Nicola Veronese1, Brendon Stubbs2,3, Luigi Fontana4,5,6, Caterina Trevisan1, Francesco Bolzetta1, Marina De Rui1, Leonardo Sartori7, Estella Musacchio7, Sabina Zambon5,8, Stefania Maggi8, Egle Perissinotto9, Maria Chiara Corti10, Gaetano Crepaldi8, Enzo Manzato1,8, Giuseppe Sergi1. 1. Geriatrics Division, Department of Medicine-DIMED, University of Padova, Italy. 2. Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK. 3. Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience King's College London, London, UK. 4. Department of Clinical and Experimental Sciences, Brescia University, Italy. 5. Department of Medicine, Washington University School of Medicine, St Louis, Missouri. 6. CEINGE Biotecnologie Avanzate, Napoli, Italy. 7. Department of Medicine-DIMED, ClinicaMedica I, University of Padova, Italy. 8. National Research Council, Neuroscience Institute, Padova, Italy. 9. Biostatistics, Epidemiology and Public Health Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy. 10. Division of Health Care Planning and Evaluation of the Regione Veneto, Venice, Italy.
Abstract
Background: Physical performance is an important predictor of mortality, but little is known on the comparative prognostic utility of different objective physical performance tests in community-dwelling older adults. We compared the prognostic usefulness of several objective physical performance tests on mortality, adjusting our analyses for potential confounders. Methods: Among 3,099 older community-dwelling participants included in the Progetto Veneto Anziani study, 2,096 were followed for a mean of 4.4 years. Physical performance tests measured were Short Physical Performance Battery (SPPB), 4-meter gait speed, chair stands time, leg extension and flexion, handgrip strength, and 6-Minute Walking Test (6MWT), treated as continuous variables and categorized in gender-specific quartiles. The main outcome was mortality assessed with death certificates. Results: Participants who died during the follow-up (n = 327) scored significantly worse in all physical performance tests measured at baseline than those who survived (n = 1,769). Using a Harrell's C-index, the highest C-index was observed for 6MWT in men (C-index = 0.735; 95% confidence interval [CI]: 0.701-0.770, p < .0001) and SPPB in women (C-index = 0.781; 95% CI: 0.740-0.822, p = .0009). However, in both genders, only SPPB, 4-meter walking speed, and 6MWT are significant predictors of mortality. Analyses using sex-specific quartiles substantially confirmed these findings. Conclusions: Slow gait speed, 6MWT, and SPPB are significant predictors for mortality in community-dwelling older men and women. Physicians should consider using these tests to identify elderly individuals who are at higher risk of death to improve clinical decision making.
Background: Physical performance is an important predictor of mortality, but little is known on the comparative prognostic utility of different objective physical performance tests in community-dwelling older adults. We compared the prognostic usefulness of several objective physical performance tests on mortality, adjusting our analyses for potential confounders. Methods: Among 3,099 older community-dwelling participants included in the Progetto Veneto Anziani study, 2,096 were followed for a mean of 4.4 years. Physical performance tests measured were Short Physical Performance Battery (SPPB), 4-meter gait speed, chair stands time, leg extension and flexion, handgrip strength, and 6-Minute Walking Test (6MWT), treated as continuous variables and categorized in gender-specific quartiles. The main outcome was mortality assessed with death certificates. Results:Participants who died during the follow-up (n = 327) scored significantly worse in all physical performance tests measured at baseline than those who survived (n = 1,769). Using a Harrell's C-index, the highest C-index was observed for 6MWT in men (C-index = 0.735; 95% confidence interval [CI]: 0.701-0.770, p < .0001) and SPPB in women (C-index = 0.781; 95% CI: 0.740-0.822, p = .0009). However, in both genders, only SPPB, 4-meter walking speed, and 6MWT are significant predictors of mortality. Analyses using sex-specific quartiles substantially confirmed these findings. Conclusions: Slow gait speed, 6MWT, and SPPB are significant predictors for mortality in community-dwelling older men and women. Physicians should consider using these tests to identify elderly individuals who are at higher risk of death to improve clinical decision making.
Authors: Lee Smith; Peter Allen; Shahina Pardhan; Trish Gorely; Igor Grabovac; Annetta Smith; Guillermo F López-Sánchez; Lin Yang; Sarah E Jackson Journal: Wien Klin Wochenschr Date: 2020-01-07 Impact factor: 1.704
Authors: Maria Amasene; María Medrano; Iñaki Echeverria; Miriam Urquiza; Ana Rodriguez-Larrad; Amaia Diez; Idoia Labayen; Besga-Basterra Ariadna Journal: Front Nutr Date: 2022-06-24