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Predictive value of different physical performance assessment methods for falls in older adults: a 3-year
Fei Lu1, Xiaohong Liu2, Jiaojiao Li1
1Department of Geriatrics, Peking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, No. 1 Shuai Fu Yuan, Dong Cheng District, Beijing, 100730, China.
Purpose:
This study aimed to analyze the predictive value of different physical performances including short physical performance battery (SPPB), time-up and go test (TUGT), gait speed (GS), five times sit-to-stand test (FTSST) and handgrip strength (HGS) on the incidence of falls among community-dwelling older adults and to propose the cut-off values for predicting the incidence of falls.
Methods:
This 3-year longitudinal observational study continuously recruited community-dwelling older adults in 2018, assessing baseline physical performances and recording fall incidence (at least one fall) after 3 years.
Results:
Of the 215 older adults (mean age, 84.0 ± 4.4 years; 123 [57.2%] females) included in this study, 98 (45.6%) fell. After adjusting for age, sex, and comorbidity, decreased SPPB score (odds ratio [OR] = 0.84, 95% confidence interval [CI], 0.75-0.94), increased TUGT time (OR = 1.07, 95% CI, 1.03-1.12), and lower GS (OR = 0.11, 95% CI, 0.03-0.37) were significantly associated with higher risk of fall and had similar predictive values, while the FTSST and HGS were not. To predict the incidence of falls, the areas under the curve for SPPB, TUGT, and GS were 0.71 (95% CI: 0.65-0.77), 0.73 (95% CI: 0.67-0.79), and 0.71 (95% CI: 0.64-0.77), whereas the cut-offs were 7 points, 14.8 s, and 0.75 m/s, according to the Youden index, respectively.
Conclusion:
As physical performance indicators, SPPB, TUGT, and GS may be more effective in assessing fall risk, and the threshold values proposed in this study can be used as a reference for stratified fall risk management among community-dwelling older residents.
