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椅子站立测试在社区居住的老年人中不良身体功能的切点及其与不良健康结局的关系:一项横断面和纵向研究。

Cut Points of Chair Stand Test for Poor Physical Function and Its Association With Adverse Health Outcomes in Community-Dwelling Older Adults: A Cross-Sectional and Longitudinal Study.

机构信息

Department of Biomedical Science and Technology, College of Medicine, East-West Medical Research Institute, Kyung Hee University, Seoul, Korea.

Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea; Department of Family Medicine, Kyung Hee University Medical Center, Seoul, Korea.

出版信息

J Am Med Dir Assoc. 2022 Aug;23(8):1375-1382.e3. doi: 10.1016/j.jamda.2021.11.007. Epub 2021 Dec 7.

Abstract

OBJECTIVES

To identify the optimal cutoff points for poor physical function [measured by a 5-times sit-to-stand (5-STS) test] associated with slowness in community-dwelling older adults and to validate the 5-STS cut points by determining whether they predicted future slowness and clinically relevant health outcomes over a 2-year-follow-up period.

DESIGN

Cross-sectional and longitudinal analyses of a cohort study.

SETTING AND PARTICIPANTS

We conducted cross-sectional (n = 2977) and prospective 2-year follow-up analyses (n = 2515) among participants aged 70-84 years enrolled in the nationwide Korean Frailty and Aging Cohort Study (KFACS).

METHODS

Classification and regression tree (CART) analysis was used to identify the 5-STS cut points for poor performance in terms of slowness (eg, gait speed ≥1.0 m/s, gait speed >0.8 m/s and <1.0 m/s, gait speed ≤0.8 m/s) at baseline. Multinomial logistic regression models were used to evaluate the prevalence and incidence of slowness and clinical outcomes according to the three 5-STS categories (normal, intermediate, and poor) in the cross-sectional and longitudinal analyses.

RESULTS

The overall prevalence of slowness in our study sample was 9.0% for a gait speed of ≤0.8 m/s and 32.1% for a gait speed of <1.0 m/s. The CART model identified 5-STS cut points of 10.8 seconds and 12.8 seconds for intermediate and poor physical function, respectively. In the adjusted model, the cut point of 12.8 seconds had a significantly increased likelihood of incident slowness and clinically relevant health outcomes (ie, mobility limitation, disability, frailty, sarcopenia risk, and falls) over the 2-year-follow-up period (all, P < .05).

CONCLUSIONS AND IMPLICATIONS

Our study established 5-STS test cutoff points for poor physical function. Thresholds of 10.8 and 12.8 seconds (intermediate and poor physical function, respectively) for a 5-STS test might help identify individuals at risk of physical function impairments and, thus, help design preventive interventions in community health care settings.

摘要

目的

确定与社区居住的老年人动作缓慢相关的较差身体功能(通过 5 次坐站测试[5-STS]测量)的最佳截断点,并通过确定它们是否在 2 年随访期间预测未来的动作缓慢和临床相关健康结局来验证 5-STS 截断点。

设计

队列研究的横断面和纵向分析。

地点和参与者

我们对参加全国韩国虚弱和衰老队列研究(KFACS)的 70-84 岁参与者进行了横断面(n=2977)和前瞻性 2 年随访分析(n=2515)。

方法

使用分类和回归树(CART)分析确定 5-STS 测试在基线时动作缓慢(例如,步行速度≥1.0m/s、步行速度>0.8m/s 和<1.0m/s、步行速度≤0.8m/s)方面表现不佳的截断点。多变量逻辑回归模型用于评估横断面和纵向分析中 5-STS 三个类别(正常、中等和较差)中动作缓慢和临床结局的发生率和患病率。

结果

在我们的研究样本中,动作缓慢的总体患病率为 0.8m/s 时为 9.0%,<1.0m/s 时为 32.1%。CART 模型确定了中间和较差身体功能的 5-STS 测试截断点分别为 10.8 秒和 12.8 秒。在调整后的模型中,12.8 秒的截断点在 2 年随访期间具有更高的发生动作缓慢和临床相关健康结局(即移动受限、残疾、虚弱、肌肉减少症风险和跌倒)的可能性(均,P<.05)。

结论和意义

我们的研究确定了 5-STS 测试较差身体功能的截断点。5-STS 测试的 10.8 和 12.8 秒(分别为中等和较差的身体功能)阈值可能有助于识别身体功能受损风险较高的个体,从而有助于在社区保健环境中设计预防干预措施。

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