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Short-Physical Performance Battery (SPPB) score is associated with falls in older outpatients

  • Fulvio Lauretani
  • Andrea Ticinesi
  • Luciano Gionti
  • Beatrice Prati
  • Antonio Nouvenne
  • Claudio Tana
  • Tiziana Meschi
  • Marcello Maggio
Original Article
  • 64 Downloads

Abstract

Background

The capacity of Short-Physical Performance Battery (SPPB) test to discriminate between fallers and non-fallers is controversial, and has never been compared with fall risk assessment-specific tools, such as Performance-Oriented Mobility Assessment (POMA).

Aim

To verify the association of SPPB and POMA scores with falls in older outpatients.

Methods

451 older subjects (150 males, mean age 82.1 ± 6.8) evaluated in a geriatric outpatient clinic for suspected frailty were enrolled in this cross-sectional study. Self-reported history of falls and medication history were carefully assessed. Each participant underwent comprehensive geriatric assessment, including SPPB, POMA, Geriatric Depression Scale (GDS), mini-mental state examination (MMSE) and mini-nutritional assessment-short form (MNA-SF). Multivariate logistic regression and receiver-operating characteristic (ROC) analyses were performed to determine the factors associated with the status of faller.

Results

245 (54.3%) subjects were identified as fallers. They were older and had lower SPPB and POMA test scores than non-fallers. At ROC analysis, SPPB (AUC 0.676, 95% CI 0.627–0.728, p < 0.001) and POMA (AUC 0.677, 95% CI 0.627–0.726, p < 0.001) scores were both associated with falls. At multivariate logistic regression models, SPPB total score (OR 0.83, 95% CI 0.76–0.92, p < 0.001), POMA total score (OR 0.94, 95% CI 0.91–0.98, p = 0.002) and SPPB balance score alteration (OR 2.88, 95% CI 1.42–5.85, p = 0.004), but not POMA balance subscale score alteration, were independently associated with recorded falls, as also GDS, MMSE and MNA-SF scores.

Conclusions

SPPB total score was independently associated with reported falls in older outpatients, resulting non-inferior to POMA scale. The use of SPPB for fall risk assessment should be implemented.

Keywords

Comprehensive geriatric assessment Falls Frailty Balance 

Notes

Acknowledgements

No funds were received for this study.

Author contributions

FL and MM conceived and designed the study; FL, LG, AN and BP performed the investigation and collected data; FL and AT analyzed the data; AT wrote the paper; CT, TM and MM revised the manuscript for substantial content; TM and MM provided supervision.

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.

Ethical approval

The protocol of the TRIP (Traumatic Risk Identikit Parma) Study, which the analyses reported in this paper are part of, has been approved by the Ethics Committee of Parma province (ID 17262).

Informed consent

Written informed consent was obtained for all participants.

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Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  1. 1.Department of Medicine and SurgeryUniversity of ParmaParmaItaly
  2. 2.Geriatric-Rehabilitation DepartmentAzienda Ospedaliero-Universitaria di ParmaParmaItaly

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