Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168, Rome, Italy.
Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy.
Aging Clin Exp Res. 2024 Feb 12;36(1):33. doi: 10.1007/s40520-024-02693-y.
Declining physical performance in old age is associated with a wide range of negative health-related outcomes. However, it is unclear which physical capabilities should be prioritized to obtain prognostic information in older adults.
To examine the associations between the performance on several physical function tests and falls, disability, and death in a well-characterized sample of very old Italian adults.
This was a prospective cohort study of older adults who lived in the mountain community of the Sirente geographic area in Central Italy. Physical performance was assessed using isometric handgrip strength (IHG), walking speed (WS) at a usual and fast pace, 5-time sit-to-stand test (5STS), and sit-to-stand power measures. Appendicular skeletal muscle mass was estimated from calf circumference using a validated equation. History of falls, incident falls, and disability status according to basic Activities of Daily Living (ADLs) were recorded over two years. Survival status was obtained from the participants' general practitioners and was confirmed by the National Death Registry over 10 years from enrolment. Linear, binary, and Cox regressions were performed to evaluate the association between physical performance measures and health outcomes.
The mean age of the 255 participants was 84.2 ± 5.1 years, and 161 (63.1%) were women. Logistic regression indicated that IHG was significantly associated with incident ADL disability, whereas specific sit-to-stand muscle power was an independent predictor of death. No significant associations were observed between physical function and falls.
Our findings indicate selective associations between physical function tests and the occurrence of negative events in very old adults, with poor IHG predicting disability and specific sit-to-stand muscle power being longitudinally associated with death.
老年人体力下降与广泛的负面健康相关结果有关。然而，目前尚不清楚哪些身体能力应该优先考虑，以获得老年人的预后信息。
在意大利老年人的特征明确的样本中，检查几种身体功能测试的表现与跌倒、残疾和死亡之间的关系。
这是一项对居住在意大利中部 Sirente 地理区域山区社区的老年人进行的前瞻性队列研究。使用等长握力（IHG）、常规和快速步行速度（WS）、5 次坐立测试（5STS）和坐立功率测量来评估身体表现。使用经过验证的方程从小腿围估计四肢骨骼肌质量。在两年内记录了跌倒史、新发跌倒和根据基本日常生活活动（ADL）确定的残疾状况。通过参与者的全科医生获得生存状况，并通过国家死亡登记处在登记后 10 年以上进行确认。进行线性、二项和 Cox 回归，以评估身体表现测量与健康结果之间的关联。
255 名参与者的平均年龄为 84.2±5.1 岁，其中 161 名（63.1%）为女性。逻辑回归表明，IHG 与新发 ADL 残疾显著相关，而特定的坐立起肌肉力量是死亡的独立预测因子。身体功能与跌倒之间没有显著关联。
我们的研究结果表明，在非常老的成年人中，身体功能测试与负面事件的发生之间存在选择性关联，握力差预测残疾，特定的坐立起肌肉力量与死亡呈纵向相关。
