Assistive Systems and Medical Device Technology, Department of Health Services Research, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany.
Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, Hannover, Germany.
Aging Clin Exp Res. 2021 Mar;33(3):563-572. doi: 10.1007/s40520-020-01562-8. Epub 2020 May 1.
It is important to identify the relevant parameters of physical performance to prevent early functional decline and to prolong independent living. The aim of this study is to describe the development of physical performance in a healthy community-dwelling older cohort aged 70+ years using comprehensive assessment over two years and to subsequently identify the most relevant predictive tests for physical decline to minimize assessment.
Physical performance was measured by comprehensive geriatric assessment. Predictors for the individual decline of physical performance by Principal Component and k-means Cluster Analysis were developed, and sensitivity and specificity determined accordingly.
251 subjects (Ø 75.4 years) participated in the study. Handgrip strength was low in 21.1%. The follow-up results of tests were divergent. Handgrip strength [- 16.95 (SD 11.55)] and the stair climb power test (power) [- 9.15 (SD 16.84)] yielded the highest percentage changes. Four most relevant tests (handgrip strength, stair climb power time, timed up & go and 4-m gait speed) were identified. A predictor based on baseline data was determined (sensitivity 82%, specificity 96%) to identify subjects characterized by a high degree of physical decline within two years.
Although the cohort of older adults is heterogeneous, most of the individuals in the study exhibited high levels of physical performance; only a few subjects suffered a relevant decline within the 2-year follow-up. Four most relevant tests were identified to predict relevant decline of physical function.
In spite of ceiling effects of the geriatric assessment in high-performers, we assume that it is possible to predict an individual's risk of physical decline within 2 years with four tests of a comprehensive geriatric assessment.
识别与身体表现相关的参数对于预防早期功能下降和延长独立生活至关重要。本研究的目的是描述使用综合评估在 70 岁以上的健康社区居住的老年人队列中身体表现的发展，并随后确定最相关的预测测试，以最小化评估来预测身体下降。
身体表现通过综合老年评估进行测量。通过主成分和 K-均值聚类分析为身体表现的个体下降开发了预测因子，并相应确定了敏感性和特异性。
251 名受试者（Ø 75.4 岁）参与了研究。握力低的占 21.1%。测试的随访结果存在差异。握力（-16.95（SD 11.55））和爬楼梯力量测试（功率）（-9.15（SD 16.84））的下降百分比最高。确定了四个最相关的测试（握力、爬楼梯功率时间、起立行走和 4 米步行速度）。基于基线数据确定了一个预测因子（敏感性 82%，特异性 96%），以识别在两年内身体下降程度较高的受试者。
尽管老年队列存在异质性，但研究中的大多数个体表现出较高的身体表现水平；只有少数受试者在 2 年随访期间出现了相关下降。确定了四个最相关的测试来预测身体功能的相关下降。
尽管综合老年评估在高表现者中存在天花板效应，但我们假设可以使用综合老年评估的四个测试来预测个体在 2 年内身体下降的风险。
