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

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.

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RISING FROM THE FLOOR IN PERSONS WITH PARKINSON’S DISEASE

Innovation in Aging ◽

10.1093/geroni/igz038.1768 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S474-S475

Author(s):

Dennis W Klima ◽

Jeremy Stewart ◽

Frank Freijomil ◽

Mary DiBartolo

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Physical Performance ◽

Performance Measure ◽

Community Dwelling ◽

Gait Velocity ◽

Performance Tests ◽

Motor Patterns ◽

Timed Up And Go ◽

Cross Sectional

Abstract While considerable research has targeted gait, balance and preventing falls in individuals with Parkinson’s disease (PD), less in known about the ability to rise from the floor in this population. The aims of this study were to 1) Examine the relationship between locomotion and physical performance tests and the timed supine to stand performance measure and to 2) Identify both the time required and predominant motor patterns utilized by persons with PD to complete to floor rise transition. A cross-sectional design was utilized. Twenty community-dwelling older adults with PD (mean age 74.8+/-9.5 years; 13 men) performed a standardized floor rise test and locomotion tests in a structured task circuit. Subject demographic and anthropometric data were also collected. Statistical analyses included descriptive statistics and Pearson Product Moment correlations. Fifteen subjects (75%) demonstrated the crouch kneel pattern and fourteen (70%) used an all-4’s strategy to rise to stand. The mean time to rise from the floor was 14.9 (+/- 7.6) seconds and slower than published norms for persons without PD. Nine subjects required the use of a chair to perform floor recovery. Supine to stand performance time was significantly correlated with the: Dynamic Gait Index (r= - 0.66; p<0.002), Five Times Sit to Stand Test (r=0.78; p<0.001), Timed Up and Go Test (r=0.74; p<0.001), and gait velocity (r= -0.77; p<0.001). Rising from the floor demonstrates concurrent validity with locomotion and physical performance tests. Floor recovery techniques can be incorporated in fall prevention initiatives in conjunction with PD symptom management.

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50 Sociodemographic, Physical Performance and Fear of Falls Profile of Older Adult Fallers and Non Fallers: A Preliminary Study

Age and Ageing ◽

10.1093/ageing/afz164.50 ◽

2019 ◽

Vol 48 (Supplement_4) ◽

pp. iv13-iv17

Author(s):

Azianah Ibrahim ◽

Nur Aimuni Abu Hassan ◽

Halizahanim Hassan

Keyword(s):

Older Adults ◽

Older Adult ◽

Physical Performance ◽

Cross Sectional Study ◽

Falls Prevention ◽

Timed Up And Go ◽

Cross Sectional ◽

Sit To Stand ◽

Management Plans ◽

Fear Of Falls

Abstract Introduction It is important to identify older adult fallers in order to implement early prevention management also prevent recurrent falls. This study aimed to explore the profiles of older adult fallers and non-fallers in regards to socio-demographic, physical performance, fear of falls that includes the activities that were feared in regard to falls. Analysis Descriptive and mean comparison test. Methodology Participants for this study were recruited among individuals aged 60 years and above, able to walk 3m, able to stand independently for longer than 1min and able to comprehend and follow instructions. Exclusion criteria include recent vertebral or lower limb fracture (less than 6months), unstable angina, unable to follow command and severe hearing and vision impairment. Design: Cross-sectional study. Results A number of 27 older adults were screened for falls. Based on Timed Up and Go test (cut off 11.18s), 8 (29.6%) of them were identified as fallers. Fallers were majority females (10, 37%), had visual impairment (4,14.8%), older (77.4±2.9years versus 68.4±5.7years) and had slightly higher in fear of falls score (13.2±5.5 versus 12.0±7.0). In view of physical performance, fallers were slower in Timed Up and Go test (13.6±2.4 versus 9.1±1.4), weaker in hand grip strength (14.3±2.5kg versus 21.5±19.3kg) and weaker in sit-to-stand performance (13.3±2.7s versus 10.7±2.7s). Age (p<0.05) and sit-to-stand performance (p<0.05) significantly differed between fallers and non-fallers. Among seven activities assessed using short Falls Efficacy Scale-International, non-fallers were found to have more fear during various activities compared to fallers. Implication Exploration of falls risk profiles in older adults will hopefully allow better understanding and further improvement in developing falls prevention management plans.

