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Preliminary validation of the short physical performance battery in older adults with multiple sclerosis: secondary data analysis.

ABSTRACT: BACKGROUND:There are relatively few standard, objective measures for studying physical function among older adults with multiple sclerosis (MS), yet such measures are necessary considering the shift in prevalence and associated consequences of both MS and older age on physical function. We undertook a preliminary examination of the construct validity of Short Physical Performance Battery (SPPB) scores in older adults with MS based on an expected differential pattern of associations with measures of lower and upper extremity function. METHODS:The sample included 48 persons with MS aged 50 years and older who were enrolled in a pilot, randomized controlled trial of exercise training. Participants completed the SPPB and other objective and self-report measures of lower and upper extremity function as part of baseline testing. RESULTS:SPPB scores demonstrated strong associations with measures of lower extremity function (|r s|?=?.66-.79), and weak associations with measures of upper extremity function (|r s|?=?.03-.33). CONCLUSIONS:We provide preliminary evidence that supports the validity of scores from the SPPB as a measure of lower extremity function for inclusion in clinical research and practice involving older adults with MS.

SUBMITTER: Motl RW

PROVIDER: S-EPMC4668658 | biostudies-literature | 2015 Dec

REPOSITORIES: biostudies-literature

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Preliminary validation of the short physical performance battery in older adults with multiple sclerosis: secondary data analysis.

Motl Robert W RW Learmonth Yvonne C YC Wójcicki Thomas R TR Fanning Jason J Hubbard Elizabeth A EA Kinnett-Hopkins Dominique D Roberts Sarah A SA McAuley Edward E

BMC geriatrics 20151203

<h4>Background</h4>There are relatively few standard, objective measures for studying physical function among older adults with multiple sclerosis (MS), yet such measures are necessary considering the shift in prevalence and associated consequences of both MS and older age on physical function. We undertook a preliminary examination of the construct validity of Short Physical Performance Battery (SPPB) scores in older adults with MS based on an expected differential pattern of associations with ...[more]

PMID: 26630923

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Project description:ObjectiveReduced functional capacity is a hallmark of early pre-clinical stages of heart failure (HF). The Short Physical Performance Battery (SPPB) is a valid measure of lower extremity physical function, has relatively low implementation burden, and is associated with cardiovascular disease and mortality. However, the SPPB-HF association is understudied in older women among whom HF burden is high.MethodsWomen (n = 5325; mean age 79 ± 7 years; 34% Black, 18% Hispanic, and 49% White) without prior HF completed the SPPB consisting of standing balance, strength, and walking tests that were summarized as a composite score from 0 (lowest) to 12 (highest), categorized as very low (0-3), low (4-6), medium (7-9), or high (10-12). Participants were followed for up to 8 years for incident HF (306 cases identified). Cox proportional hazards regression estimated hazard ratios (HR) adjusting for age, race/ethnicity, education, smoking, alcohol, diabetes, hypertension, COPD, osteoarthritis, depression, BMI, systolic blood pressure, lipids, glucose, and accelerometer-measured moderate-vigorous physical activity (MVPA) and sedentary time.ResultsIncident HF cases (crude rate per 1000 person-years) in the four SPPB categories (very low to high) were 34 (26.0), 79 (14.5), 128 (9.3), and 65 (5.6). Corresponding multivariable-adjusted HRs (95% CIs) were 2.22 (1.34-3.66), 1.63 (1.11-2.38), 1.39 (1.00-1.94), and 1.00 (referent; P-trend<0.001). Higher HF risk was associated with lower SPPB in women with major modifiable HF risk factors including obesity (HR per 3-unit SPPB decrement: present HR = 1.41, absent HR = 1.41), hypertension (present HR = 1.45, absent HR = 1.30), diabetes (present HR = 1.32, absent HR = 1.44), and lower accelerometer-measured MVPA (<45 min/day HR = 1.29, ≥45 min/day HR = 1.60); all P-interaction>0.10.ConclusionLower SPPB scores were associated with greater risk of incident HF in older women even after accounting for differences in HF risk factors and objectively measured PA. Implementing the SPPB in clinical settings could potentially enhance individual-level HF risk assessment, which should be further explored.

