A multidimensional assessment of physical performance for older Japanese people with community-based long-term care needs.

Abstract

A multidimensional assessment representing overall lower- and upper-extremity performance is necessary to identify functional decline among older adults. The aim of this study was to develop and validate a physical performance scale (PPS) using both cross-sectional and observational approaches in older adults with and without community-based long-term care (LTC) needs in Japan. A total of 416 community-living adults aged 75 years and over. The 7 items of the PPS include a range of physiological challenges, such as assessment of upper-extremity strength, lower-extremity strength, balance, and walking ability. Concurrent validity [correlating the PPS with self-reported functional status in activities of daily living (ADLs), instrumental ADLs, and Physical Function subscale of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36PF)] and discriminative validity were assessed. Sensitivity to changes was evaluated with a 12-week exercise program. Total PPS score was significantly correlated with self-reported functional status such as ADLs, instrumental ADLs (IADLs), and SF-36PF (r = 0.53-0.62) and demonstrated no floor effect and minimal ceiling effect (8.7 %). The total PPS score showed large areas under the curve (AUC = 0.89; 95 % confidence interval, 0.86-0.92) with regard to discrimination between individuals with and without LTC needs. In observational analysis, total PPS score demonstrated small meaningful change in high-risk individuals requiring care (effect size 0.34). The PPS may be a useful tool for identifying functional status decline and improvement in older adults requiring community-based LTC.