Miller Douglas K, Wolinsky Fredric D, Andresen Elena M, Malmstrom Theodore K, Miller J Philip
Center for Aging Research, Indiana University, Indianapolis, IN 46202-3012, USA.
J Gerontol A Biol Sci Med Sci. 2008 May;63(5):487-94. doi: 10.1093/gerona/63.5.487.
The Short Physical Performance Battery (SPPB) is a well-established measure of lower body physical functioning in older persons but has not been adequately examined in African Americans or younger persons. Moreover, factors associated with changes in SPPB over time have not been reported.
A representative sample of 998 African Americans (49-65 years old at baseline) living in St. Louis, Missouri were followed for 36 months to examine the predictive validity of SPPB in this population and identify factors associated with changes in SPPB. SPPB was calibrated to this population, ranged from 0 (worst) to 12 (best), and required imputation for about 50% of scores. Adverse outcomes of baseline SPPB included death, nursing home placement, hospitalization, physician visits, incident basic and instrumental activity of daily living disabilities, and functional limitations. Changes in SPPB over 36 months were modeled.
Adjusted for appropriate covariates, weighted appropriately, and using propensity scores to address potential selection bias, baseline SPPB scores were associated with all adverse outcomes except physician visits, and were marginally associated with hospitalization. Declines in SPPB scores were associated with low falls efficacy (b = -1.311), perceived income adequacy (-0.121), older age (-0.073 per year), poor vision (-0.754), diabetes mellitus (-0.565), refusal to report household income (1.48), ever had Medicaid insurance (-0.610), obesity (-0.437), hospitalization in the prior year (-0.521), and kidney disease (-.956).
The effect of baseline SPPB on adverse outcomes in this late middle-age African American population confirms reports involving older, primarily white participants. Alleviating deterioration in lower body physical functioning guided by the associated covariates may avoid or delay multiple age-associated adverse outcomes.
简短体能测试电池（SPPB）是一种成熟的衡量老年人下肢身体功能的方法，但尚未在非裔美国人或年轻人中得到充分研究。此外，尚未有关于SPPB随时间变化的相关因素的报道。
对居住在密苏里州圣路易斯的998名非裔美国人（基线年龄49 - 65岁）进行了为期36个月的跟踪研究，以检验SPPB在该人群中的预测效度，并确定与SPPB变化相关的因素。SPPB针对该人群进行了校准，范围从0（最差）到12（最佳），约50%的分数需要进行插补。基线SPPB的不良结局包括死亡、入住养老院、住院、就医、出现基本和工具性日常生活活动障碍以及功能受限。对36个月内SPPB的变化进行了建模。
在对适当的协变量进行调整、进行适当加权并使用倾向得分来解决潜在的选择偏倚后，基线SPPB分数与除就医外的所有不良结局相关，与住院有微弱关联。SPPB分数下降与跌倒效能低（b = -1.311）、感知收入充足度（-0.121）、年龄较大（每年-0.073）、视力差（-0.754）、糖尿病（-0.565）、拒绝报告家庭收入（1.48）、曾有医疗补助保险（-0.610）、肥胖（-0.437）、前一年住院（-0.521）以及肾病（-0.956）有关。
基线SPPB对这一中老年非裔美国人人群不良结局的影响证实了涉及主要为白人的老年参与者的报道。通过相关协变量指导减轻下肢身体功能的恶化可能避免或延迟多种与年龄相关的不良结局。
