主要移动性功能障碍的自我报告指标与 400 米步行测试失败的比较：LIFE 研究。
A Comparison of Self-report Indices of Major Mobility Disability to Failure on the 400-m Walk Test: The LIFE Study.
机构信息
Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina.
Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina.
出版信息
J Gerontol A Biol Sci Med Sci. 2018 Mar 14;73(4):513-518. doi: 10.1093/gerona/glx153.
BACKGROUND
The objective assessment of major mobility disability (objective MMD) by a 400-m walk test (400 MWT) is important but not always practical. Previous research on the relationship between self-reported MMD (SR MMD) and objective MMD is sparse and limited to cross-sectional data.
METHODS
We evaluated agreement between SR MMD and objective MMD using longitudinal data from the Lifestyle Interventions for Elders (LIFE) study. The SR MMD indices were defined based on having a lot of difficulty or inability to walk a quarter of a mile (SR-1/4MILE), walk several blocks (SR-BLOCKS), and climb one flight of stairs (SR-STAIRS).
RESULTS
Using objective MMD as the gold standard, SR-1/4MILE and SR-BLOCKS had relatively low sensitivity (around 0.4) and high specificity (around 0.9) for prevalence. Their overall sensitivity and specificity for cumulative incident objective MMD were approximately 0.6 and 0.8, respectively. While the annual probability of staying MMD free was similar for objective MMD, SR-1/4MILE, and SR-BLOCKS (90% for all), the probability of recovering from SR MMD was higher (50%) than that of objective MMD (22%). The development of objective MMD (439 events), SR-1/4MILE (356 events), and SR-BLOCKS (379 events) had a similar trajectory over time with substantially overlapping survival curves. SR-STAIRS generally did not agree well with objective MMD. Incorporating SR-STAIRS with either SR-1/4MILE or SR-BLOCKS did not significantly improve the agreement between SR MMD and objective MMD.
CONCLUSIONS
Simple SR-1/4MILE and SR-BLOCKS are reasonable candidates to define MMD if the primary outcome of interest is incident MMD.
背景
通过 400 米步行测试（400 MWT）对主要移动障碍（客观 MMD）进行客观评估很重要，但并不总是可行的。先前关于自我报告的 MMD（SR MMD）与客观 MMD 之间关系的研究很少，且仅限于横断面数据。
方法
我们使用生活方式干预老年人研究（LIFE）的纵向数据来评估 SR MMD 与客观 MMD 之间的一致性。SR MMD 指数是基于走四分之一英里（SR-1/4MILE）、走几个街区（SR-BLOCKS）和爬一段楼梯（SR-STAIRS）有很大困难或无法行走而定义的。
结果
以客观 MMD 为金标准，SR-1/4MILE 和 SR-BLOCKS 的患病率敏感性（约 0.4）相对较低，特异性（约 0.9）较高。它们对累积性客观 MMD 的总体敏感性和特异性分别约为 0.6 和 0.8。虽然客观 MMD、SR-1/4MILE 和 SR-BLOCKS 的无 MMD 年度概率相似（均为 90%），但从 SR MMD 中恢复的概率更高（50%），高于客观 MMD（22%）。客观 MMD（439 例）、SR-1/4MILE（356 例）和 SR-BLOCKS（379 例）的发展轨迹相似，生存曲线重叠程度较大。SR-STAIRS 与客观 MMD 一般一致性较差。将 SR-STAIRS 与 SR-1/4MILE 或 SR-BLOCKS 结合使用，并不会显著提高 SR MMD 与客观 MMD 之间的一致性。
结论
如果感兴趣的主要结局是新发 MMD，则简单的 SR-1/4MILE 和 SR-BLOCKS 是定义 MMD 的合理候选指标。
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