Enrica Patrizio, Azienda di Servizi alla Persona Istituti Milanesi Martinitt e Stelline e Pio Albergo Trivulzio, Milan, Italy, Email:
J Frailty Aging. 2021;10(2):141-149. doi: 10.14283/jfa.2020.61.
The evaluation of the physical domain represents a critical part of the assessment of the older person, both in the clinical as well as the research setting. To measure physical function, clinicians and researchers have traditionally relied on instruments focusing on the capacity of the individual to accomplish specific functional tasks (e.g., the Activities of Daily Living [ADL] or the Instrumental ADL scales). However, a growing number of physical performance and muscle strength tests has been developed in parallel over the past three decades. These measures are specifically designed to: 1) provide objective results (not surprisingly, they are frequently timed tests) taken in standardized conditions, whereas the traditional physical function scales are generally self- or proxy-reported measures; 2) be more sensitive to changes; 3) capture the real biology of the function through the assessment of standardized tasks mirroring specific functional subdomains; and 4) mirror the quality of specific mechanisms underlying more complex and multidomain functions. Among the most commonly used instruments, the usual gait speed test, the Short Physical Performance Battery, the handgrip strength, the Timed Up-and-Go test, the 6-minute walk test, and the 400-meter walk test are widely adopted by clinicians and researchers. The clinical and research importance of all these instruments has been demonstrated by their predictive capacity for negative health-related outcomes (i.e., hospitalization, falls, institutionalization, disability, mortality). Moreover, they have shown to be associated with subclinical and clinical conditions that are also not directly related to the physical domain (e.g., inflammation, oxidative stress, overall mortality). For this reason, they have been repeatedly indicated as markers of wellbeing linked to the burden of multiple chronic conditions rather than mere parameters of mobility or strength. In this work protocols of the main tests for the objective assessment of physical function in older adults are presented.
身体领域的评估是评估老年人的重要组成部分，无论是在临床环境还是研究环境中。为了测量身体功能，临床医生和研究人员传统上依赖于专注于个体完成特定功能任务能力的工具（例如，日常生活活动[ADL]或工具性日常生活活动量表）。然而，在过去的三十年中，越来越多的身体表现和肌肉力量测试已经并行开发。这些措施专门设计用于：1）提供客观结果（毫不奇怪，它们通常是定时测试），在标准化条件下进行，而传统的身体功能量表通常是自我或代理报告的措施；2）更敏感地检测变化；3）通过评估反映特定功能子领域的标准化任务来捕捉功能的真正生物学；4）反映更复杂和多领域功能背后特定机制的质量。在最常用的仪器中，常用的步态速度测试、简短身体表现电池、握力测试、计时起立行走测试、6 分钟步行测试和 400 米步行测试被临床医生和研究人员广泛采用。所有这些仪器的临床和研究重要性都已通过它们对负面健康相关结果（即住院、跌倒、住院、残疾、死亡）的预测能力得到证明。此外，它们还与与身体领域无关的亚临床和临床状况相关联（例如，炎症、氧化应激、总死亡率）。出于这个原因，它们被反复表示为与多种慢性疾病负担相关的幸福感标志物，而不仅仅是移动性或力量的参数。在这项工作中，呈现了用于评估老年人身体功能的主要客观测试的方案。
