Performance-based measures of physical function as mortality predictors: Incremental value beyond self-reports.
Performance-based measures of physical function as mortality predictors: Incremental value beyond self-reports.
复制标题
DOI：
10.4054/demres.2013.30.7
复制
发表时间：
2014-01-23
影响因子：
2.1
通讯作者：
Weinstein M
中科院分区：
文献类型：
--
作者：
Goldman N;Glei DA;Rosero-Bixby L;Chiou ST;Weinstein M
虽然以前的研究表明，性能评估强烈预测未来的生存，很少有评估的增量值存在的控制自我报告的活动和流动性限制。我们评估和比较四项测试的附加值-步行速度，椅子站立，握力和呼气峰流量（PEF）-预测全因死亡率。使用基于人口的样本的老年人在哥斯达黎加（n = 2290，年龄60岁以上）和台湾（n = 1219，年龄53岁以上），我们估计的比例风险模型的死亡率为大约五年的时间。受试者操作特征（ROC）曲线用于评估每个性能评估的预后价值。自我报告的身体限制措施在死亡率预测方面有很大的贡献，而基于性能的评估产生了适度的增量收益。PEF提供了最大的附加值，其次是握力。我们的研究结果表明，包括两个以上的性能评估可能提供死亡率预测的改善不大。PEF和握力在家庭访谈中通常更容易管理，对一些受访者的负担较小，并且在存在自我报告的限制的情况下，似乎比步行速度或椅子站立更好地预测死亡率。无法进行测试通常是死亡率的一个强有力的预测因素，但这些指标并没有得到很好的定义。排除率因具体任务而异，可能取决于样本的基本人口、健康、社会和文化特征。
Although previous studies have indicated that performance assessments strongly predict future survival, few have evaluated the incremental value in the presence of controls for self-reported activity and mobility limitations. We assess and compare the added value of four tests – walking speed, chair stands, grip strength, and peak expiratory flow (PEF) – for predicting all-cause mortality. Using population-based samples of older adults in Costa Rica (n = 2290, aged 60+) and Taiwan (n = 1219, aged 53+), we estimate proportional hazards models of mortality for an approximate five-year period. Receiver Operator Characteristic (ROC) curves are used to assess the prognostic value of each performance assessment. Self-reported measures of physical limitations contribute substantial gains in mortality prediction, whereas performance-based assessments yield modest incremental gains. PEF provides the greatest added value, followed by grip strength. Our results suggest that including more than two performance assessments may provide little improvement in mortality prediction. PEF and grip strength are often simpler to administer in home interview settings, impose less of a burden on some respondents, and, in the presence of self-reported limitations, appear to be better predictors of mortality than do walking speed or chair stands. Being unable to perform the test is often a strong predictor of mortality, but these indicators are not well-defined. Exclusion rates vary by the specific task and are likely to depend on the underlying demographic, health, social and cultural characteristics of the sample.