Abstract
BackgroundPhysical function measures have been shown to predict negative health-related events in older persons, including mortality. These markers of functioning may interact with the self-rated health (SRH) in the prediction of events. Aim of the present study is to compare the predictive value for mortality of measures of physical function and SRH status, and test their possible interactions.MethodsData are from 335 older persons aged ≥ 80 years (mean age 85.6 years) enrolled in the "Invecchiamento e Longevità nel Sirente" (ilSIRENTE) study. The predictive values for mortality of 4-meter walk test, Short Physical Performance Battery (SPPB), hand grip strength, Activities of Daily Living (ADL) scale, Instrumental ADL (IADL) scale, and a SRH scale were compared using proportional hazard models. Kaplan-Meier survival curves for mortality and Receiver Operating Characteristic (ROC) curve analyses were also computed to estimate the predictive value of the independent variables of interest for mortality (alone and in combination).ResultsDuring the 24-month follow-up (mean 1.8 years), 71 (21.2%) events occurred in the study sample. All the tested variables were able to significantly predict mortality. No significant interaction was reported between physical function measures and SRH. The SPPB score was the strongest predictor of overall mortality after adjustment for potential confounders (per SD increase; HR 0.64; 95%CI 0.48–0.86). A similar predictive value was showed by the SRH (per SD increase; HR 0.76; 95%CI 0.59–0.97). The chair stand test was the SPPB subtask showing the highest prognostic value.ConclusionAll the tested measures are able to predict mortality with different extents, but strongest results were obtained from the SPPB and the SRH. The chair stand test may be as useful as the complete SPPB in estimating the mortality risk.
Highlights
Physical function measures have been shown to predict negative health-related events in older persons, including mortality
Among the different possible options to evaluate the physical functioning of older persons, the use of designed questionnaires aimed at evaluating how the subject interacts with the surrounding environment and identifying his impairments is one of the more commonly chosen. Best examples of this kind of tests are the Activities of Daily Living (ADL)[10], and Instrumental Activities of Daily Living (IADL)[11] scales, which were designed about 30–40 years ago
Receiver Operating Characteristic (ROC) curve analyses were computed to estimate the predictive value of the independent variables of interest for mortality through the evaluation of the Areas Under the Curves (AUCs)
Summary
Physical function measures have been shown to predict negative health-related events in older persons, including mortality. Over the past two decades, there has been a growing recognition of the functional status assessment as a key factor in the evaluation of older persons[1] This importance is mainly due to the large evidence that physical function measures are associated with clinical and subclinical age-related modifications[2,3], but are able to predict future health-related events, including disability[4,5], institutionalization [6,7,8], and mortality[6,9]. Despite of the demonstrated critical role of physical function in the evaluation of older persons, the screening visit of an older person still mostly relies on self-reported questions (mainly due to time and/or space restrains commonly present especially in the clinical practice)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
