Links of Short Physical Performance Battery Score with Incident Dementia: Results from the NHATS

Abstract Physical performance is associated with cognitive function in later life, but few studies have examined the prospective association of physical performance with incident dementia. We studied 4539 community-dwelling National Health and Aging Trends Study (NHATS) participants aged ≥65 years with data on demographics and the Short Physical Performance Battery (SPPB) in 2011, who were followed through 2014. Our outcome was dementia diagnosis from a validated NHATS algorithm. We applied survey weights to make results nationally representative and performed Cox regression analyses. After adjustment for potential confounders, lower baseline SPPB scores were associated with incident dementia (HR=1.68, p < 0.01). Slower gait speed was the SPPB component most strongly associated with incident dementia (HR=1.21, p < 0.01). We found that poorer physical performance was linked to incident dementia in a cohort of older adults. More research is needed to examine the effect of improving physical performance on the prevention of dementia.

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EXAMINING WHETHER LIFESTYLE ACTIVITY PATTERNS PREDICT DEMENTIA INCIDENCE AMONG COMMUNITY-DWELLING OLDER ADULTS

Innovation in Aging ◽

10.1093/geroni/igz038.2993 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S812-S812

Author(s):

Kyle Moored ◽

Jeanine Parisi ◽

Michelle Carlson

Keyword(s):

Latent Class ◽

Cox Regression ◽

Activity Patterns ◽

Intervention Group ◽

Community Dwelling ◽

Activity Frequency ◽

Incident Dementia ◽

Dementia Incidence ◽

Lifestyle Activities ◽

Community Dwelling Older Adults

Abstract Engagement in lifestyle activities can be neuroprotective, but it remains unclear what aspects of engagement are most beneficial. Examining activity patterns may better characterize both quantitative (e.g., number) and qualitative (e.g., characteristic/motivational) differences in engagement. We used a novel, latent class analysis (LCA) to characterize subgroups with distinct activity patterns and examined whether they have differential risk of incident dementia. We compared these findings to models including standard activity frequency and variety metrics. Using the Ginkgo Evaluation of Memory Study (N=3,069), we fit Cox regressions of each activity metric on time to dementia, adjusting for intervention group and demographics. For the LCA, we derived group/class indicators for Cox regression. Variety predicted incident dementia and will be compared to LCA activity metrics in predicting risk. Activity metrics that are most protective against dementia inform intervention design. Unlike standard activity metrics, LCA may further identify subgroups with common motivations to sustain activity.

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Short Physical Performance Battery (SPPB) score as a discriminator of dynapenic abdominal obesity among community-dwelling older adults

Geriatric Nursing ◽

10.1016/j.gerinurse.2021.02.016 ◽

2021 ◽

Vol 42 (2) ◽

pp. 467-472

Author(s):

Elane Priscila Rosa dos Santos ◽

Caroline Fátima Ribeiro Silva ◽

Daniela Gonçalves Ohara ◽

Areolino Pena Matos ◽

Ana Carolina Pereira Nunes Pinto ◽

...

Keyword(s):

Older Adults ◽

Physical Performance ◽

Abdominal Obesity ◽

Community Dwelling ◽

Short Physical Performance Battery ◽

Community Dwelling Older Adults

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Association of Systolic and Diastolic Blood Pressure With All-Cause Mortality Among Community-Dwelling Older Adults: A Prospective Observational Study

Journal of Aging and Health ◽

10.1177/08982643211055245 ◽

2021 ◽

pp. 089826432110552

Author(s):

Qian Lian ◽

Tazeen H. Jafar ◽

John C. Allen ◽

Stefan Ma ◽

Rahul Malhotra

Keyword(s):

Blood Pressure ◽

Older Adults ◽

Diastolic Blood Pressure ◽

Mortality Risk ◽

Cox Regression ◽

Community Dwelling ◽

Representative Study ◽

Hazard Ratios ◽

Nationally Representative ◽

Community Dwelling Older Adults

Objectives To assess the association of systolic blood pressure (SBP) and diastolic blood pressure (DBP) with mortality among older adults in Singapore. Methods Association of SBP and DBP measured in 2009 for 4443 older adults (69.5±7.4 years; 60–97 years) participating in a nationally representative study with mortality risk through end-December 2015 was assessed using Cox regression. Results Higher mortality risk was observed at the lower and upper extremes of SBP and DBP. With SBP of 100–119 mmHg as the reference, multivariable mortality hazard ratios [HRs (95% confidence interval)] were SBP <100 mmHg: 2.41 (1.23–4.72); SBP 160–179 mmHg: 1.51 (1.02–2.22); and SBP ≥180 mmHg: 1.78 (1.12–2.81). With DBP of 70–79 mmHg as the reference, HRs were DBP <50 mmHg: 2.41 (1.28–4.54) and DBP ≥110 mmHg: 2.16 (1.09–4.31). Discussion Management of high blood pressure among older adults will likely reduce their mortality risk. However, the association of excessively low SBP and DBP values with mortality risk needs further evaluation.

