Short-Physical Performance Battery (SPPB) score is associated with falls in older outpatients
- 64 Downloads
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).
To verify the association of SPPB and POMA scores with falls in older outpatients.
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.
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.
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.
KeywordsComprehensive geriatric assessment Falls Frailty Balance
No funds were received for this study.
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.
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).
Written informed consent was obtained for all participants.
- 16.WHO Global Report on Fall Prevention in Older Age, World Health Organization (2007) https://extranet.who.int/agefriendlyworld/wp-content/uploads/2014/06/WHo-Global-report-on-falls-prevention-in-older-age.pdf. Accessed 10 Sep 2018
- 21.Minneci C, Mello AL, Mossello E et al (2015) Comparative study of four physical performance measures as predictors of death, incident disability, and falls in unselected older persons: the Insufficienza Cardiaca negli Anziani Residenti a Dicomano Study. J Am Geriatr Soc 63:136–141CrossRefPubMedGoogle Scholar
- 38.Yingyongyudha A, Saengsirisuwan V, Panichaporn W et al (2016) The mini-balance evaluation systems test (Mini-BESTest) demonstrates higher accuracy in identifying older adult participants with history of falls than do the BESTest, berg balance scale, or timed up and go test. J Geriatr Phys Ther 39:64–70CrossRefPubMedGoogle Scholar