Abstract
The early identification of seniors at high risk of geriatric syndromes is fundamental for targeting interventions to those who most need them. To date, the predictive value of the Short Physical Performance Battery (SPPB) for multifactorial clinical conditions has not been clearly established. Thus, the aim of the present study was to determine whether the SPPB could identify frailty and predict geriatric syndromes in community-dwelling older adults. Participants comprised men and women aged 60 years and older who participated in the Health and Well-being and Aging Survey in Colombia 2015 (n=4125, 57.6% women). A structured interview was administered to obtain socio-demographic data which included age, sex, ethnicity, socioeconomic status, and urbanicity. The study included the measurement of body mass, grip strength, SPPB, Lawton’s instrumental ADL scale, specific subjective memory complaints (SSMC), frailty phenotype (Fried and FRAIL Scale), and self-reported falls, geriatric syndromes and/or medical conditions. ROC analysis was used to examine the ability of the SPPB test to predict frailty and geriatric syndromes. The cutoff that maximized both sensitivity and specificity for the frailty phenotype was 8 points or below for men and 7 points or below for women. These cutoff values significantly predicted four geriatric syndromes in descending order: mild dementia (♀ ORajus 3.34, and ♂ ORajus 2.79), low grip strength (♀ ORajus 1.98, and ♂ ORajus 2.45), falls (♀ ORajus 1.39, and ♂ ORajus 1.49), and SSMC (♀ ORajus 1.39). In summary, the main finding of the present study was that SPPB score (i.e., ≤ 8 ♀ and ≤ 7 ♀) seems to be a useful measure for identifying the physical frailty phenotype and predicting geriatric syndromes in community-dwelling older adults.
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References
Sleeper RB. Geriatric primer — common geriatric syndromes and special problems. Consult Pharm 2009;24:447–462.
Inouye SK, Studenski S, Tinetti ME, Kuchel GA. Geriatric syndromes: clinical, research, and policy implications of a core geriatric concept. J Am Geriatr Soc 2007;55:780–791.
Strandberg TE, Pitkala KH, Tilvis RS, O’Neill D, Erkinjuntti TJ. Geriatric syndromes-vascular disorders? Ann Med 2013;45:265–273.
Morley JE, Vellas B, van Kan GA et al. Frailty consensus: a call to action. J Am Med Dir Assoc 2013;14:392–397.
Sanchez-Garcia S, Sanchez-Arenas R, Garcia-Pena C et al. Frailty among community-dwelling elderly Mexican people: prevalence and association with sociodemographic characteristics, health state and the use of health services. Geriatr Gerontol Int 2014;14:395–402.
Siriwardhana DD, Hardoon S, Rait G, Weerasinghe MC, Walters KR. Prevalence of frailty and prefrailty among community-dwelling older adults in low-income and middle-income countries: a systematic review and meta-analysis. BMJ Open 2018;8:e018195.
Fried LP, Tangen CM, Walston J et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001;56:M146–M156.
Morley JE, Malmstrom TK, Miller DK. A simple frailty questionnaire (FRAIL) predicts outcomes in middle aged African Americans. J Nutr Health Aging 2012;16:601–608.
Belloni G, Cesari M. Frailty and Intrinsic Capacity: Two Distinct but Related Constructs. Front Med (Lausanne) 2019;6:133.
Vermeiren S, Vella-Azzopardi R, Beckwee D et al. Frailty and the Prediction of Negative Health Outcomes: A Meta-Analysis. J Am Med Dir Assoc 2016; 17:1163.
Newman AB, Gottdiener J S, Mcburnie MA et al. Associations of subclinical cardiovascular disease with frailty. J Gerontol A Biol Sci Med Sci 2001;56:M158–M166.
Rockwood K, Hogan DB, MacKnight C. Conceptualisation and measurement of frailty in elderly people. Drugs Aging 2000; 17:295–302.
Aprahamian I, Cezar NOC, Izbicki R et al. Screening for Frailty With the FRAIL Scale: A Comparison With the Phenotype Criteria. J Am Med Dir Assoc 2017; 18:592–596.
Cesari M, Prince M, Thiyagarajan JA, De Carvalho IA, Bernabei R, Chan P, Gutiérrez-Robledo LM, Michel JP, Morley JE, Ong P, Rodriguez Manas L, Sinclair A, Won CW, Beard J, Vellas B. Frailty: An Emerging Public Health Priority. J Am Med Dir Assoc. 2016; 17(3): 188–92.
St John PD, Tyas SL, Menee V, Tate R. Multimorbidity, disability, and mortality in community-dwelling older adults. Can Fam Physician 2014;60:e272–e280.
