Muscle strength and physical performance as predictors of mortality, hospitalization, and disability in the oldest old. The relationship between physical performance and cardiac function in an elderly Russian cohort. Lower limb function and 10-year survival in population aged 75 years and older. Physical Performance Measures as Predictors of Mortality in a Cohort of Community-dwelling Older French Women Pre‐Kidney Transplant Lower Extremity Impairment and Post‐Kidney Transplant Mortality The relationship of physical performance with HIV disease and mortality Predictive value of the Short Physical Performance Battery following hospitalization in older patients. The influence of lower-extremity function in elderly individuals' quality of life (QOL): an analysis of the correlation between SPPB and EQ-5D. Improving Physical Activity and Function in Overweight and Obese Older Adults with Osteoarthritis of the Knee: A Feasibility Study Should physical activity programs be tailored when older adults have compromised function? Personal mastery and lower body mobility in community-dwelling older persons: the Invecchiare in Chianti study. Disentangling the Impact of Chronic Kidney Disease, Anemia, and Mobility Limitation on Mortality in Older Patients Discharged From Hospital. Effect of Physical Activity versus Health Education on Physical Function, Grip Strength and Mobility Validity and Reliability of the Short Physical Performance Battery in Two Diverse Older Adult Populations in Quebec and Brazil
OBJECTIVES To evaluate the predictive value of muscle strength and physical performance in the oldest old for all-cause mortality ; hospitalization ; and the onset of disability , defined as a decline in activities of daily living ( ADLs ) , independent of muscle mass , inflammatory markers , and comorbidities . DESIGN A prospect i ve , observational , population -based follow-up study . SETTING Three well-circumscribed areas of Belgium . PARTICIPANTS Five hundred sixty participants aged 80 and older were followed for 33.5 months ( interquartile range 31.1 - 35.6 months ) . MEASUREMENTS  Grip strength , Short Physical Performance Battery ( SPPB ) score , and muscle mass  were measured at baseline ; ADLs at baseline and after 20 months ; and all-cause mortality and time to first hospitalization from inclusion onward . Kaplan-Meier curves and Cox proportional hazards models were calculated for all-cause mortality and hospitalization . Logistic regression analysis was used to determine predictors of decline in ADLs . RESULTS Kaplan-Meier curves showed significantly higher all-cause mortality and hospitalization in subjects in the lowest tertile of grip strength and SPPB score . The adjusted Cox proportional hazards model showed that participants with high grip strength or a high SPPB score had a lower risk of mortality and hospitalization , independent of muscle mass , inflammatory markers , and comorbidity . A relationship was found between SPPB score and decline in ADLs , independent of muscle mass , inflammation , and comorbidity . CONCLUSION In people aged 80 and older , physical performance is a strong predictor of mortality , hospitalization , and disability , and muscle strength is a strong predictor of mortality and hospitalization . All of these relationships were independent of muscle mass , inflammatory markers , and comorbidity This study aims to determine the cardiac dysfunction prevalence , to investigate the relationship between the Short Physical Performance Battery ( SPPB ) test and structural and functional echocardiographic parameters and to determine whether SPPB scores and cardiac dysfunction are independent mortality predictors in an elderly Russian population . A r and om sample of 284 community-dwelling adults aged 65 and older were selected from a population -based register and divided into two age groups ( 65 - 74 and ≥75 ) .  The SPPB test , echocardiography and all-cause mortality were measured . The prevalence of cardiac dysfunction was 12 % in the 65 - 74 group and 23 % in the ≥75 group . The multivariate models could explain 15 % and 23 % of the SPPB score total variance for the 65 - 74 and ≥75 age groups , respectively . In the younger age group , the mean follow-up time was 2.6±0.46 years , and the adjusted hazard ratio ( HR ) for risk of mortality from cardiac dysfunction was 4.9 . In the older age group , the mean follow-up time was 2.4±0.61 years , and both cardiac dysfunction and poor physical performance were found to be independent predictors of mortality ( adjusted HR=3.4 and adjusted HR=4.2 , respectively ) . The cardiac dysfunction prevalence in this elderly Russian population was found to be comparable to , or even lower than , reported prevalences for Western countries . Furthermore , the observed correlations between echocardiographic abnormalities and SPPB scores were limited . Cardiac dysfunction was shown to be a strong mortality predictor in both age groups , and poor physical performance was identified as an independent mortality predictor in the oldest