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Using Functional Ability Measures to Assess Fall Risk in Acute Care

Western Journal of Nursing Research ◽

10.1177/0193945920924637 ◽

2020 ◽

Vol 42 (12) ◽

pp. 1050-1058

Author(s):

Alaina M. Bassett ◽

Ka-Chun Siu ◽

Julie A. Honaker

Keyword(s):

Acute Care ◽

Functional Ability ◽

Fall Risk ◽

Assessment Tool ◽

Functional Performance ◽

Risk Measures ◽

Cross Sectional Study ◽

Timed Up And Go ◽

Cross Sectional ◽

Acute Care Settings

Currently, it is not known whether integration of functional performance measures is sensitive and feasible for use in acute care settings. This cross-sectional study explored the subjective and objective measures of the risks of falling, falls efficacy, and functional abilities for inpatients in an adult acute care unit. The Morse Fall Scale ( n = 30) and Timed Up and Go (TUG; n = 10) had excellent sensitivity (100%) for identifying participants with prior fall histories, while the St. Thomas Risk Assessment Tool in Falling Elderly Inpatients only had good sensitivity (87.5%). Study findings suggest that implementation of feasible functional ability measures in conjunction with subjective fall risk measures could enhance accuracy and performance in identifying inpatient risks of falling in acute care settings.

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Twelve-Month Retention in and Impact of Enhance®Fitness on Older Adults in Hawai‘i

Journal of Aging Research ◽

10.1155/2019/9836181 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7

Author(s):

Michiyo Tomioka ◽

Kathryn L. Braun ◽

Yan Yan Wu ◽

Kay Holt ◽

Paula Keele ◽

...

Keyword(s):

Older Adults ◽

Physical Performance ◽

Performance Measures ◽

Healthy Aging ◽

Low Cost ◽

Exercise Program ◽

Performance Measure ◽

Self Report ◽

Future Research ◽

Health Promotion Initiative

Introduction. Enhance®Fitness is a low-cost group exercise program designed specifically for older adults (60+ years) to improve physical performance. The Hawai‘i Healthy Aging Partnership, a statewide health promotion initiative, has continuously offered Enhance®Fitness to Hawai‘i’s multicultural population since 2007. This study examined 12-month participation in and impact of Enhance®Fitness on physical performance among older adults in Hawai‘i. Method. Linear mixed-effects models were applied to analyze the physical performance measures (chair-stands, arm curls, and the up-and-go test) collected at baseline (month 0) and at 4, 8, and 12 months. We also compared the characteristics of participants who participated in the program for 12 months with those who dropped out in order to gain insights on participant retention. Results. Of 1,202 older adults with baseline data, 427 (35.5%) were continuously enrolled in Enhance®Fitness for 12 months and participated in follow-up data collection. On average, participants attended 63.7% of thrice-weekly classes each month. Participants’ physical performance measures improved after 4 months, continued to improve until 8 months, and were maintained thereafter. Besides continuous attendance, performance-measure improvements were associated with younger age, male gender, living with others (vs. alone), and fewer chronic conditions. Compared to those who completed 12 months of the program, the 775 who left the program over the course of the year were more likely to be younger, to be Caucasian (vs. Asian or Pacific Islander), to self-report depression as a chronic condition, and to have lower levels of fitness at baseline. Common reasons for dropping out were illness, relocation, time conflicts, lost interest, and transportation issues. Conclusions. Long-term participants in Enhance®Fitness initially improved and then maintained physical performance. Future research is needed to identify strategies to maintain enrollment of older adults in the exercise programs over time.

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The Relationship between Modified Short Physical Performance Battery and Falls: A Cross-Sectional Study of Older Outpatients

Geriatrics ◽

10.3390/geriatrics6040106 ◽

2021 ◽

Vol 6 (4) ◽

pp. 106

Author(s):

Kazuki Fukui ◽

Noriaki Maeda ◽

Makoto Komiya ◽

Junpei Sasadai ◽

Tsubasa Tashiro ◽

...

