A Comparison of Objective Physical Performance Tests and Future Mortality in the Elderly People

作者：Veronese Nicola^*; Stubbs Brendon; Fontana Luigi; Trevisan Caterina; Bolzetta Francesco; De Rui Marina; Sartori Leonardo; Musacchio Estella; Zambon Sabina; Maggi Stefania; Perissinotto Egle; Corti Maria Chiara; Crepaldi Gaetano; Manzato Enzo; Sergi Giuseppe

来源：Journals of Gerontology Series A-Biological Sciences and Medical Sciences, 2017, 72(3): 362-368.

DOI：10.1093/gerona/glw139

• Mortality
• Physical activity
• Physical performance

Background: Physical performance is an important predictor of mortality, but little is known on the comparative prognostic utility of different objective physical performance tests in community-dwelling older adults. We compared the prognostic usefulness of several objective physical performance tests on mortality, adjusting our analyses for potential confounders.
Methods: Among 3,099 older community-dwelling participants included in the Progetto Veneto Anziani study, 2,096 were followed for a mean of 4.4 years. Physical performance tests measured were Short Physical Performance Battery (SPPB), 4-meter gait speed, chair stands time, leg extension and flexion, handgrip strength, and 6-Minute Walking Test (6MWT), treated as continuous variables and categorized in genderspecific quartiles. The main outcome was mortality assessed with death certificates.
Results: Participants who died during the follow-up (n = 327) scored significantly worse in all physical performance tests measured at baseline than those who survived (n = 1,769). Using a Harrell's C-index, the highest C-index was observed for 6MWT in men (C-index = 0.735; 95% confidence interval [CI]: 0.701-0.770, p <.0001) and SPPB in women (C-index = 0.781; 95% CI: 0.740-0.822, p =.0009). However, in both genders, only SPPB, 4-meter walking speed, and 6MWT are significant predictors of mortality. Analyses using sex-specific quartiles substantially confirmed these findings.
Conclusions: Slow gait speed, 6MWT, and SPPB are significant predictors for mortality in community-dwelling older men and women. Physicians should consider using these tests to identify elderly individuals who are at higher risk of death to improve clinical decision making.

• 出版日期2017-3