Assistance Systems and Medical Device Technology, Department of Health Services Research, School of Medicine and Health Sciences, Carl von Ossietzky University of Oldenburg, Ammerlaender Heerstr. 140, 26129, Oldenburg, Germany.
Geriatric Medicine, Agaplesion Bethanien Krankenhaus Heidelberg, Ruprecht-Karls-University, Heidelberg, Germany.
Aging Clin Exp Res. 2022 Nov;34(11):2769-2778. doi: 10.1007/s40520-022-02230-9. Epub 2022 Sep 2.
When older adults fall below the thresholds of functional geriatric assessment (FGA), they may already be at risk of mobility impairment. A reduction in (jumping) power could be an indication of functional decline, one of the main risk factors for falls.
This paper explores whether six-month delta (∆) values of muscle power can predict 24-month follow-up FGA in older adults.
This observational study of independent, healthy, high-performing community-dwelling adults aged 70 + years involved FGA (mobility, balance, and endurance tests) at baseline (t), after 6 months (t), and after 24 months (t); maximum jumping power (max JP) was determined at t and t. A predictive linear model was developed in which the percentage change of Δmax JP was transferred to all FGA (t) values. The results were compared with measured FGA values at t via sensitivity and specificity in terms of the clinically meaningful change (CMC) or the minimal detectable change (MDC).
In 176 individuals (60% female, mean age 75.3 years) the mean percentage (SD) between predicted and measured FGA ranged between 0.4 (51.3) and 18.11 (51.9). Sensitivity to identify the CMC or MDC of predicted FGA tests at t ranged between 17.6% (Timed up and go) and 75.0% (5-times-chair-rise) in a test-to-test comparison and increased to 97.6% considering clinically conspicuousness on global FGA.
The potential of jumping power to predict single tests of FGA was low regarding sensitivity and specificity of CMC (or MDC). 6 months Δmax JP seem to be suitable for predicting physical function, if the measured and predicted tests were not compared at the test level, but globally, in the target group in the long term.
老年人的功能老年评估（FGA）分数低于临界值时，他们可能已经有行动障碍的风险。（跳跃）力量的下降可能是功能下降的一个迹象，这是跌倒的主要危险因素之一。
本研究旨在探讨 6 个月肌肉力量的变化值是否可以预测老年人 24 个月的 FGA 随访结果。
本观察性研究纳入了独立、健康、表现良好的社区居住的 70 岁及以上成年人，基线（t）时进行 FGA（包括移动、平衡和耐力测试），6 个月（t）和 24 个月（t）时进行 FGA 随访；t 和 t 时测定最大跳跃力（max JP）。在模型中，将 Δmax JP 的百分比变化转移到所有 FGA（t）值。然后通过灵敏度和特异性比较预测 FGA 值与 t 时的测量 FGA 值，以评估临床有意义的变化（CMC）或最小可检测变化（MDC）。
在 176 名个体（60%为女性，平均年龄 75.3 岁）中，预测和测量的 FGA 之间的平均百分比（SD）差值在 0.4（51.3）至 18.11（51.9）之间。在 t 时，预测 FGA 测试的 CMC 或 MDC 的灵敏度在单项测试中从 Timed up and go（计时起立行走）的 17.6%到 5-times-chair-rise（五次椅子站立起身）的 75.0%不等，而在整体 FGA 考虑到明显的临床变化时，灵敏度增加到 97.6%。
从灵敏度和特异性来看，跳跃力预测 FGA 单项测试的能力较低（CMC 或 MDC）。6 个月的 max JP 变化可能适合预测身体功能，如果在目标人群中，在长期内不将测量值和预测值在测试水平上进行比较，而是在整体水平上进行比较。