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Physical Performance Predictors for Incident Dementia Among Japanese Community-Dwelling Older Adults

Physical Therapy ◽

10.1093/ptj/pzz077 ◽

2019 ◽

Vol 99 (9) ◽

pp. 1132-1140

Author(s):

Takehiko Doi ◽

Kota Tsutsumimoto ◽

Sho Nakakubo ◽

Min-Ji Kim ◽

Satoshi Kurita ◽

...

Keyword(s):

Older Adults ◽

Risk Assessment ◽

Grip Strength ◽

Physical Performance ◽

Performance Level ◽

Community Dwelling ◽

Sit To Stand ◽

Dementia Risk ◽

Incident Dementia ◽

Community Dwelling Older Adults

Abstract Background Evaluating physical performance could facilitate dementia risk assessment. However, findings differ regarding which type of physical performance best predicts dementia. Objective The objective of this study was to examine the association between physical performance and incidence of dementia in Japanese community-dwelling older adults. Design This was a prospective study of community-dwelling older adults. Methods Of 14,313 invited individuals who were ≥ 65 years old, 5104 agreed to participate from 2011 to 2012, and 4086 (52% women; mean age = 72.0 years) met the criteria. Baseline assessments of the following physical performance indicators were obtained: grip strength, the Five-Times Sit-to-Stand Test, and the Timed “Up & Go” Test. The physical performance level in each test was categorized as C1 (highest), C2 (middle–high), C3 (middle–low), or C4 (lowest) on the basis of sex-stratified quartile values. Incident dementia status was obtained from medical records that were updated monthly. Results During follow-up (mean duration = 42.9 months), there were 243 incident cases of dementia (5.9%). Log-rank test results indicated that a lower physical performance level constituted a significant risk factor for dementia. After adjustment for covariates, Cox proportional hazards models (reference: highest physical performance level [C1]) demonstrated that the Five-Times Sit-to-Stand Test in the group with the lowest physical performance level (hazard ratio = 1.69; 95% CI = 1.10–2.59) was significantly associated with a risk of dementia. Likewise, the Timed “Up & Go” Test in the group with the lowest physical performance level (hazard ratio = 1.54; 95% CI = 1.01–2.35) was significantly associated with a risk of dementia. However, grip strength was not significantly associated with a risk of dementia. Limitations This study was limited by the use of medical record data. Conclusions A lower mobility-related physical performance level was associated with dementia risk. Dementia risk assessment should include an adequate evaluation of physical function.

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THE DIFFERENTIAL INFLUENCE OF REGIONAL CONTEXT ON LATER-LIFE HEALTH AND MORTALITY

Innovation in Aging ◽

10.1093/geroni/igz038.2970 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S806-S806

Author(s):

Alicia Riley

Keyword(s):

Older Adults ◽

Life Course ◽

Health Effect ◽

Later Life ◽

Community Dwelling ◽

Life Course Perspective ◽

The South ◽

Nationally Representative ◽

Health And Mortality ◽

The U.S

Abstract This study examines regional disparities in later life health from a life course perspective. To sort out when and how region influences health over the life course, I focus on the sharp contrast between the South and the rest of the U.S. in health and mortality. I draw on data from the National Life Health and Aging Project (NSHAP), a nationally representative sample of community-dwelling older adults in the U.S., to estimate the differential risk of multiple health outcomes and mortality by regional trajectory. I find that older adults who leave the South are worse off in multiple outcomes than those who stay. I also find evidence of a protective health effect of community cohesion and dense social networks for the Southerners who stay in the South. My results suggest that regional trajectory influences health in later life through its associations with socioeconomic status, access to healthcare, and social rootedness.

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88 Prospective Association of Obesity and Falls among Malaysian Community-Dwelling Older Adults

Age and Ageing ◽

10.1093/ageing/afz164.88 ◽

2019 ◽

Vol 48 (Supplement_4) ◽

pp. iv18-iv27

Author(s):

Sheng Hui Kioh ◽

Sumaiyah Mat ◽

Phyo Myint ◽

Shahrul B Kamaruzzaman ◽

Maw Pin Tan

Keyword(s):

