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Performance-based measures of physical function as mortality predictors: Incremental value beyond self-reports.

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Performance assessments offer modest gains in predicting mortality, with peak expiratory flow (PEF) and grip strength showing the most value. Self-reported limitations significantly improve mortality prediction in older adults.

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Area of Science:

  • Gerontology
  • Public Health
  • Biostatistics

Background:

  • Previous research shows performance assessments predict survival.
  • Limited studies evaluate their added value alongside self-reported limitations.

Purpose of the Study:

  • Compare the predictive value of four performance tests for all-cause mortality.
  • Assess the incremental value of walking speed, chair stands, grip strength, and peak expiratory flow (PEF).

Main Methods:

  • Population-based samples of older adults in Costa Rica and Taiwan.
  • Five-year mortality prediction using proportional hazards models.
  • Receiver Operator Characteristic (ROC) curves to evaluate prognostic value.

Main Results:

  • Self-reported physical limitations substantially improve mortality prediction.
  • Performance assessments provide modest incremental gains.
  • PEF and grip strength offer the greatest added value.

Conclusions:

  • PEF and grip strength are simpler, less burdensome, and better mortality predictors than walking speed or chair stands when self-reported limitations are considered.
  • Inability to perform tests strongly predicts mortality but requires careful definition and interpretation.