subjects BACKGROUND Scientific societies recommend assessing lower limb function in usual clinical practice . The Short Physical Performance Battery ( SPPB ) is one of the most vali date d tools to assess this , but its capacity to predict long-term mortality in very old population attending primary care has not been studied . OBJECTIVE To assess the ability of the SPPB to predict 10-year survival in individuals aged 75 and over . METHODS Prospect i ve cohort study with a 10-year follow-up . A representative sample of people aged 75 years or older without severe dependence ( Barthel Index > 20 ) treated at a Spanish primary care centre ( n = 315 ) . Baseline evaluation included  geriatric assessment  with most well-known death predictors . The three SPPB subtasks ( st and ing balance , walking speed and chair st and tests ) were administered . Kaplan-Meier curves and Cox proportional hazard models were calculated for all-cause mortality . RESULTS Mean age was 81.9 years ( 60.6 % female ) . Ten-year survival of elders with SPPB score < 7 and ≥7 was 0.23 and 0.37 ( P < 0.001 ) , respectively . This difference remained statistically significant in the Cox model adjusted by age , gender , number of drugs prescribed , cognitive status , body mass index and visual sharpness ( adjusted hazard ratio = 1.37 ; 95 % confidence interval : 1.01 - 1.86 ) . Also , walking speed and chair st and subtasks were both individual-independent predictors of 10-year survival . CONCLUSIONS Our findings indicate that SPPB is an independent predictor of long-term survival . The chair st and subtask could be a predictor as useful as the full performance battery , becoming a good alternative for primary care where the burden of performing all three subtasks could be excessive This prospect i ve cohort study evaluate the predictive value of physical performance measures for mortality in older French women , in particular those with a high health status . The subjects were 7,250 community-dwelling non-disabled French women aged 75 years or older , enrolled in the Epidémiologie de l’ostéoporose ( EPIDOS ) study .  The short physical performance battery ( SPPB ) , including walking speed , repeated chair st and s , and balance tests , was administered and h and grip strength was measured . Anthropometric measurements , physical function , cognitive performance , sensory status , smoking , medical history , medication use , subjective self- assessment of health status , and physical activity level were assessed at the baseline visit . During a mean follow-up of 3.8 years , 754 ( 10.4 % ) participants died . Complementary analysis was performed on the 2,157 non-disabled healthiest participants ( no disease at baseline ) . The SPPB and h and grip strength distinguished a gradient of risk for mortality from a low to high functional spectrum . Risk of death was 2.04-fold higher in poor ( SPPB 0–6 ) than in good ( SPPB 10–12 ) performers and 1.56-fold higher in participants with lower tertile grip strength . Walking speed alone also distinguished a gradient of mortality risk . After adjustment for confounders , low SPPB , grip strength score and slow walking speed remained significantly associated with death . In the non-disabled healthiest women , no physical performance measure predicted death . In community-dwelling elderly French women , physical performance measures significantly and independently predicted mortality . Increased risk of death was partly explained by baseline health status and was absent in the healthiest elderly Prediction models for post‐kidney transplantation mortality have had limited success ( C‐statistics ≤0.70 ) . Adding objective measures of potentially modifiable factors may improve prediction and , consequently , kidney transplant ( KT ) survival through intervention . The Short Physical Performance Battery ( SPPB ) is an easily administered objective test of lower extremity function consisting of three parts ( balance , walking speed , chair st and s ) , each with scores of 0–4 , for a composite score of 0–12 , with higher scores indicating better function .  SPPB performance and frailty ( Fried frailty phenotype ) were assessed at admission for KT in a prospect i ve cohort of 719 KT recipients at Johns Hopkins Hospital ( 8/2009 to 6/2016 ) and University of Michigan ( 2/2013 to 12/2016 ) . The independent associations between SPPB impairment ( SPPB composite score ≤10 ) and composite score with post‐KT mortality were tested using adjusted competing risks models treating graft failure as a competing risk . The 5‐year posttransplantation mortality for impaired recipients was 20.6 % compared to 4.5 % for unimpaired recipients ( p < 0.001 ) . Impaired recipients had a 2.30‐fold ( adjusted hazard ratio [ aHR ] 2.30 , 95 % confidence interval [ CI ] 1.12–4.74 , p = 0.02 ) increased risk of postkidney transplantation mortality compared to unimpaired recipients . Each one‐point decrease in SPPB score was independently associated with a 1.19‐fold ( 95 % CI 1.09–1.30 , p < 0.001 ) higher risk of