Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, Indiana, USA.
Department of Kinesiology, School of Public Health, Indiana University, Bloomington, Indiana, USA.
Geriatr Gerontol Int. 2023 Oct;23(10):715-721. doi: 10.1111/ggi.14654. Epub 2023 Aug 31.
Objective measurements of physcial function, including gait speed, handgrip strength, and the chair stand test, have been shown to have predictive capacity for negative health-related outcomes. The aim of this study was to examine campariatively which of these common assessments may be optimal in terms of their predictive capacity for mortality.
A total of 9834 community-dwelling older women aged 65-89 years from the Study of Osteoporotic Fractures (SOF) were followed for 20 years. Gait speed, handgrip strength, and the chair stand test were measured every 2-4 years on up to 9 visits. All deaths were adjudicated.
All three measurements of physical function were significantly associated with overall, cardiovascular disease and other mortality. Gait speed had the greatest magnitude of hazard ratios (HRs) for all outcomes of interest. A one-unit standard deviation increase in gait speed was associated with a 33% (HR = 0.67, 95% confidence interval [95% CI]: 0.64-0.70) lower risk for overall mortality, a 31% (HR = 0.69, 95% CI: 0.64-0.73) lower risk for cardiovascular disease mortality, a 15% (HR = 0.85, 95% CI: 0.78-0.92) lower risk for cancer mortality and a 42% (HR = 0.58, 95% CI: 0.55-0.62) lower risk for other mortality. Further examination of gait speed identified two cut-points (0.9 and 0.7 m/s) that were strongly indicative of increased mortality risk.
Our large prospective study indicates that gait speed possesses a better prediction of mortality among older women compared with handgrip strength or the chair stand test. Using cut-points of 0.9 and 0.7 m/s can help identify older women at higher mortality risk, who may benefit from physical function improvement interventions. Geriatr Gerontol Int 2023; 23: 715-721.
身体机能的客观测量指标，包括步速、握力和坐站测试，已被证明对负面健康相关结果具有预测能力。本研究旨在比较这些常见评估方法中，哪一种在预测死亡率方面具有最佳的预测能力。
共有 9834 名年龄在 65-89 岁的社区居住的老年女性参与了骨质疏松性骨折研究（SOF），随访时间为 20 年。在多达 9 次的随访中，每 2-4 年测量一次步速、握力和坐站测试。所有死亡均经过裁定。
所有三种身体机能测量指标均与全因、心血管疾病和其他死亡率显著相关。步速与所有感兴趣的结局的危害比（HR）幅度最大。步速每增加一个标准差，全因死亡率的风险降低 33%（HR=0.67，95%置信区间[95%CI]：0.64-0.70），心血管疾病死亡率的风险降低 31%（HR=0.69，95%CI：0.64-0.73），癌症死亡率的风险降低 15%（HR=0.85，95%CI：0.78-0.92），其他死亡率的风险降低 42%（HR=0.58，95%CI：0.55-0.62）。进一步研究步速发现了两个切点（0.9 和 0.7 m/s），它们强烈提示了更高的死亡风险。
我们的大型前瞻性研究表明，与握力或坐站测试相比，步速对老年女性的死亡率具有更好的预测能力。使用 0.9 和 0.7 m/s 的切点可以帮助识别死亡率较高的老年女性，她们可能受益于身体机能改善干预。