Older Adults ◽

Physical Performance ◽

Body Fat ◽

Community Dwelling ◽

Percentage Body Fat ◽

Waist Hip Ratio ◽

Increased Risk ◽

Prospective Association ◽

Community Dwelling Older Adults

Abstract Background Cross-sectional studies linking the association between obesity and falls are limited and their results are somewhat conflicting. The inconsistent evidence between obesity and falls could be explained by the utilization of different measures of obesity including BMI, WC, waist hip ratio (WHR) and percentage body fat (%BF) in different studies. Aims To examine the prospective association between various measures of obesity and falls among community-dwelling older adults. Methods We utilized data from the wave 1 and wave 2 of the Malaysian Elder’s Longitudinal Research Study (MELoR). Basic demographic characteristics, medical history, lifestyle factors and falls history in preceding 12 months was recorded by computer assisted questionnaire in participant’s home while anthropometric measurements, body composition assessments and physical performance were collected at the hospital during a hospital check-up at baseline. The main exposure variables were increased body mass index (BMI), waist circumference (WC), waist hip ratio (WHR) and percentage body fat (%BF) and the main outcome was self-report falls in the preceding 12 months at time of follow-up. Results Among 746 participants at baseline and follow-up (mean age 68.9 ± 7.3 years, old, 56.7% women), 150(20.1%) individuals had ≥1 time of fall at follow-up. No differences in mean age and proportion of men and women among fallers and non-fallers. However, fallers were found to have higher WHR, lower percentage muscle mass and performed poorer in physical performance (p-value<0.01). Of the four obesity indicators, higher WHR at baseline was associated with increased risk of fall 12 months later even after adjustment for all potential confounders (aOR= 2.01; 95%CI= 1.26-3.18). Conclusions In conclusion, our findings suggest that WHR is the measure of adiposity most likely to differentiate fallers from non-fallers prospectively. Future studies should evaluate the mechanisms underlying the increased risk of falls associated with increased WHR.

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Loneliness, Social Integration, and Incident Dementia Over 6 Years: Prospective Findings From the English Longitudinal Study of Ageing

The Journals of Gerontology Series B ◽

10.1093/geronb/gbx087 ◽

2017 ◽

Vol 75 (1) ◽

pp. 114-124 ◽

Cited By ~ 39

Author(s):

Snorri Bjorn Rafnsson ◽

Martin Orrell ◽

Eleonora d’Orsi ◽

Eef Hogervorst ◽

Andrew Steptoe

Keyword(s):

Longitudinal Study ◽

Social Isolation ◽

Close Relationships ◽

Cox Regression ◽

Later Life ◽

Sensitivity Analyses ◽

Reverse Causality ◽

Dementia Risk ◽

Incident Dementia ◽

English Longitudinal Study

Abstract Objectives Social relationships are important for the maintenance of cognitive function at older ages, with both objective features of social networks and perceived social connections (loneliness) being relevant. There is limited evidence about how different aspects of social experience predict diagnosed dementia. Methods The sample comprised 6,677 dementia-free individuals at baseline (2004) from the English Longitudinal Study of Ageing. Baseline information on loneliness, number of close relationships, marital status, and social isolation (contact with family and friends and participation in organizations) was analyzed in relation to incident dementia over an average 6.25 years using Cox regression, controlling for potential confounding factors. Results Two hundred twenty participants developed dementia during follow-up. In multivariable analyses, dementia risk was positively related to greater loneliness (hazard ratio 1.40, 95% confidence interval 1.09–1.80, p = .008), and inversely associated with number of close relationships (p < .001) and being married (p = .018). Sensitivity analyses testing for reverse causality and different criteria for diagnosing dementia confirmed the robustness of these findings. There was no association with social isolation. Discussion Dementia risk is associated with loneliness and having fewer close relationships in later life. The underlying mechanisms remain to be elucidated, but efforts to enhance older peoples’ relationship quality may be relevant to dementia risk.

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Daytime Sleepiness and Sleep Inadequacy as Risk Factors for Dementia

Dementia and Geriatric Cognitive Disorders Extra ◽

10.1159/000431311 ◽

2015 ◽

Vol 5 (2) ◽

pp. 286-295 ◽

Cited By ~ 33

Author(s):

Angeliki Tsapanou ◽

Yian Gu ◽

Jennifer Manly ◽

Nicole Schupf ◽

Ming-Xin Tang ◽

...

Keyword(s):

