Luisa Costanzo1, Claudio Pedone1, Matteo Cesari2, Luigi Ferrucci3, Stefania Bandinelli4, Raffaele Antonelli Incalzi1. 1. Geriatric Unit, Campus Bio-Medico University of Rome, Rome. 2. Geriatric Unit, Department of Medical Sciences and Community Health, University of Milan, Milan, Italy. 3. National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA. 4. Healthcare Agency of Florence, Florence, Italy.
Abstract
AIM: To date, there is no consensus on which set of variables should be used to identify older persons at risk of disability in activities of daily living. The present study aimed to: (i) evaluate how different deficits cluster in a population of community-dwelling older persons; and (ii) investigate whether the discriminative capacity of physical performance measures towards the development of disability might be improved by adding psychological, social and environmental indicators. METHODS: Data are from 709 non-disabled older persons participating in the "Invecchiare in Chianti" study. We carried out a cluster analysis of 12 deficits in multiple functional domains, selected from the available frailty assessment instruments. Then, participants were assigned to a group, based on the obtained clusters of variables. For each group, we measured the prognostic capacity and the predictive ability for 6-year disability. RESULTS: The analysis showed a "physical" cluster (including weight loss, reduced grip strength/gait speed/physical activity, impaired balance, environmental barriers) and a "psychosocial" cluster (e.g. living alone, depression, low income). Thus, participants were classified into four groups according to the presence of a physical and/or psychosocial cluster. Compared with the "fit" group, the relative risks of becoming disabled in the "physical," "psychosocial" and "mixed" deficit groups were 2.23 (95% CI 0.71-7.00), 1.52 (95% CI 0.62-3.75) and 6.37 (95% CI 2.83-14.33), respectively. The positive and negative predictive values for the "physical," "psychosocial" and "mixed" deficit groups were, respectively, 9% and 87%, 6% and 83%, and 27% and 94%. CONCLUSIONS: As expected, physical and psychosocial deficits cluster predominantly into different groups. Even when both are considered simultaneously, the ability to predict incident disability is still insufficient. Geriatr Gerontol Int 2018; 18: 685-691.
AIM: To date, there is no consensus on which set of variables should be used to identify older persons at risk of disability in activities of daily living. The present study aimed to: (i) evaluate how different deficits cluster in a population of community-dwelling older persons; and (ii) investigate whether the discriminative capacity of physical performance measures towards the development of disability might be improved by adding psychological, social and environmental indicators. METHODS: Data are from 709 non-disabled older persons participating in the "Invecchiare in Chianti" study. We carried out a cluster analysis of 12 deficits in multiple functional domains, selected from the available frailty assessment instruments. Then, participants were assigned to a group, based on the obtained clusters of variables. For each group, we measured the prognostic capacity and the predictive ability for 6-year disability. RESULTS: The analysis showed a "physical" cluster (including weight loss, reduced grip strength/gait speed/physical activity, impaired balance, environmental barriers) and a "psychosocial" cluster (e.g. living alone, depression, low income). Thus, participants were classified into four groups according to the presence of a physical and/or psychosocial cluster. Compared with the "fit" group, the relative risks of becoming disabled in the "physical," "psychosocial" and "mixed" deficit groups were 2.23 (95% CI 0.71-7.00), 1.52 (95% CI 0.62-3.75) and 6.37 (95% CI 2.83-14.33), respectively. The positive and negative predictive values for the "physical," "psychosocial" and "mixed" deficit groups were, respectively, 9% and 87%, 6% and 83%, and 27% and 94%. CONCLUSIONS: As expected, physical and psychosocial deficits cluster predominantly into different groups. Even when both are considered simultaneously, the ability to predict incident disability is still insufficient. Geriatr Gerontol Int 2018; 18: 685-691.
Authors: Jeremy Walston; Evan C Hadley; Luigi Ferrucci; Jack M Guralnik; Anne B Newman; Stephanie A Studenski; William B Ershler; Tamara Harris; Linda P Fried Journal: J Am Geriatr Soc Date: 2006-06 Impact factor: 5.562
Authors: L P Fried; C M Tangen; J Walston; A B Newman; C Hirsch; J Gottdiener; T Seeman; R Tracy; W J Kop; G Burke; M A McBurnie Journal: J Gerontol A Biol Sci Med Sci Date: 2001-03 Impact factor: 6.053
Authors: Robbert J J Gobbens; Katrien G Luijkx; Maria Th Wijnen-Sponselee; Jos M G A Schols Journal: J Am Med Dir Assoc Date: 2010-03-24 Impact factor: 4.669
Authors: John E Morley; Bruno Vellas; G Abellan van Kan; Stefan D Anker; Juergen M Bauer; Roberto Bernabei; Matteo Cesari; W C Chumlea; Wolfram Doehner; Jonathan Evans; Linda P Fried; Jack M Guralnik; Paul R Katz; Theodore K Malmstrom; Roger J McCarter; Luis M Gutierrez Robledo; Ken Rockwood; Stephan von Haehling; Maurits F Vandewoude; Jeremy Walston Journal: J Am Med Dir Assoc Date: 2013-06 Impact factor: 4.669
Authors: Daniel X M Wang; Jessica Yao; Yasar Zirek; Esmee M Reijnierse; Andrea B Maier Journal: J Cachexia Sarcopenia Muscle Date: 2019-12-01 Impact factor: 12.910