post‐KT mortality . SPPB‐derived lower extremity function is a potentially highly useful and modifiable objective measure for pre‐KT risk prediction Objective : To evaluate whether HIV infection was associated with reduced physical performance , and to examine if reduced physical performance predicted mortality in our aging cohort of HIV-infected and HIV-uninfected persons . Design : Prospect i ve , observational cohort of current and former injection drug users in the AIDS Linked to the IntraVenous Experience study in Baltimore , Maryl and , USA . Methods : The  Short Physical Performance Battery ( SPPB )  was used as an objective measure of physical performance and measured semiannually along with behavioral and demographic data . Correlates of reduced physical performance ( SPPB score ⩽10 ) were identified and the relationship between reduced physical performance , HIV infection and mortality was analyzed by Cox regression . Results : Among 12 270 person-visits contributed by 1627 participants , the median age was 51 , 30.3 % were HIV-infected and 32.6 % had an SPPB score 10 or less . In multivariable models , HIV infection was independently associated with 30 % increased odds of reduced physical performance [ odds ratio 1.30 ; 95 % confidence interval (CI):1.12–1.52 ] . Reduced physical performance predicted mortality in a dose-response manner and within all HIV disease strata . Whereas reduced physical performance alone ( hazard ratio 2.52 , 95 % CI : 1.59–4.00 ) and HIV infection alone ( hazard ratio 2.78 , 95 % CI : 1.70–4.54 ) increased mortality , HIV-infected participants with reduced physical performance had a six-fold increased mortality risk ( hazard ratio 6.03 , 95 % CI : 3.80–10.0 ) compared with HIV-uninfected participants with higher physical performance . Conclusion : HIV infection was independently associated with reduced physical performance . HIV and reduced physical performance have independent and joint effects on mortality . Physical performance measurement may be an important research and clinical tool to predict adverse outcomes among aging HIV-infected persons BACKGROUND Hospitalization represents a stressful and potentially hazardous event for older persons . We evaluated the value of the Short Physical Performance Battery ( SPPB ) in predicting rates of functional decline , rehospitalization , and death in older acutely ill patients in the year after discharge from the hospital . METHODS Prospect i ve cohort study of 87 patients aged 65 years and older who were able to walk and with a Mini-Mental State Examination score ≥ 18 and admitted to the hospital with a clinical diagnosis of congestive heart failure , pneumonia , chronic obstructive pulmonary disease , or minor stroke . Patients were evaluated with the SPPB at hospital admission , were reevaluated the day of hospital discharge , and 1 month later . Subsequently , they were followed every 3 months by telephone interviews to ascertain functional decline , new hospitalizations , and vital status . RESULTS After adjustment for potential confounders , including self-report activity of daily living and comorbidity , the SPPB score at discharge was inversely correlated with the rate of decline in activity of daily living performance over the follow-up ( p < .05 ) . In a multivariable discrete-time survival analysis , patients with poor SPPB scores at hospital discharge ( 0 - 4 ) had a greater risk of rehospitalization or death ( odds ratio : 5.38 , 95 % confidence interval : 1.82 - 15.9 ) compared with those with better SPPB scores ( 8 - 12 ) . Patients with early decline in SPPB score after discharge also had steeper increase in activity of daily living difficulty and higher risk of rehospitalization or death over the next year . CONCLUSIONS In older acutely ill patients who have been hospitalized , the SPPB provides important prognostic information . Lower extremity performance-based functional assessment might identify older patients at high risk of poor outcomes after hospital discharge BACKGROUND If an association between a decline in physical performance and subjective QOL is confirmed , the SPPB could be used as a predictor for declining  QOL in older people . OBJECTIVE This study aim ed to eluci date the association between the short physical performance battery ( SPPB ) and QOL ( EQ-5D ) to determine the utility of the SPPB as a predictor of declining QOL . METHODS The SPPB and the EQ-5D test were performed with a r and om sample of participants nested in the Korean Longitudinal Study of Aging ( KLoSA ) panel . Comparisons of the adjusted mean scores on the EQ-5D index between normal and abnormal SPPB groups were performed . We selected the quartiles of the EQ-5D index variables for the analysis . The association between the EQ-5D index and SPPB abnormality was examined using multinomial logistic regression analysis . Additionally , the associations between gait speed and chair st and time and the EQ-5D index were examined using the same analysis . RESULTS Four hundred and twenty-two subjects were