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Predicting Persistent Reduced Physical Performance in Adults 65+ in Emergency Departments: A Temporal Validation
Inge H Bruun1,2, Thomas Maribo3,4, Christian B Mogensen1,5
1Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
Journal of Geriatric Physical Therapy (2001)
|December 23, 2024
Summary
A new 5-item model effectively identifies older adults with persistent reduced physical performance after hospitalization. This model is more accurate than subjective assessments and aids targeted interventions for better recovery.
Area of Science:
- Gerontology
- Rehabilitation Medicine
- Clinical Prediction Models
Background:
- Maintaining physical performance in older adults is crucial for independence.
- Early identification of declining physical function in older adults is essential for timely intervention.
- Existing prediction models may not generalize across diverse older adult populations.
Purpose of the Study:
- To validate an existing 4-item prediction model for persistent reduced physical performance in older adults.
- To develop and validate a new, accurate prediction model for identifying older adults at risk of persistent physical decline post-hospitalization.
Main Methods:
- A temporal validation study involving adults aged 65+ admitted to the emergency department.
- Participants underwent the 30-second chair-stand test (30s-CST) within 48 hours of admission and 3-4 weeks post-discharge.
- Logistic regression analysis was used to develop a new prediction model, with the area under the curve (AUC) determining model performance.
Main Results:
- The existing 4-item model showed inconsistent applicability across different older adult populations.
- A new 5-item model was developed using combined samples (n=382), incorporating age >80, female sex, self-reported stair climbing difficulty, poor self-rated health, and a 30s-CST score ≤5.
- The new model achieved an AUC of 84%, demonstrating strong predictive accuracy for persistent reduced physical performance.
Conclusions:
- The previously developed 4-item prediction model requires re-evaluation for broader applicability.
- A novel, easily implementable 5-item prediction model accurately identifies acutely hospitalized older adults with persistent reduced physical performance.
- This 5-item model offers a valuable tool for healthcare professionals to guide targeted interventions, potentially improving outcomes for older adults post-hospitalization. Further validation is recommended.