Keyword(s):

Physical Activity ◽

Logistic Regression ◽

Physical Performance ◽

Fall Risk ◽

Assessment Tool ◽

Handgrip Strength ◽

Multivariate Logistic Regression Analysis ◽

Short Physical Performance Battery ◽

Multivariate Logistic Regression ◽

Cross Sectional

The Short Physical Performance Battery (SPPB) is a physical fall-risk screening tool and predictor of adverse health effects for the older. Its limited use in Japan is due to the relative ease for high-functioning older adults to achieve perfect scores. Japanese researchers thus created a community-based SPPB (SPPB-com). This study investigated whether the SPPB-com score can distinguish between older patients classified as “fallers” and “non-fallers.” Participants comprised 185 older outpatients aged 65 and above who self-reported their history of accidental falls and relevant physical activity. Fall risk was assessed using SPPB and SPPB-com. Handgrip strength, maximum isometric knee extensor strength, and maximum walking speed were measured as physical functions. Multivariate logistic regression and receiver-operating characteristic analyses determined criteria indicating faller status. Fallers were older and had lower physical function, physical activity, SPPB, and SPPB-com scores than non-fallers. Multivariate logistic regression analysis showed SPPB (OR 0.76, 95% CI 0.59–0.99, p = 0.045) and SPPB-com (OR 0.63, 95% CI 0.45–0.87, p = 0.005) scores were both independently associated with prior falls. The SPPB-com score may function as a fall-risk assessment tool for older outpatients, and its combined use with SPPB can increase the accuracy and precision of distinction between fallers and non-fallers.

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Talk or Walk? Gait Speed over Self-Report in Association with Cognitive Speed in Healthy Older Adults

GeroPsych ◽

10.1024/1662-9647/a000202 ◽

2019 ◽

Vol 32 (1) ◽

pp. 41-52

Author(s):

Matthew C. Costello ◽

Shane J. Sizemore ◽

Kimberly E. O’Brien ◽

Lydia K. Manning

Keyword(s):

Older Adults ◽

Older Adult ◽

Gait Speed ◽

Well Being ◽

Self Report ◽

Subjective Report ◽

Healthy Older Adults ◽

Relative Value ◽

Cognitive Speed ◽

Age Range

Abstract. This study explores the relative value of both subjectively reported cognitive speed and gait speed in association with objectively derived cognitive speed. It also explores how these factors are affected by psychological and physical well-being. A group of 90 cognitively healthy older adults ( M = 73.38, SD = 8.06 years, range = 60–89 years) were tested in a three-task cognitive battery to determine objective cognitive speed as well as measures of gait speed, well-being, and subjective cognitive speed. Analyses indicated that gait speed was associated with objective cognitive speed to a greater degree than was subjective report, the latter being more closely related to well-being than to objective cognitive speed. These results were largely invariant across the 30-year age range of our older adult sample.

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Physical Activity Trajectories and Associated Changes in Physical Performance in Older Men: The MrOS Study

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa073 ◽

2020 ◽

Vol 75 (10) ◽

pp. 1967-1973

Author(s):

Deepika R Laddu ◽

Neeta Parimi ◽

Katie L Stone ◽

Jodi Lapidus ◽

Andrew R Hoffman ◽

...

Keyword(s):

Physical Activity ◽

Grip Strength ◽

High Activity ◽

Physical Performance ◽

Gait Speed ◽

Functional Independence ◽

Performance Measure ◽

Least Square ◽

Activity Group ◽

Low Activity

Abstract Background Physical activity (PA) is important to maintaining functional independence. It is not clear how patterns of change in late-life PA are associated with contemporaneous changes in physical performance measures. Methods Self-reported PA, gait speed, grip strength, timed chair stand, and leg power were assessed in 3,865 men aged ≥ 65 years at baseline (2000–2002) and Year 7 (2007–2009). Group-based trajectory modeling, using up to four PA measures over this period, identified PA trajectories. Multivariate linear regression models (adjusted least square mean [95% confidence interval {CI}]) described associations between-PA trajectories and concurrent changes in performance. Results Three discrete PA patterns were identified, all with declining PA. Linear declines in each performance measure (baseline to Year 7) were observed across all three PA groups, but there was some variability in the rate of decline. Multivariate models assessing the graded response by PA trajectory showed a trend where the high-activity group had the smallest declines in performance while the low-activity group had the largest (p-for trend < .03). Changes in the high-activity group were the following: gait speed (−0.10 m/s [−0.12, −0.08]), grip strength (−3.79 kg [−4.35, −3.23]), and chair stands (−0.38 [−0.50, −0.25]), whereas changes in the low-activity group were the following: gait speed (−0.16 [−0.17, −0.14]), grip strength (−4.83 kg [−5.10, −4.55]), and chair stands (−0.53 [−0.59, −0.46]). Between-group differences in leg power trajectories across PA patterns were not significant. Conclusions Declines in functional performance were higher among those with lower PA trajectories, providing further evidence for the interrelationship between changes in PA and performance during old age.

