Diagnostic Accuracy of the Short Physical Performance Battery for Detecting Frailty in Older People

Abstract

Background The Short Physical Performance Battery (SPPB) is widely used to predict negative health-related outcomes in older adults. However, the cutoff point for the detection of the frailty syndrome is not yet conclusive. Objective The aim of this study was to determine the diagnostic value of the SPPB for detecting frailty in community-dwelling older adults. Design This was a population-based cross-sectional study focusing on households in urban areas. A total of 744 people who were 65 years old or older participated in this study. Methods Frailty was determined by the presence of 3 or more of the following components: unintentional weight loss, self-reported fatigue, weakness, low level of physical activity, and slowness. Diagnostic accuracy measures of the SPPB cutoff points were calculated for the identification of frailty (individuals who were frail) and the frailty process (individuals who were considered to be prefrail and frail). Receiver operating characteristic curves were constructed. Odds ratios for frailty and the frailty process and respective CIs were calculated on the basis of the best cutoff points. A bootstrap analysis was conducted to confirm the internal validity of the findings. Results The best cutoff point for the determination of frailty was ≤8 points (sensitivity = 79.7%; specificity = 73.8%; Youden J statistic = 0.58; positive likelihood ratio = 3.05; area under the curve = 0.85). The best cutoff point for the determination of the frailty process was ≤10 points (sensitivity = 75.5%; specificity = 52.8%; Youden J statistic = 0.28; positive likelihood ratio = 1.59; area under the curve = 0.76). The adjusted odds of being frail and being in the frailty process were 7.44 (95% CI = 3.90–14.19) and 2.33 (95% CI = 1.65–3.30), respectively. Limitations The external validation using separate data was not performed and the cross-sectional design does not allow SPPB predictive capacity to be established. Conclusions The SPPB might be used as a screening tool to detect frailty syndrome in community-dwelling older adults, but the cutoff points should be tested in another sample as a further validation step.

Early rehabilitation after stroke: relationship between the heart rate variability and functional outcome

“…We performed the assessment of SPPB in the current study, which is widely used in geriatric medicine to assess frailty, sarcopenia, and lower extremity function in older persons 35,36,37 . The results have shown that only 22% of all stroke patients at baseline and 43% of patients after a 4‐week FU were able to perform the test.…”

Performance-Based Screening Tools for Physical Frailty in Community Settings

“…It has primarily been used to assess elderly patients in the hospital, clinical and community settings. The SPPB test might be also used as a screening tool to detect frailty syndrome in community dwelling older adults [214,215]. The SPPB test consists of three assessments: repeated chair stands, balance tests (side-by-side, semi-tandem and tandem balance tests) and eight-foot walk (2.44 m) test [213].…”

Sex Differences in Association Between Body Composition and Frailty or Physical Performance in Community-Dwelling Older Adults

“…Physical performance The SPPB is a useful screening tool for identifying poor physical performance and frailty syndrome in the elderly population. [27] The SPPB score only objectively measures lower limb physical performance but also is highly associated with adverse health outcomes such as fall risk, disability, and mortality, even in high-functioning older adults. [28] It consists of three tests, including standing balance, gait speed in a 4-m walk, and a timed test of 5 repeated chair stands.…”