Department of Physiotherapy, Singapore General Hospital, Singapore; Medicine Academic Programme, Duke-NUS Graduate Medical School, Singapore.
Department of General Medicine (Geriatric Medicine), Sengkang General Hospital, Singapore.
J Am Med Dir Assoc. 2024 Dec;25(12):105292. doi: 10.1016/j.jamda.2024.105292. Epub 2024 Oct 2.
The 4-m gait speed (4mGS) and 10-m gait speed (10mGS) tests and the 30-second sit-to-stand (30sSTS) and 5-times sit-to-stand (5xSTS) tests are commonly used and advocated in consensus recommendations. We compared these tests on their predictive and clinical value concerning the risk of prefrailty/frailty and restricted life-space mobility (RLSM).
Cross-sectional study.
A sample of 1235 community-dwelling adults (mean ± SD, 68 ± 7 years) participated in this prospective cohort study.
At baseline assessment, participants completed a survey and functional assessment, from which gait speed, sit-to-stand performance, self-reported mobility limitation, 40-item Frailty Index, and Life Space Assessment were measured. Participants with a 40-item Frailty Index >0.15 and a Life Space Assessment <60 points were classified as having prefrailty/frailty and RLSM, respectively. At 1-year follow-up assessment, prefrailty/frailty and RLSM were evaluated.
Correlations between gait speed and sit-to-stand measures were high (ρ values >0.80). In multivariable ordinal models, these measures added incremental prognostic value beyond a base model comprising demographics and self-reported mobility limitation variables in predicting baseline and 1-year outcomes. Between 10mGS and 4mGS, models with 10mGS had higher concordance indices (differences, 0.005-0.009), and these differences translated to generally greater net benefit in decision curve analyses. Between 30sSTS and 5xSTS measures, no one measure consistently outperformed the other, with small net benefit differences between measures (<0.2%).
In community-dwelling older adults, gait speed and sit-to-stand measures meaningfully predicted prefrailty/frailty and RLSM. 10mGS provided more robust prognostic information than the 4mGS, whereas 5xSTS and 30sSTS measures showed near equivalence of performance. These findings could guide the choice of functional measures in clinical and research settings.
4 米步速（4mGS）和 10 米步速（10mGS）测试以及 30 秒坐站（30sSTS）和 5 次坐站（5xSTS）测试在共识建议中被广泛使用和提倡。我们比较了这些测试在预测衰弱前期/衰弱和受限生活空间移动性（RLSM）风险方面的预测和临床价值。
横断面研究。
一项由 1235 名社区居住的成年人（平均 ± 标准差，68 ± 7 岁）组成的样本参加了这项前瞻性队列研究。
在基线评估时，参与者完成了一项调查和功能评估，从中测量了步速、坐站表现、自我报告的移动能力限制、40 项衰弱指数和生活空间评估。40 项衰弱指数>0.15 和生活空间评估<60 分的参与者分别被归类为衰弱前期/衰弱和 RLSM。在 1 年随访评估时，评估了衰弱前期/衰弱和 RLSM。
步速和坐站测量之间的相关性很高（ρ 值>0.80）。在多变量有序模型中，这些测量值在预测基线和 1 年结果方面，除了包含人口统计学和自我报告的移动能力限制变量的基本模型外，还增加了额外的预后价值。在 10mGS 和 4mGS 之间，包含 10mGS 的模型具有更高的一致性指数（差异，0.005-0.009），这些差异在决策曲线分析中转化为总体更大的净收益。在 30sSTS 和 5xSTS 测量之间，没有一个测量值始终优于另一个测量值，测量值之间的净收益差异较小（<0.2%）。
在社区居住的老年人中，步速和坐站测量值有意义地预测了衰弱前期/衰弱和 RLSM。10mGS 提供了比 4mGS 更稳健的预后信息，而 5xSTS 和 30sSTS 测量值表现出近乎等效的性能。这些发现可以指导临床和研究环境中功能测量的选择。
