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Development of an Expanded Measure of Physical Functioning for Older Persons in Epidemiologic Research.

ABSTRACT: We scaled a measure of physical functioning to a population-based normative sample by extending self-reported basic and instrumental activities of daily living with items from the Medical Outcomes Study 12-Item Short Form Survey. We used item response theory to place items administered to a sample of older elective surgery patients on a common metric linked to the Patient Reported Outcomes Measurement Information System (PROMIS) normative sample using published data. The summary measure for physical functioning was internally consistent (Cronbach's ? = .83), reliable across a broad range of functioning, and was moderately correlated with walking speed (r = .52) and energy expenditure (r = .40). Demonstrating predictive criterion validity, less impaired scores were associated with lower risk of discharge to a rehabilitation facility (odds ratio = .38, 95% confidence interval [CI] [0.22, 0.66]) and shorter hospital stays (incidence rate ratio [IRR] = 0.87, 95% CI [0.79, 0.97]). Our approach may facilitate direct comparison of physical functioning measures across existing and future studies using a common, population-based metric, when overlapping items with the National Institutes of Health (NIH) PROMIS item bank are present.

SUBMITTER: Gross AL

PROVIDER: S-EPMC4843810 | biostudies-literature | 2015 Oct

REPOSITORIES: biostudies-literature

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Development of an Expanded Measure of Physical Functioning for Older Persons in Epidemiologic Research.

Gross Alden L AL Jones Richard N RN Inouye Sharon K SK

Research on aging 20140915 7

We scaled a measure of physical functioning to a population-based normative sample by extending self-reported basic and instrumental activities of daily living with items from the Medical Outcomes Study 12-Item Short Form Survey. We used item response theory to place items administered to a sample of older elective surgery patients on a common metric linked to the Patient Reported Outcomes Measurement Information System (PROMIS) normative sample using published data. The summary measure for phys ...[more]

PMID: 25651587

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Project description:BackgroundTo further inform benefits and risks of medications on physical function in aging populations, we have evaluated the associations of antihypertensive (antiHTN) class and number used with skeletal muscle function, mobility, sedentary time, and symptoms in older persons.MethodsUsing baseline data from the Lifestyle Interventions and Independence in Elder (LIFE) study (N = 1567, mean age 78.9 years) and multivariable models, we evaluated cross-sectional associations of antiHTN class and number used with physical measures and symptom questionnaires. AntiHTN class included diuretics, angiotensin converting enzyme inhibitors (ACEi), angiotensin receptor blockers (ARB), calcium channel blockers (CCB), and beta blockers (BB). Physical measures included respiratory muscle weakness (maximal inspiratory pressure), grip weakness (dynamometer), impaired lower extremity proximal muscle strength (chair stands), impaired balance (three-stage test), slow gait (400 m walk), mobility impairment (Short Physical Performance Battery), and high sedentary time (accelerometry). Symptoms included dyspnea and fatigue. Covariates included clinical characteristics and non-antiHTNs.ResultsUse of any antiHTN was highly prevalent (n = 1248 [79.6%]). In the antiHTN subgroup, each antiHTN class was well represented (ranging 36.6%-62.7%) and included use of three or more antiHTNs (32.0%). In adjusted models, the only statistically significant associations were use of BB and three or more antiHTNs with high sedentary time: odds ratios (95% confidence intervals) 1.44 (1.12, 1.85) and 1.52 (1.04, 2.23), respectively.ConclusionUse of BB and three or more antiHTNs yielded 44% and 52% increased odds of accelerometry-defined high sedentary time, respectively. Notably, high sedentary time is a risk factor for adverse health outcomes. Thus, future work should evaluate whether high sedentary time mitigates benefits or increases risks, regarding antiHTN use in aging populations.

Dataset Information

Development of an Expanded Measure of Physical Functioning for Older Persons in Epidemiologic Research.

Publications

Development of an Expanded Measure of Physical Functioning for Older Persons in Epidemiologic Research.

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