Project description:BackgroundThe Short Physical Performance Battery (SPPB) is an instrument for assessing physical performance widely used in research among the elderly in multiple settings. We did not find Brazilian longitudinal studies that aimed to analyze the predictive capacity and accuracy of the SPPB among community-dwelling older adults and no systematic reviews were found on the accuracy of the SPPB in predicting mortality in community- dwelling older adults. This study aimed to analyze the capacity and accuracy of the SPPB for predicting mortality in community-dwelling older adults, as well as to determine cut-off points for men and women.MethodLongitudinal observational study conducted with 411 (70.1 ± 7.25 years) community-dwelling older adults, between 2017 and 2020 (37.7 ± 6.24 months). Physical performance was evaluated using the SPPB and information on the all-cause mortality rate was also recorded. Multivariate Cox regression analyses and curves were performed using the Kaplan-Meier method. Receiver Operating Characteristic (ROC) curves were constructed, with the parameters of area under the ROC curve (AUC) to determine cutoff points for discriminating mortality, considering a significance level of 5% (p < 0.05) and 95% confidence interval (CI) 95%.ResultsOlder adults with very low and low physical performance in the SPPB, showed higher risks of mortality (HR = 9.67; 95% CI [1.20-77.65]; HR = 4.06; 95% CI [1.09-15.01]), respectively. In the subtest's analysis, older adults with low performance in the balance (HR = 0.54; 95% CI [0.36-0.81]) and gait speed tests (HR = 0.50; 95% CI [0.33-0.76]) showed greater risks of dying. The same was reproduced for categories in each test (participants that scored 2 points in the balance test had an HR = 5.86; 95% CI [1.84-18.61] and 2 points in the gait speed test, HR = 5.07; 95% CI [1.76-14.58]. The cutoff point ≤ 9 in the SPPB set the discriminator criterion for mortality in older people of both sexes.ConclusionsThe SPPB, as well as the balance and gait speed subtests were predictors of mortality, and the SPPB is accurate in predicting mortality among community-dwelling older adults.

Project description:BackgroundFear of falling (FOF) negatively affects health-related quality of life and is common in neurogeriatric patients, however, related parameters are not well understood. This study investigated the relationship between FOF, physical performance (as assessed with the Short Physical Performance Battery and its subscores) and other aspects of sarcopenia in a sample of hospitalized neurogeriatric patients.MethodsIn 124 neurogeriatric patients, FOF was assessed with the Falls Efficacy Scale International (FES-I). Physical performance was measured using the Short Physical Performance Battery (SPPB) including walking duration, balance and five times sit-to-stand task (5xSST) subscores. Appendicular skeletal muscle mass (ASMM) was estimated with the cross-validated Sergi equation using Bioelectrical impedance analysis measures. The Depression im Alter-Skala (DIA-S) was used to assess depressive symptoms. Multiple regression models with FES-I score as outcome variable were computed using backward selection with AICc as selection criterion, including: (i) SPPB total score, ASMM/height2, grip strength, age, gender, positive fall history, number of medications, use of a walking aid, DIA-S score and Montreal Cognitive Assessment (MoCA) score; and (ii) SPPB subscores, ASMM/height2, grip strength, age, gender, positive fall history, number of medications, DIA-S score and MoCA score, once with and once without including use of a walking aid as independent variable.ResultsLower SPPB total score, as well as lower SPPB balance and 5xSST subscores were associated with higher FES-I scores, but SPPB walking duration subscore was not. Moreover, DIA-S, number of medications and use of a walking aid were significantly associated with FOF.ConclusionOur preliminary results suggest that -if confirmed by subsequent studies- it may be worthwhile to screen patients with low SPPB balance and 5xSST subscores for FOF, and to treat especially these mobility deficits in neurogeriatric patients with FOF. Moreover, training neurogeriatric patients to use their walking aids correctly, critical evaluation of medication and treating depressive symptoms may further help reduce FOF in this highly vulnerable cohort.

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Preliminary validation of the short physical performance battery in older adults with multiple sclerosis: secondary data analysis.

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Preliminary validation of the short physical performance battery in older adults with multiple sclerosis: secondary data analysis.

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