2018 ◽  
Vol 3 (3) ◽  
pp. 51 ◽  
Author(s):  
Margaret Danilovich ◽  
Laura Diaz ◽  
Daniel Corcos ◽  
Jody Ciolino
Keyword(s):  
Older Adult ◽  
Physical Performance ◽  
Performance Measures ◽  
Gait Speed ◽  
Fall Risk ◽  
Assessment Tool ◽  
Performance Measure ◽  
Self Report ◽  
Timed Up And Go ◽  
Cross Sectional

The Survey of Health, Ageing and Retirement in Europe-Frailty Instrument (SHARE-FI) is a frailty assessment tool designed for primary care settings comprised of four self-report questions and grip strength measurement, yet it is not known how SHARE-FI scores relate to objective physical performance measures that assess physical functioning, fall risk, and disability. This cross-sectional, observational study examined the association between SHARE-FI scores and a battery of physical performance measures in a sample of older adult, Medicaid waiver recipients (n = 139, mean age = 74.19 ± 8.36 years). We administered the SHARE-FI, Timed Up and Go (TUG), gait speed, and Short Physical Performance Battery (SPPB) in participants’ homes. Among clients, 45% were frail, 35% pre-frail, and 20% non-frail. There were significant differences in all physical performance measure scores with respect to SHARE-FI category. SHARE-FI continuous scores significantly predicted TUG time, all domains of the SPPB, gait speed, and inability to complete the chair rise test. Self-reported walking difficulty and objectively measured gait speed were significantly correlated. The SHARE-FI continuous frailty score predicts scores on a variety of validated physical performance measures. Given the fast administration time, the SHARE-FI could potentially be used to serve as a surrogate for physical performance measures with known association with physical function, fall risk, and disability.

P1543FACTORS ASSOCIATED WITH CHANGE IN FUNCTIONAL STATUS IN HEMODIALYSIS PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Keigo Imamura ◽  
Yuta Suzuki ◽  
Shohei Yamamoto ◽  
Manae Harada ◽  
Haruka Ito ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Functional Status ◽  
Gait Speed ◽  
Odds Ratio ◽  
Handgrip Strength ◽  
Risk Index ◽  
Treatment Strategies ◽  
Katz Index ◽  
Nutritional Risk Index ◽  
Usual Gait Speed

Abstract Background and Aims Hemodialysis (HD) patients have poor functional capacity. Expert clinical practice guidelines strongly recommend an assessment of functional status (FS) and treatment strategies in chronic kidney disease patients. A previous study demonstrated a high level of disability in daily activities in most HD patients, and a dose-response association was seen between poor FS at baseline and adverse clinical outcomes in HD patients. Moreover, a recent study reported that patients with a decline in FS over a 1-year period are at an elevated risk of mortality. Therefore, identifying factors that predict a decline in FS is important for developing treatment strategies. The purpose of this study was to investigate the factors that predict this decline in HD patients. Method A total of 146 outpatients (mean age of 66.1±11.0 years; 48% were female) undergoing maintenance HD thrice a week at an HD center were included. FS was assessed based on the ability to perform activities of daily living (ADLs) and instrumental ADLs (IADLs) as self-reported on the Katz Index of Independence and the Lawton-Brody IADL scale, respectively The Katz Index of Independence examines five tasks of ADLs, and the Lawton-Brody IADL scale examines eight tasks of IADLs. Both have been validated in the general population. We then calculated the FS score by combining the scores of the Katz Index of Independence and Lawton-Brody IADL scale in accordance with the algorithm developed in a previous study, and the assessments were conducted at baseline and after 1 year. We classified patients into two groups based on having or not having at least a 1-point decline in the FS score. Background factors such as age, sex, body mass index, comorbidities score, hemodialysis time, primary kidney disease, hemoglobin level, and geriatric nutritional risk index were collected at baseline. In addition, for physical function, the usual gait speed and handgrip strength and for body composition, the skeletal muscle mass by bioelectrical impedance analysis were analyzed at baseline. To investigate factors predicting a decline in FS 1 year later, logistic regression analysis was used. Results Over the study period, 29.5% of the patients showed a decline in the FS score. Patients who showed a decline were older (71.2 years vs. 64.0 years), had weaker handgrip strength (22.9 kg vs. 24.8 kg), and exhibited slower usual gait speed (1.06 m/s vs. 1.22 m/s) than those who did not show decline at baseline. To predict a decline in FS 1 year later, age (odds ratio: 1.07, 95% confidence interval [CI]:1.02-1.13, p=0.003) and usual gait speed (odds ratio: 0.17, 95% CI: 0.03-0.96, p=0.04) were determined as significant factors. Conclusion Gait speed was a predictor of a decline in FS after 1 year. These findings underscore the significance of gait speed assessment in addition to monitoring the patient's FS. Moreover, intervention in maintaining gait speed may be essential in preventing the FS from deteriorating over time.

scholarly journals Association between anemia, physical performance and cognitive function in Iranian elderly people: evidence from Bushehr Elderly Health (BEH) program

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maryam Marzban ◽  
Iraj Nabipour ◽  
Akram Farhadi ◽  
Afshin Ostovar ◽  
Bagher Larijani ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Physical Performance ◽  
Gait Speed ◽  
Elderly Population ◽  
Handgrip Strength ◽  
Cross Sectional ◽  
Elderly Health ◽  
Category Fluency ◽  
Usual Gait Speed ◽  
Fluency Test

