Common Physical Performance Tests for Evaluating Health in Older Adults: Cross-Sectional Study

Interdisciplinary evaluation of older adults' health care is a priority in the prevention of chronic health conditions and maintenance of daily functioning. While many studies evaluate different physical performance tests (PPTs) from a retrospective view in predicting mortality or cardiopulmonary health, it remains unclear which of the commonly used PPTs is the most effective at evaluating the current health of older adults. Additionally, the time and participant burden for each PPT must be considered when planning and implementing them for clinical or research purposes.

This cross-sectional study aimed to determine how elements of overall physical capacity, performance, and other nongait factors in older adults affect the results of 3 commonly used tests: the Short Physical Performance Battery (SPPB), 6-minute walk test (6MWT), and Incremental Shuttle Walk Test (ISWT).

A total of 53 community-dwelling older adults met the inclusion and exclusion criteria (mean age 77.47, SD 7.25 years; n=41, 77% female; and n=21, 40% Hispanic). This study evaluated older adults using 3 different PPTs including the SPPB, 6MWT, and ISWT, as well as constructed multiple linear regression models with measures of physical activity, static balance, and fear of falling (FoF). The nongait measures included 7 days of physical activity monitoring using the ActiGraph GT9X Link instrument, objective measurement of static balance using the BTrackS Balance System, and FoF using the short Fall Efficacy Scale-International.

The models revealed that the complete SPPB provided the most comprehensive value, as indicated by a greater R² value (0.523), and that performance on the SPPB was predicted by both moderate to vigorous physical activity (P=.01) and FoF (P<.001). The ISWT was predicted by moderate to vigorous physical activity (P=.02), BMI (P=.02), and FoF (P=.006) and had a similar R² value (0.517), whereas the gait component of the SPPB (P=.001) and 6MWT (P<.001) was predicted by only FoF and had lower R² values (0.375 and 0.228, respectively).

The results indicated the value of a multicomponent, comprehensive test, such as the SPPB, in evaluating the health of older adults. Additionally, a comparison of the 2 field walking tests (ISWT and 6MWT) further distinguished the ISWT as more responsive to overall health in older adults. In comparing these commonly used PPTs, clinicians and researchers in the field can determine and select the most optimal test to evaluate older adults in communities and research settings.