included in the analysis . The adjusted means for the EQ-5D index were significantly lower when the SPPB score was abnormal ( p=0.022 for men , p=0.047 for women ) . An abnormal SPPB score was significantly associated with the lowest quartile of EQ-5D index score ( adjusted OR 3.54 in the lowest quartile for men ; adjusted OR 2.50 and 3.37 in the lowest and second quartiles for women ) . Gait speed was significantly associated with the EQ-5D index for participants of both sexes , but st and up time was associated with the EQ-5D index only for men . CONCLUSIONS An abnormal SPPB score was associated with lower QOL . Thus , the SPPB has the potential to be used as an early predictor of declining QOL in clinical setting s and epidemiological studies & NA ; Osteoarthritis of the knee , a prevalent condition in older adults , can impact physical function and ability to perform physical activity . This r and omized controlled trial examined the effects of a 6‐month self‐efficacy‐based , individually delivered , lower‐extremity exercise and fitness walking intervention with 6‐month follow‐up on physical activity and function . The 26 subjects were mostly older ( M = 63.2 years , SD = 9.8 ) , White ( 83 % ) , obese ( BMI M = 33.3 , SD = 6.0 ) women ( 96 % ) . Physical activity was measured by diaries . Physical function was measured by the 6‐minute walk , Short Physical Performance Battery ( SPPB ) , and WOMAC Physical Function subscale . Exercise self‐efficacy was assessed by a question naire . Results showed significant increases in self‐reported performance of lower‐extremity exercise and participation in fitness walking , distance in the 6‐minute walk , and SPPB scores from baseline to 6‐month follow‐up with a trend for improvement in self‐efficacy . Results suggest that the intervention was feasible , acceptable , and improved physical activity and function The purpose of this study was to determine whether a walking program supplemented by tasks design ed to challenge balance and mobility ( WALK+ ) could improve physical function more than a traditional walking program ( WALK ) in older adults at risk for mobility disability . 31 community-dwelling older adults ( M + /- SD age = 76 + /- 5 yr ; Short Physical Performance Battery [ SPPB ] score = 8.4 + /- 1.7 ) were r and omized to treatment . Both interventions were 18 sessions ( 1 hr , 3x/wk ) and progressive in intensity and duration . Physical function was assessed using the SPPB and the 400-m-walk time . A subset of participants in the WALK group who had relatively lower baseline function showed only small improvement in their SPPB scores after the intervention ( 0.3 + /- 0.5 ) , whereas a subset of participants in the WALK+ group with low baseline function showed substantial improvement in their SPPB scores ( 2.2 + /- 0.7 ) . These preliminary data underscore the potential importance of tailoring interventions for older adults based on baseline levels of physical function OBJECTIVES To test the hypothesis that , in older persons , sense of personal mastery , defined as the extent to which one regards one 's life chance as being under one 's own control , predicts change in lower extremity performance during a 6-year follow-up . DESIGN Prospect i ve cohort study . SETTING Community based . PARTICIPANTS Six hundred twenty-six participants aged 65 and older . MEASUREMENTS  Personal mastery  was assessed at baseline using  Pearlin 's mastery scale . Lower extremity performance was measured at baseline and at 6-year follow-up using the Short Physical Performance Battery ( SPPB ) of lower extremity function . RESULTS Higher sense of mastery was associated with a significantly less-steep decline in lower extremity performance . Participants in the two lowest quartiles of personal mastery had , respectively , a 2.6 ( 95 % confidence interval (CI)=1.4 - 5.1 , P=.01 ) and 3.2 ( 95 % CI=1.6 - 6.6 , P=.002 ) higher risk of experiencing a substantial decline ( > or =3 points ) in SPPB scores after 6 years as those in the highest quartile . CONCLUSIONS Older individuals with poor sense of personal mastery are at high risk of accelerated lower extremity physical function decline . Whether interventions aim ed at improving personal mastery may prevent disability remains unknown BACKGROUND S Chronic kidney disease ( CKD ) , anemia , and mobility limitation are important predictors of mortality . We aim ed at investigating the interactions between estimated glomerular filtration rate ( eGFR ) , anemia , and physical performance on 1-year mortality in older patients discharged from acute care hospitals . METHODS Four hundred and eighty seven patients enrolled in a multicenter , prospect i ve observational study were included in the analysis . eGFR was estimated by the Berlin Initiative Study 1 equation . Anemia was defined on the basis of hemoglobin values . Mobility limitation was rated by the Short Physical Performance Battery ( SPPB ) . Covariates included demographics , nutritional status , cognitive performance , and comorbidity . The outcome of the