Lower extremity function and subsequent disability: Consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery
Lower extremity function and subsequent disability: Consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery
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DOI：
10.1093/gerona/55.4.m221
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发表时间：
2000-04-01
影响因子：
5.1
通讯作者：
Wallace, RB
中科院分区：
文献类型：
--
作者：
Guralnik, JM;Ferrucci, L;Wallace, RB
背景资料。虽然已经证明，体能测量可预测以前未致残的老年人的意外残疾，但现有数据尚未充分发展，无法创建可用于确定社区居住人口风险概况的方法。使用几个人群和不同的随访期，这项研究通过使用老年人流行病学研究(EPESE)绩效组合的既定人群重复了先前的发现，并提供了根据年龄、性别和绩效水平预测残疾风险的方程。在EPESE的四个地点对4588名最初的非残疾人和在西班牙裔EPESE的1,946名最初的非残疾人进行了平衡、行走8英尺的时间和从椅子上站起5次的时间的测试。术后1~6年对患者进行日常生活能力(ADL)和行动能力相关残疾的随访评估。在EPESE中，与表现最好的人(EPESE总分10-12)相比，4-6分的人患与行动能力相关的残疾的相对风险为2.9至4.9，7-9分的人患行动能力相关残疾的相对风险为1.5-2.1，与ADL残疾的结果相似。根据西班牙裔EPESE的表现水平观察到的事件致残率与从EPESE站点开发的模型预测的致残率非常一致。受试者操作特征曲线显示，单独的步态速度在预测事件伤残方面的表现几乎与完整的电池一样好。下肢功能的性能测试准确地预测了不同人群的残疾。从使用汇总分数和步速的模型导出的方程仅允许估计社区居民的残疾风险，并为估计残疾预防临床试验的样本量提供了有价值的信息。
Background. Although it has been demonstrated that physical performance measures predict incident disability in previously nondisabled older persons, the available data have not been fully developed to create usable methods for determining risk profiles in community-dwelling populations. Using several populations and different follow-up periods, this study replicates previous findings by using the Established Populations for the Epidemiologic Study of the Elderly (EPESE) performance battery and provides equations for the prediction of disability risk according to age, sex, and level of performance.Methods. Tests of balance, time to walk 8 ft, and time to rise from a chair 5 times were administered to 4,588 initially nondisabled persons in the four sites of the EPESE and to 1,946 initially nondisabled persons in the Hispanic EPESE. Follow-up assessment for activity of daily living (ADL) and mobility-related disability occurred from 1 to 6 years later.Results. In the EPESE, compared with those with the best performance (EPESE summary performance score of 10-12), the relative risks of mobility-related disability for those with scores of 4-6 ranged from 2.9 to 4.9 and the relative risk of disability for those with scores of 7-9 ranged from 1.5 to 2.1, with similar consistent results for ADL disability. The observed rates of incident disability according to performance level in the Hispanic EPESE agreed closely with rates predicted from models developed from the EPESE sites. Receiver operating characteristic curves showed that gait speed alone performed almost as well as the full battery in predicting incident disability.Conclusions. Performance tests of lower extremity function accurately predict disability across diverse populations. Equations derived from models using both the summary score and the gait speed alone allow for the estimation of risk of disability in community-dwelling populations and provide valuable information for estimating sample size for clinical trials of disability prevention.