Guralnik JM, Simonsick EM, Ferrucci L et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol 1994;49:M85–M94.
Thaweewannakij T, Wilaichit S, Chuchot R et al. Reference values of physical performance in Thai elderly people who are functioning well and dwelling in the community. Phys Ther 2013;93:1312–1320.
Pavasini R, Guralnik J, Brown JC et al. Short Physical Performance Battery and all-cause mortality: systematic review and meta-analysis. BMC Med 2016; 14:215.
Freiberger E, de Vreede P, Schoene D, Rydwik E, Mueller V, Frändin K, et al. Performance-based physical function in older community-dwelling persons: a systematic review of instruments. Age Ageing. 2012;41(6):712–21.
Guralnik JM, Ferrucci L, Simonsick EM, Salive ME, Wallace RB. Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. N Engl J Med 1995;332:556–561.
Veronese N, Bolzetta F, Toffanello ED et al. Association between Short Physical Performance Battery and falls in older people: the Progetto Véneto Anziani Study. Rejuvenation Res 2014; 17:276–284.
Guralnik JM, Ferrucci L, Pieper CF et al. Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A Biol Sci Med Sci 2000;55:M221–M231.
Fisher S, Ottenbacher KJ, Goodwin JS, Graham JE, Ostir GV. Short Physical Performance Battery in hospitalized older adults. Aging Clin Exp Res 2009;21:445–452.
Studenski S, Perera S, Wallace D et al. Physical performance measures in the clinical setting. J Am Geriatr Soc 2003;51:314–322.
Sverdrup K, Bergh S, Selbaek G, Roen I, Kirkevold O, Tangen GG. Mobility and cognition at admission to the nursing home — a cross-sectional study. BMC Geriatr 2018; 18:30.
Landi F, Calvani R, Tosato M et al. Impact of physical function impairment and multimorbidity on mortality among community-living older persons with sarcopaenia: results from the ilSIRENTE prospective cohort study. BMJ Open 2016;6:e008281.
Lim YJ, Ng YS, Sultana R, Tay EL, Mah SM, Chan CHN, Latib AB, Abu-Bakar UM, Ho JCY, Kwek THH, Tay L. Frailty Assessment in Community-Dwelling Older Adults: A Comparison of 3 Diagnostic Instruments. J Nutr Health Aging. 2020;24(6):582–590.
Vasunilashorn S, Coppin AK, Patel KV, Lauretani F, Ferrucci L, Bandinelli S, Guralnik JM. Use of the Short Physical Performance Battery Score to predict loss of ability to walk 400 meters: analysis from the InCHIANTI study. J Gerontol A Biol Sci Med Sci. 2009;64(2):223–9.
Ramirez-Velez R, Perez-Sousa MA, Venegas-Sanabria LC et al. Gait speed moderates the adverse effect of obesity on dependency in older Colombian adult. Exp Gerontol 2019;127:110732.
Ramírez-Vélez R, Pérez-Sousa MA, Venegas-Sanabria LC, Cano-Gutierrez CA, Hernández-Quiñonez PA, Rincón-Pabón D, García-Hermoso A, Zambom-Ferraresi F, Sáez de Asteasu ML, Izquierdo M. Normative Values for the Short Physical Performance Battery (SPPB) and Their Association With Anthropometric Variables in Older Colombian Adults. The SABE Study, 2015. Front Med (Lausanne). 2020;7:52.
Barberg er-Gateau P, Commenges D, Gagnon M, Letenneur L, Sauvel C, Dartigues JF. Instrumental activities of daily living as a screening tool for cognitive impairment and dementia in elderly community dwellers. J Am Geriatr Soc 1992;40:1129–1134.
Barberger-Gateau P, Fabrigoule C, Rouch I, Letenneur L, Dartigues JF. Neuropsychological correlates of self-reported performance in instrumental activities of daily living and prediction of dementia. J Gerontol B Psychol Sci Soc Sci 1999;54:293–303.
Amariglio RE, Townsend MK, Grodstein F, Sperling RA, Rentz DM. Specific subjective memory complaints in older persons may indicate poor cognitive function. J Am Geriatr Soc 2011;59:1612–1617.
Friedman SM, Muñoz B, West SK, Rubin GS, Fried LP. Falls and fear of falling: which comes first? A longitudinal prediction model suggests strategies for primary and secondary prevention. J Am Geriatr Soc 2002;50:1329–1335.
Oh-Park M, Xue X, Holtzer R, Verghese J. Transient versus persistent fear of falling in community-dwelling older adults: incidence and risk factors. J Am Geriatr Soc 2011;59:1225–1231.
