Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, Seoul, Republic of Korea.
Dyphi Research Institute, Dyphi Inc., Daejeon, Republic of Korea.
Clin Interv Aging. 2020 Nov 11;15:2175-2182. doi: 10.2147/CIA.S280542. eCollection 2020.
The importance of evaluating frailty status of older adults in clinical practice has been gaining attention with cumulative evidence showing its relevance in clinical outcomes and decision-making. We aimed to develop and validate whether the functional age predicted by an electronic continuous short physical performance battery (eSPPB) could predict frailty status.
We reviewed medical records of outpatients (N=834) of Asan Medical Center, aged 51-95 years. We used the eSPPB data of 717 patients as a development cohort, and that of 117 patients, who also underwent comprehensive geriatric assessments, as a validation cohort. Frailty index was calculated by counting deficits of 45 geriatric items including comorbidities, daily functions, mobility, mood, and cognition. For functional age, we used balance score (0-4), gait speed (m/s), and stand-up time (s) measured 5 times in the chair rise test.
From the development cohort, we established a functional age using the formula (83.61 - 1.98*[balance score] - 5.21*[gait speed] + 0.23*[stand-up time]), by multivariate linear regression analysis with chronological age as a dependent variable (R = 0.233). In the validation cohort, the functional age positively correlated with frailty index (p < 0.001). C-statistics classifying frailty (defined as frailty index ≥0.25) was higher (p < 0.001) with functional age (0.912) than that with chronological age (0.637). A cut-off functional age of ≥77.2 years maximized Youden's J when screening for frailty, with sensitivity of 94.4% and specificity of 80.8%.
A newly developed functional age predictor using eSPPB parameters can predict the frailty status as defined by the deficit accumulation method and may serve as a physical biomarker of human aging.
随着越来越多的证据表明其与临床结局和决策相关，评估老年人虚弱状态的重要性在临床实践中受到关注。我们旨在开发和验证电子连续短体性能电池 (eSPPB) 预测的功能年龄是否可以预测虚弱状态。
我们回顾了 51-95 岁的 Asan 医疗中心门诊患者（N=834）的病历。我们使用 717 名患者的 eSPPB 数据作为开发队列，使用另外 117 名患者的 eSPPB 数据作为验证队列，这些患者还接受了全面的老年评估。虚弱指数通过计算包括合并症、日常功能、移动性、情绪和认知在内的 45 项老年项目的缺陷来计算。对于功能年龄，我们使用在椅子上升测试中测量的 5 次平衡得分（0-4）、步态速度（m/s）和站立时间（s）。
从开发队列中，我们通过多元线性回归分析，以年龄为因变量（R = 0.233），使用公式（83.61 - 1.98*[平衡得分]-5.21*[步态速度]+0.23*[站立时间]）建立了一个功能年龄。在验证队列中，功能年龄与虚弱指数呈正相关（p < 0.001）。分类虚弱（定义为虚弱指数≥0.25）的 C 统计量（p < 0.001）功能年龄（0.912）高于年龄（0.637）。功能年龄≥77.2 岁的截断值可最大程度地提高用于筛查虚弱的 Youden's J，敏感性为 94.4%，特异性为 80.8%。
一种使用 eSPPB 参数开发的新功能年龄预测器可以预测根据缺陷积累方法定义的虚弱状态，并且可以作为人类衰老的物理生物标志物。