study was mortality over 1-year follow-up . Interactions among study variables were investigated by survival tree analysis . RESULTS eGFR < 30 mL/min/1.73 m(2 ) , anemia , and SPPB = 0 - 4 were significantly associated with mortality , as were hypoalbuminemia and cognitive impairment . Survival tree analysis showed that compared to patients with SPPB ≥ 4 and eGFR ≥ 46.7 mL/min/1.73 m(2 ) ( ie , patients with the least mortality ) , patients with SPPB < 4 and hemoglobin < 12.2 g/dL had the highest risk of mortality [ hazard ratio ( HR ) = 28.9 , 95%CI 10.3 - 81.2 ] . Patients with SPPB ≥ 4 and eGFR < 46.7 mL/min/1.73 m(2 ) and those with SPPB > 4 , hemoglobin ≥ 12.2g/dL , and eGFR ≥ 58.6 mL/min/1.73 m(2 ) had intermediate risk ( HR = 6.58 , 95%CI = 2.15 - 20.2 , and HR = 15.11 , 95%CI=4.42 - 51.7 , respectively ) . Having SPPB < 4 , hemoglobin ≥ 12.2 g/dL , and eGFR<58.6 mL/min/l.73 m(2 ) was not significantly associated with increased mortality ( HR = 2.95 , 95%CI = 0.74 - 11.8 ) . CONCLUSIONS Interactions among eGFR , anemia , and mobility limitation define different profiles of risk in older patients discharged from acute care hospitals , which deserve to be considered to identify patients needing special care and careful follow-up after discharge BACKGROUND : Physical activity ( PA ) reduces the rate of mobility disability , compared with health education ( HE ) , in at risk older adults . It is important to underst and aspects of performance contributing to this benefit . OBJECTIVE : To evaluate intervention effects on tertiary physical performance outcomes . DESIGN : The Lifestyle Interventions and Independence for Elders ( LIFE ) was a multi‐centered , single‐blind r and omized trial of older adults . SETTING : Eight field centers throughout the United States . PARTICIPANTS : 1635 adults aged 78.9 ± 5.2 years , 67.2 % women at risk for mobility disability ( Short Physical Performance Battery [ SPPB ] < 10 ) . INTERVENTIONS : Moderate PA including walking , resistance and balance training compared with HE consisting of topics relevant to older adults . OUTCOMES : Grip strength , SPPB score and its components ( balance , 4 m gait speed , and chair‐st and s ) , as well as 400 m walking speed . RESULTS : Total SPPB score was higher in PA versus HE across all follow‐up times ( overall P = .04 ) as was the chair‐st and component ( overall P < .001 ) . No intervention effects were observed for balance ( overall P = .12 ) , 4 m gait speed ( overall P = .78 ) , or grip strength ( overall P = .62 ) . However , 400 m walking speed was faster in PA versus HE group ( overall P = < .001 ) . In separate models , 29 % of the rate reduction of major mobility disability in the PA versus HE group was explained by change in SPPB score , while 39 % was explained by change in the chair st and component . CONCLUSION : Lower extremity performance ( SPPB ) was significantly higher in the PA compared with HE group . Changes in chair‐st and score explained a considerable portion of the effect of PA on the reduction of major mobility disability‐consistent with the idea that preserving muscle strength/power may be important for the prevention of major mobility disability Objectives : To assess the validity and reliability of the Short Physical Performance Battery ( SPPB ) in adults 65 to 74 years old , capable in all basic activities of daily living ( ADL ) , in Quebec and Brazil . Methods : Participants were recruited in St. Bruno ( Quebec ) by local advertisements ( n = 60 ) and in Santa Cruz ( Brazil ) by r and om sampling ( n = 64 ) . The SPPB includes tests of gait , balance , and lower-limb strength . Disability status was categorized as intact mobility , limited mobility , and difficulty in any of ADL . Results : There was a grade d decrease in mean SPPB scores with increasing limitation of lower limbs , disability , and poor health . Using the test – retest reliability the authors evaluated the intraclass correlation coefficient , which was high in both sample s : .89 ( 95 % CI : 0.83 , 0.93 ) in St. Bruno and .83 in Santa Cruz ( 95 % CI : 0.73 , 0.89 ) . Discussion : This study provides evidence for the validity and reliability of SPPB in diverse population
The association between poor performance on SPPB and all-cause mortality remained highly consistent independent of follow-up length , subsets of participants , geographic area , and age of the population .
Conclusions An SPPB score lower than 10 is predictive of all-cause mortality .
The systematic implementation of the SPPB in clinical practice setting s may provide useful prognostic information about the risk of all-cause mortality .
Background The Short Physical Performance Battery ( SPPB ) is a well-established tool to assess lower extremity physical performance status .
Its predictive ability for all-cause mortality has been sparsely reported , but with conflicting results in different subsets of participants .
The aim of this study was to perform a meta- analysis investigating the relationship between SPPB score and all-cause mortality  .