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Walking and postural balance in adults with severe short stature due to isolated GH deficiency

Endocrine Connections ◽

10.1530/ec-19-0103 ◽

2019 ◽

Vol 8 (4) ◽

pp. 416-424 ◽

Cited By ~ 2

Author(s):

Ananda A Santana-Ribeiro ◽

Giulliani A Moreira-Brasileiro ◽

Manuel H Aguiar-Oliveira ◽

Roberto Salvatori ◽

Vitor O Carvalho ◽

...

Keyword(s):

Short Stature ◽

Postural Balance ◽

Fall Risk ◽

Gh Deficiency ◽

Muscle Tone ◽

Receptor Gene ◽

Leg Length ◽

Timed Up And Go ◽

Cross Sectional ◽

Severe Short Stature

Objectives Walking and postural balance are extremely important to obtain food and to work. Both are critical for quality of life and ability to survive. While walking reflects musculoskeletal and cardiopulmonary systems, postural balance depends on body size, muscle tone, visual, vestibular and nervous systems. Since GH and IGF-I act on all these systems, we decided to study those parameters in a cohort of individuals with severe short stature due to untreated isolated GH deficiency (IGHD) caused by a mutation in the GHRH receptor gene. These IGHD subjects, despite reduction in muscle mass, are very active and have normal longevity. Methods In a cross-sectional study, we assessed walking (by a 6-min walk test), postural balance (by force platform) and fall risk (by the 'Timed Up and Go' test) in 31 IGHD and 40 matched health controls. Results The percentage of the walked distance measured in relation to the predicted one was similar in groups, but higher in IGHD, when corrected by the leg length. Absolute postural balance data showed similar velocity of unipodal support in the two groups, and better values, with open and closed eyes and unipodal support, in IGHD, but these differences became non-significant when corrected for height and lower-limb length. The time in 'Timed Up and Go' test was higher in IGHD cohort, but still below the cut-off value for fall risk. Conclusion IGHD subjects exhibit satisfactory walking and postural balance, without increase in fall risk.

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Prevalence of Sarcopenic Obesity Using Different Definitions and the Relationship With Strength and Physical Performance in the Canadian Longitudinal Study of Aging

Frontiers in Physiology ◽

10.3389/fphys.2020.583825 ◽

2021 ◽

Vol 11 ◽

Author(s):

Sarah A. Purcell ◽

Michelle Mackenzie ◽

Thiago G. Barbosa-Silva ◽

Isabelle J. Dionne ◽

Sunita Ghosh ◽

...

Keyword(s):

Longitudinal Study ◽

Physical Performance ◽

Gait Speed ◽

Walking Speed ◽

Handgrip Strength ◽

Sarcopenic Obesity ◽

Cross Sectional ◽

X Ray ◽

The Relationship ◽

Negative Health Outcomes

Sarcopenic obesity is associated with several negative health outcomes. However, the prevalence of this condition – and the relationship to physical performance parameters – varies across definitions. The aim of this cross-sectional investigation was to describe the prevalence of sarcopenic obesity using different published definitions and their relationship with handgrip strength and walking speed in older Canadian adults. Individuals aged 65+ in the Canadian Longitudinal Study on Aging (n = 11,803; 49.6% male, 50.4% female) were included. Body composition was measured using dual X-ray absorptiometry. Sarcopenic obesity was defined using 29 definitions. Low handgrip strength was identified as < 27 kg in males and < 16 kg in females and poor physical performance was defined as gait speed ≤ 0.8 m/s. The prevalence of sarcopenic obesity ranged from 0.1 to 85.3% in males, and from 0 to 80.4% in females. Sarcopenic obesity was frequently associated with low handgrip strength (p < 0.05) in both males (14/17 definitions, 82.4%) and females (21/29 definitions, 72.4%). In very few definitions, sarcopenic obesity was associated with slow gait speed (males: 1/17 definitions [6.7%]; females: 2/29 [6.9%]). In conclusion, the prevalence of sarcopenic obesity varied greatly according to definitions and sarcopenic obesity was frequently associated with low handgrip strength.

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