Article: Role of Gait Speed, Strength, and Balance in Predicting Adverse Outcomes of Acutely Ill Older Outpatients
journal of nutrition, health & aging. 2020 Jan., v. 24, no. 1
2020
Abstract: AIM: To evaluate the ability of the Short Physical Performance Battery (SPPB) for predicting 1-year adverse outcomes of acutely ill older outpatients. METHODS: Prospective study with 512 acutely ill older outpatients (79.4±8.3 years, 63% female) in an ... ...
| Abstract | AIM: To evaluate the ability of the Short Physical Performance Battery (SPPB) for predicting 1-year adverse outcomes of acutely ill older outpatients. METHODS: Prospective study with 512 acutely ill older outpatients (79.4±8.3 years, 63% female) in an acute care day hospital. The SPPB was administered at admission. Participants were classified as low (0–4 points), intermediate (5–8 points), or high (9–12 points) performance. Primary outcomes were new dependence in basic activities of daily living (ADL), hospitalization, and death at 1 year. Cox models tested whether the SPPB predicted outcomes after adjustment for sociodemographic factors, comorbidities and well-known geriatric conditions. We also estimated whether the chair-stand and balance tests improve the SPPB’s ability to identify patients at high risk of adverse outcomes. RESULTS: Patients with intermediate or low SPPB performance were at higher risk of 1-year new ADL dependence (32% vs 13%: adjusted hazard ratio [aHR]=2.00; 95%CI=1.18–3.37; 58% vs 13%: aHR=3.40; 95%CI=2.00–5.85, respectively), hospitalization (43% vs 29%: aHR=1.56; 95%CI=1.04–2.33; 44% vs 29%: aHR=1.80; 95%CI=1.15–2.82), and death (18% vs 6%: aHR=2.54; 95%CI=1.17–5.53; 21% vs 6%: aHR=2.70; 95%CI=1.17–6.21). Use of all three components (versus gait speed alone) improved predictions of new ADL dependence (Harrell’s C=0.73 vs 0.70;P=0.01), hospitalization (Harrell’s C=0.60 vs 0.57;P=0.04), and death (Harrell’s C=0.67 vs 0.62;P=0.04). CONCLUSIONS: The SPPB is as a powerful tool for identifying acutely ill older outpatients at high-risk of adverse outcomes. The combination of the three components of the SPPB resulted in better predictive performance than gait speed alone. |
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| Keywords | adults at risk ; comorbidity ; death ; exercise test ; females ; gait ; hospitals ; patients ; prediction ; prospective studies ; sociodemographic characteristics |
| Language | English |
| Dates of publication | 2020-01 |
| Size | p. 113-118. |
| Publishing place | Springer Paris |
| Document type | Article |
| ZDB-ID | 2081921-3 |
| ISSN | 1760-4788 ; 1279-7707 |
| ISSN (online) | 1760-4788 |
| ISSN | 1279-7707 |
| DOI | 10.1007/s12603-019-1279-6 |
| Database | NAL-Catalogue (AGRICOLA) |
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