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.
J Am Med Dir Assoc. 2022 Aug;23(8):1375-1382.e3. doi: 10.1016/j.jamda.2021.11.007. Epub 2021 Dec 7.
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.
Cross-sectional and longitudinal analyses of a cohort study.
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).
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.
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).
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.
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。
队列研究的横断面和纵向分析。
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)。
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。
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)。
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。