Gonzalez-Bautista Emmanuel, de Souto Barreto Philipe, Salinas-Rodriguez Aaron, Manrique-Espinoza Betty, Sourdet Sandrine, Rolland Yves, Rodríguez-Mañas Leocadio, Andrieu Sandrine, Vellas Bruno
Gérontopole of Toulouse, Institute of Aging, Toulouse University Hospital (CHU Toulouse), Toulouse, France.
CERPOP UMR 1295, University of Toulouse III, INSERM, UPS, Toulouse, France.
J Gerontol A Biol Sci Med Sci. 2023 Jan 26;78(1):104-110. doi: 10.1093/gerona/glac055.
The 5-repetition chair stand test (CST) is increasingly being used to assess locomotion capacity in older adults. However, there is a lack of age-stratified cutoffs for adults aged ≥70 validated against a higher risk of functional loss.
We used 2 population-based studies (Study on global AGEing and adult health in Mexico [SAGE Mexico] and Toledo Study for Healthy Aging [TSHA]) and receiver operating characteristic (ROC) analyses to develop and cross-validate age-stratified chair stand cutoffs with activities of daily living (ADL) disability as the outcome. Then, we used data from an randomized controlled trial (RCT) (Multidomain Alzheimer Preventive Trial [MAPT]) and a frailty day-hospital for external validation with cross-sectional and longitudinal measures of ADL disability. The merged sample of SAGE Mexico and TSHA was n = 1 595; sample sizes for external validation were: MAPT n = 1 573 and Frailty day-hospital n = 2 434. The Cox models for incident disability in MAPT had a mean follow-up of 58.6 months.
Cutoffs obtained were 14 second (ages 70-79) and 16 second (ages 80+). Those cutoffs identified older adults at higher odds of incident ADL disability odds ratio (OR) = 1.72 (95% confidence interval [CI] 1.06; 2.78) for ages 70-79 and odds ratio (OR) = 2.27 (95% CI 1.07; 4.80) in those aged 80+. Being a slow chair stander according to the cut points was associated with ADL disability in cross-sectional and longitudinal measures.
Fourteen- and 16-second cut points for the CST are suitable to identify people at higher risk of functional decline among older adults in Mexico and Toledo, Spain. Adjusting the cut point from 14 to 16 second generally improved the psychometric properties of the test. The validation of these cutoffs can facilitate the screening for limited mobility and the implementation of the Integrated Care for Older People program.
5次重复坐立试验（CST）越来越多地用于评估老年人的运动能力。然而，对于70岁及以上成年人，缺乏针对功能丧失风险较高情况进行验证的年龄分层临界值。
我们利用两项基于人群的研究（墨西哥全球老龄化与成人健康研究[SAGE墨西哥]和托莱多健康老龄化研究[TSHA]）以及受试者工作特征（ROC）分析，以日常生活活动（ADL）残疾为结局来制定并交叉验证年龄分层的坐立临界值。然后，我们使用一项随机对照试验（RCT）（多领域阿尔茨海默病预防试验[MAPT]）和一家衰弱日间医院的数据进行外部验证，采用ADL残疾的横断面和纵向测量方法。SAGE墨西哥和TSHA的合并样本量为n = 1595；外部验证的样本量为：MAPT中n = 1573，衰弱日间医院中n = 2434。MAPT中发生残疾的Cox模型平均随访时间为58.6个月。
得到的临界值为14秒（70 - 79岁）和16秒（80岁及以上）。这些临界值确定了发生ADL残疾几率较高的老年人，70 - 79岁人群的优势比（OR）= 1.72（95%置信区间[CI] 1.06；2.78），80岁及以上人群的优势比（OR）= 2.27（95% CI 1.07；4.80）。根据这些切点成为坐立缓慢者与横断面和纵向测量中的ADL残疾相关。
CST的14秒和16秒切点适用于识别墨西哥和西班牙托莱多老年人中功能下降风险较高的人群。将切点从14秒调整到16秒总体上改善了该测试的心理测量特性。这些临界值的验证有助于筛查行动不便情况以及实施老年人综合护理计划。