Abstract Background and objectives The present study aimed to investigate the relation between anemia and hemoglobin (Hgb) concentration, physical performance, and cognitive function in a large sample of Iranian elderly population. Methods Data were collected from Bushehr elderly health (BEH) program. A total of 3000 persons aged ≥60 years were selected through multistage random sampling. Hemoglobin values lower than 12 and 13 g/dL were considered as anemia for women and men, respectively. The cognitive function was measured using the Mini-cog test and Category fluency test (CFT), and the physical function was measured using handgrip strength (muscle strength), Relative handgrip strength (RHGS), and 4.57-m usual gait speed. Univariate and adjusted multivariate logistic regression and linear regression with Stata MP (version 15) were run, and a p-value of < 0.05 was used as statistically significant for all analyses. Results Among participants, 7.43% were anemic, and 115 (51.57%) simultaneously had anemia and cognitive disorder. There were significant associations between red blood cell count (RBC), hemoglobin (Hgb), platelet count (PLT), and hematocrit percentage (HCT) with cognitive impairment. Additionally, Hgb concentration was significantly associated with all physical measures (Mean handgrip, Relative handgrip, and usual gait speed) and late recall (mini-cog) among the whole participants. This association remained statistically significant after considering multi-cofounders. In contrast, after stratifying the participants by gender, the association between Hgb concentration and usual gait speed was decreased in both men and women; moreover, Hgb association with cognitive measures (category fluency test and late recall) was no longer significant (all p-values > 0.05). Conclusion There was a cross-sectional and significant association between anemia and functional variables (e.g., Relative and mean handgrip) in Iranian elderly population, whereas Semantic memory, Late recall, and walking were more affected by gender.

Office-Based Physical Assessment in Patients Aged 75 Years and Older with Cardiovascular Disease

Gerontology ◽  
2019 ◽  
Vol 65 (2) ◽  
pp. 128-135 ◽  
Author(s):  
Ryota Matsuzawa ◽  
Kentaro Kamiya ◽  
Nobuaki Hamazaki ◽  
Kohei Nozaki ◽  
Shinya Tanaka ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Older Adults ◽  
Physical Performance ◽  
Mortality Risk ◽  
Gait Speed ◽  
Handgrip Strength ◽  
Walk Distance ◽  
Physical Assessment ◽  
All Cause Mortality ◽  
Usual Gait Speed

Background: The detection of impaired physical performance in older adults with cardiovascular disease is essential for clinical management and therapeutic decision-making. There is a requirement for an assessment tool that can be used conveniently, rapidly, and securely in clinical practice for screening decreased physical performance. Objective: The present study was performed to evaluate the association of office-based physical assessments with decreased physical performance and to compare the prognostic capability of these assessments in older adults with cardiovascular disease. Methods: A total of 1,040 patients aged 75 years and older with cardiovascular disease were included in this analysis. One-leg standing time (OLST) and handgrip strength were measured as office-based physical assessment tools, and short physical performance battery (SPPB), 6-min walk distance, and usual gait speed were also measured at hospital discharge as measurements of physical performance. All-cause mortality was assessed by death registry at the hospital. We examined the association of office-based measures with physical performance and all-cause mortality. Results: The areas under the curve of OLST for SPPB < 10, 6-min walk distance < 300 m, and usual gait speed < 1.0 m/s were 0.87 (95% CI 0.83–0.91), 0.83 (95% CI 0.80–0.86), and 0.81 (95% CI 0.78–0.85), respectively. The discrimination abilities of OLST for decreased physical performance were significantly higher than those of handgrip strength. After adjusting for the effects of patient characteristics, the hazard ratio for all-cause mortality in the < 3 s group for OLST was 1.68 (95% CI 1.06–2.67, p = 0.03). Handgrip strength, however, was not significantly associated with mortality risk in these participants. Conclusion: Short OLST, in particular < 3 s, is associated with decreased physical performance and elevated mortality risk in elderly patients with cardiovascular disease. OLST can be conveniently measured in the clinician’s office as a screening tool for impaired physical performance.

scholarly journals Positive Association between High Protein Food Intake Frequency and Physical Performance and Higher-Level Functional Capacity in Daily Life

Nutrients ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 72
Author(s):  
Mika Kimura ◽  
Ai Moriyasu ◽  
Hyuma Makizako
Keyword(s):  
Older Adults ◽  
Physical Performance ◽  
Functional Capacity ◽  
Gait Speed ◽  
Community Dwelling ◽  
High Protein ◽  
Protein Food ◽  
Community Dwelling Older Adults ◽  
Usual Gait Speed ◽  
Frequency Score

Nutritional factors, including low protein intake and poor dietary variety, affect age-associated impairment in physical performance resulting in physical frailty. This cross-sectional study investigated the association between intake frequency of major high protein foods and both physical performance and higher-level functional capacity using the food frequency score (FFS) and high protein food frequency score (PFFS) among community-dwelling older adults. The data of 1185 older adults categorized into quartiles based on FFS and PFFS were analyzed. After adjusting for covariates, FFS and PFFS were significantly associated with physical performance [FFS, usual gait speed (p for trend = 0.007); PFFS, usual gait speed (p for trend < 0.001), maximum gait speed (p for trend = 0.002), timed up and go (p for trend = 0.025)], and higher-level functional capacity [FFS (p for trend < 0.001); PFFS (p for trend < 0.001)]. After excluding PFFS data, the participants’ scores were associated with only higher-level functional capacity. Multi-regression analysis with higher-level functional capacity as the covariate showed that FFS and PFFS were significantly correlated with physical performance. Hence, improving food intake frequency, particularly that of high protein foods, and dietary variety may help maintain higher-level functional capacity and physical performance in community-dwelling older adults.

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