Reuben DB, Laliberte L, Ffiris J, Mor V. A hierarchical exercise scale to measure function at the Advanced Activities of Daily Living (AADL) level. J Am Geriatr Soc 1990;38:855–861.
Alexandre TS, Duarte YA, Santos JL, Wong R, Lebrao ML. Sarcopenia according to the European Working Group on Sarcopenia in Older People (EWGSOP) versus dynapenia as a risk factor for mortality in the elderly. J Nutr Health Aging 2014;18:751–756.
Gomez JF, Curcio CL, Alvarado B, Zunzunegui MV, Guralnik J. Validity and reliability of the Short Physical Performance Battery (SPPB): a pilot study on mobility in the Colombian Andes. Colomb Med (Cali) 2013;44:165–171.
Dent E, Kowal P, Ffoogendijk EO. Frailty measurement in research and clinical practice: A review. Eur J Intern Med 2016;31:3–10.
Cuevas-Lara C, Izquierdo M, Sáez de Asteasu ML, et al. Impact of Game-Based Interventions on Health-Related Outcomes in Hospitalized Older Patients: A Systematic Review. J AMD A. Available online 29 August 2020. Doi: https://doi.org/10.1016/j.jamda.2020.07.027
García-Hermoso A, Ramirez-Vélez R, Sáez de Asteasu ML, et al. Safety and Effectiveness of Long-Term Exercise Interventions in Older Adults: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Sports Med. 2020;50(6): 1095–1106.
Cesari M, Landi F, Calvani R et al. Rationale for a preliminary operational definition of physical frailty and sarcopenia in the SPRINTT trial. Aging Clin Exp Res 2017;29:81–88.
Turner G, Clegg A. Best practice guidelines for the management of frailty: a British Geriatrics Society, Age UK and Royal College of General Practitioners report. Age Ageing 2014;43:744–747.
da Cámara SM, Alvarado BE, Guralnik JM, Guerra RO, Maciel AC. Using the Short Physical Performance Battery to screen for frailty in young-old adults with distinct socioeconomic conditions. Geriatr Gerontol Int. 2013;13(2):421–8.
Verghese J, Xue X. Identifying frailty in high functioning older adults with normal mobility. Age Ageing 2010; 39: 382–385.
Cesari M, Calvani R, Marzetti E. Frailty in Older Persons. Clin Geriatr Med. 2017;33(3): 293–303.
Cesari M, Nobili A, Vitale G. Frailty and sarcopenia: From theory to clinical implementation and public health relevance. Eur J Intern Med. 2016;35:1–9.
Izquierdo M. Prescripción de ejercicio físico. El programa Vivifrail como modelo [Multicomponent physical exercise program: Vivifrail]. NutrHosp. 2019;36:50–56.
Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12:189–198.
Nasreddine ZS, Phillips NA, Bedirian V et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 2005;53:695–699.
Sousa-Santos AR, Afonso C, Borges N, Santos A, Padräo P, Moreira P, F Amaral T. Sarcopenia, physical frailty, undernutrition and obesity cooccurrence among Portuguese community-dwelling older adults: results from Nutrition UP 65 cross-sectional study. BMJ Open. 2020;10(6):e033661.
Acknowledgments
The SABE study is supported by a fund (2013, no. 764) from the Colciencias y Ministerio de Salud y la Protección Social de Colombia.
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Funding: This project was not directly supported by any funding. Robinson Ramírez-Vélez training grant (ID420) as a post-doctoral research fellow with the Universidad Pública de Navarra (UPNA). Mikel Izquierdo was supported by a research grant PI17/01814 of the Ministerio de Economía, Industria y Competitividad (ISCHL FEDER).
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Ethical standards: All participants were provided with written information regarding the study and informed written consent was obtained. The survey was reviewed and approved by the institutional review boards at the University of Caldas (ID protocol CBCS-021-14) and the University of Valle (ID protocol 09-014 and 011-015) (both from Colombia). The study protocol for the secondary analysis was approved by the Human Subjects Committee at Pontificia Universidad Javeriana, Colombia (ID protocol 20/2017-2017/180, FM-CIE-0459-17) in accordance with the Declaration of Helsinki of the World Medical Association, and with Resolution 8430 (1993) of the Ministry of Health of Colombia regarding technical, scientific and administrative standards for conducting research with humans.
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Ramírez-Vélez, R., López Sáez De Asteasu, M., Morley, J.E. et al. Performance of the Short Physical Performance Battery in Identifying the Frailty Phenotype and Predicting Geriatric Syndromes in Community-Dwelling Elderly. J Nutr Health Aging 25, 209–217 (2021). https://doi.org/10.1007/s12603-020-1484-3
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DOI: https://doi.org/10.1007/s12603-020-1484-3