Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan.
Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan,
Gerontology. 2019;65(2):128-135. doi: 10.1159/000493527. Epub 2019 Jan 16.
The detection of impaired physical performance in older adults with cardiovascular disease is essential for clinical management and therapeutic decision-making. There is a requirement for an assessment tool that can be used conveniently, rapidly, and securely in clinical practice for screening decreased physical performance.
The present study was performed to evaluate the association of office-based physical assessments with decreased physical performance and to compare the prognostic capability of these assessments in older adults with cardiovascular disease.
A total of 1,040 patients aged 75 years and older with cardiovascular disease were included in this analysis. One-leg standing time (OLST) and handgrip strength were measured as office-based physical assessment tools, and short physical performance battery (SPPB), 6-min walk distance, and usual gait speed were also measured at hospital discharge as measurements of physical performance. All-cause mortality was assessed by death registry at the hospital. We examined the association of office-based measures with physical performance and all-cause mortality.
The areas under the curve of OLST for SPPB < 10, 6-min walk distance < 300 m, and usual gait speed < 1.0 m/s were 0.87 (95% CI 0.83-0.91), 0.83 (95% CI 0.80-0.86), and 0.81 (95% CI 0.78-0.85), respectively. The discrimination abilities of OLST for decreased physical performance were significantly higher than those of handgrip strength. After adjusting for the effects of patient characteristics, the hazard ratio for all-cause mortality in the < 3 s group for OLST was 1.68 (95% CI 1.06-2.67, p = 0.03). Handgrip strength, however, was not significantly associated with mortality risk in these participants.
Short OLST, in particular < 3 s, is associated with decreased physical performance and elevated mortality risk in elderly patients with cardiovascular disease. OLST can be conveniently measured in the clinician's office as a screening tool for impaired physical performance.
检测老年心血管疾病患者的身体机能受损情况对于临床管理和治疗决策至关重要。因此，我们需要一种方便、快速且安全的评估工具，以便在临床实践中用于筛查身体机能下降。
本研究旨在评估基于诊室的身体评估与身体机能下降之间的关系，并比较这些评估在老年心血管疾病患者中的预后能力。
共纳入 1040 名年龄在 75 岁及以上的心血管疾病患者。单腿站立时间（OLST）和握力被作为基于诊室的身体评估工具进行测量，同时在出院时还测量了短体适能测试（SPPB）、6 分钟步行距离和日常行走速度作为身体机能的测量指标。通过医院的死亡登记来评估全因死亡率。我们检查了基于诊室的测量值与身体机能和全因死亡率之间的关系。
OLST 与 SPPB<10、6 分钟步行距离<300m 和日常行走速度<1.0m/s 的曲线下面积分别为 0.87（95%CI 0.83-0.91）、0.83（95%CI 0.80-0.86）和 0.81（95%CI 0.78-0.85）。OLST 对身体机能下降的判别能力明显高于握力。在校正了患者特征的影响后，OLST<3 秒组的全因死亡率的危险比为 1.68（95%CI 1.06-2.67，p=0.03）。然而，在这些参与者中，握力与死亡风险无显著相关性。
在老年心血管疾病患者中，OLST 较短（尤其是<3 秒）与身体机能下降和死亡率升高相关。OLST 可在临床医生办公室方便地测量，作为身体机能下降的筛查工具。