Risk Factors ◽

Daytime Sleepiness ◽

Cox Regression ◽

Sleep Problems ◽

Community Dwelling ◽

Medical Outcomes ◽

Cox Regression Analysis ◽

Incident Dementia ◽

Increased Risk ◽

Sleep Adequacy

Background/Aims: To examine the association between self-reported sleep problems and incidence of dementia in community-dwelling elderly people. Methods: 1,041 nondemented participants over 65 years old were examined longitudinally. Sleep problems were estimated using the RAND Medical Outcomes Study Sleep Scale examining sleep disturbance, snoring, sleep short of breath or with a headache, sleep adequacy, and sleep somnolence. Cox regression analysis was used to examine the association between sleep problems and risk for incident dementia. Age, gender, education, ethnicity, APOE-ε4, stroke, heart disease, hypertension, diabetes, and depression were included as covariates. Results: Over 3 years of follow-up, 966 (92.8%) participants remained nondemented, while 78 (7.2%) developed dementia. In unadjusted models, sleep inadequacy (‘Get the amount of sleep you need') at the initial visit was associated with increased risk of incident dementia (HR = 1.20; 95% CI 1.02-1.42; p = 0.027). Adjusting for all the covariates, increased risk of incident dementia was still associated with sleep inadequacy (HR = 1.20; 95% CI 1.01-1.42; p = 0.040), as well as with increased daytime sleepiness (‘Have trouble staying awake during the day') (HR = 1.24; 95% CI 1.00-1.54; p = 0.047). Conclusion: Our results suggest that sleep inadequacy and increased daytime sleepiness are risk factors for dementia in older adults, independent of demographic and clinical factors.

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Day-to-Day Variability of Physical Activity of Older Adults Living in the Community

Journal of Aging and Physical Activity ◽

10.1123/japa.18.1.75 ◽

2010 ◽

Vol 18 (1) ◽

pp. 75-86 ◽

Cited By ~ 29

Author(s):

Simone Nicolai ◽

Petra Benzinger ◽

Dawn A. Skelton ◽

Kamiar Aminian ◽

Clemens Becker ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Physical Performance ◽

Surrogate Marker ◽

Community Dwelling ◽

Short Physical Performance Battery ◽

Recording Period ◽

Intraindividual Comparison ◽

Community Dwelling Older Adults

The purpose of the study was to investigate whether a 24-hr recording period is sufficient to describe physical activity (PA) of 1 week for intraindividual comparison in older adults. Furthermore, the authors analyzed whether physical performance can be used as a surrogate marker of PA. PA was captured on 7 consecutive days by a body-fixed sensor in 44 community-dwelling older adults (80.75 ± 4.05 yr). Mean times of walking and of “time on feet” of the group were 10.2 hr (± 3.5) and 35.1 hr (± 9.43), respectively. Intraindividual variabilities of walking and of time on feet were 31.9% ± 10.79% and 19.4% ± 8.76%, respectively. Accumulated time of variables of PA showed no differences between weekdays, with variabilities of 3.8% and 1.8% for walking and time on feet, respectively. Association between Short Physical Performance Battery and PA was limited (walkingr= .397, time on feetr= .41).

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The Diagnostic Value of the Short Physical Performance Battery for Sarcopenia

10.21203/rs.3.rs-16033/v1 ◽

2020 ◽

Author(s):

Steven Phu ◽

Ben Kirk ◽

Ebrahim Bani Hassan ◽

Sara Vogrin ◽

Jesse Zanker ◽

...

Keyword(s):

Muscle Strength ◽

Physical Performance ◽

Older Persons ◽

High Sensitivity ◽

Diagnostic Value ◽

Community Dwelling ◽

Short Physical Performance Battery ◽

Clinical Settings ◽

Cut Points ◽

Cut Point

Abstract BACKGROUND: Sarcopenia is defined as the age-related loss of muscle mass, strength and physical performance. The original European Working Group on Sarcopenia in Older Persons (EWGSOP1) definition, and its revision (EWGSOP2), provide new cut-points and alternate measures for sarcopenia diagnosis. However, sarcopenia is rarely diagnosed in clinical settings owing to its labour-intensive screening process. Given the Short Physical Performance Battery (SPPB) is a quick, easily administrable and objective measure of muscle strength and physical performance, both of which are key components of sarcopenia, this study examined the diagnostic value of the SPPB for this muscle disease.METHODS: A cross-sectional analysis of 294 community-dwelling older persons (≥65 years) was conducted. Appendicular lean body mass [(ALM) divided by height squared (ALM/h 2 )], muscle strength (handgrip/sit to stand), and physical performance [gait speed, timed up and go (TUG) and SPPB] were assessed using validated procedures, while participants were diagnosed with sarcopenia following the EWGSOP1 and EWGSOP2 criteria. Diagnostic ability of the SPPB independently and combined with ALM/h 2 for sarcopenia was determined using area under the curve (AUC). Potential cut-points were identified, and sensitivity and specificity calculated.RESULTS: Prevalence of sarcopenia ranged from 4 to 16% depending on the definition. The SPPB demonstrated moderate (AUC = 0.644-0.770) value in diagnosing sarcopenia, and a cut-point of ≤8points in SPPB performance resulted in high sensitivity (82-100%) but low specificity (36-41%) for diagnosing those with severe sarcopenia.CONCLUSIONS: The SPPB displayed acceptable value in diagnosing older adults with severe sarcopenia. Moreover, the high sensitivity of the SPPB when using the cut-point of ≤8 suggests it may be a favourable screening tool for sarcopenia in clinical settings where ALM measurements are not available.

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