Meaningful Change and Responsiveness in Common Physical Performance Measures in Older Adults

Perera, Subashan; Mody, Samir H.; Woodman, Richard C.; Studenski, Stephanie A.

doi:10.1111/j.1532-5415.2006.00701.x

Cited by 1,989 publications

(1,808 citation statements)

References 28 publications

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“…In an unadjusted model, the difference in gait speed after 3 years of follow-up was significant and in an adjusted model, this difference did not reach statistical significance, but remained clinical relevant (− 0.07 m/s) according the smallest meaningful change estimate by Perera et al (− 0.05 m/s) (Perera et al 2006).…”

Section: Discussionmentioning

confidence: 79%

RETRACTED ARTICLE: Omega-3 fatty acid levels in red blood cell membranes and physical decline over 3 years: longitudinal data from the MAPT study

et al. 2017

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Studies have shown that omega-3 polyunsaturated fatty acids (PUFAs) are associated with brain, cardiovascular, and immune function, as well as physical performance and bone health in older adults. So far, few studies have investigated the associations between PUFA status and performancebased tests of physical function. The objective of this study was to investigate the associations between the omega-3 PUFA levels (eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA)) in red blood cell (RBC) membranes and physical performance, in a sample of community-dwelling older adults. This is a longitudinal observational study using data from the Multidomain Alzheimer's Disease Trial (MAPT), a randomized, placebo-controlled trial. Four hundred participants from MAPT placebo group with available PUFA data were included. Omega-3 PUFA levels in RBC membranes were measured at baseline, and their percentage of total RBC membrane fatty acid content was calculated. We dichotomized the standardized omega-3 PUFA levels in RBC membranes as low (lowest quartile) vs. high (three upper quartiles). Gait speed (in m/s) and short physical performance battery (SPPB) score (range from 0 to 12, higher is better) were used to assess physical performance at baseline and after 6, 12, 24, and 36 months. Participants were 75.2 (± 4.3) years old and 68% were female. Bivariate analyses found that the characteristic of the participants in the lowest quartile of omega-3 PUFA levels (Q1) and those in the three upper quartiles (Q2-Q4) was not different at baseline; only those in Q1 were slightly older. In an unadjusted model, the difference in gait speed after 3 years of follow-up was significant (− 0.09 ± 0.03 m/s; p = 0.008) between participants in Q1 and those in Q2-Q4. In a model adjusted for age, gender, educational level, cognitive function, depressive status, body mass index, physical activity, grip strength, and their time interaction, this difference remained clinically relevant (− 0.07 ± 0.04 m/s; p = 0.075). No difference between the two groups was found for the SPPB score development over 3 years. Older adults with subjective memory complaints and in the lower quartile of omega-3 have a faster decline on gait speed compared to people in the three upper quartiles. Other longitudinal studies are needed to explore this association and to examine mechanisms.

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Section: Discussionmentioning

confidence: 79%

RETRACTED ARTICLE: Omega-3 fatty acid levels in red blood cell membranes and physical decline over 3 years: longitudinal data from the MAPT study

et al. 2017

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“…Previous studies reported clinically meaningful changes in walking speed in community-dwelling older adults for the 4-m walking test of 0.12 m/s (Perera et al 2006). More in general, small and substantial clinically meaningful changes in walking speed were reported from 0.05 to 0.10 m/s, respectively (Bohannon and Glenney 2014;Perera et al 2006). In this study, we found differences in walking speeds of 0.11 m/s for the 10-m compared to the 4-m walking test and 0.06 m/s for the 10-m compared to the 6-min walking test.…”

Section: Discussionmentioning

confidence: 96%

Walking speed in elderly outpatients depends on the assessment method

Pasma

Stijntjes

et al. 2014

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Walking speed is shown to be an important indicator of the health status and function in older adults and part of the comprehensive geriatric assessment in clinical practice. The present study aimed to assess the influence of different assessment methods on walking speed and its association with the key aspects of poor health status, i.e., the presence of low cognitive performance and cardiopulmonary disease. In 288 community-dwelling elderly (mean age 82.2±7.1 years) referred to a geriatric outpatient clinic, walking speed was assessed with the 4-m, 10-m, and 6-min walking tests. The mean walking speed assessed with the 10-m walking test was higher compared to the 4-m and 6-min walking tests (mean difference (95 % CI) 0.11 m/s (0.10; 0.13) and 0.08 m/s (0.04; 0.13), respectively). No significant difference was found in the walking speed assessed with the 4-m compared to the 6-min walking test (mean difference (95 % CI) −0.03 m/s (−0.08; 0.03)). ICCs showed excellent agreement of the 4-m with the 10-m walking test and fair to good agreement of the 6-min with the 4-m as well as 10-m walking test. The presence of low cognitive performance was negatively associated with walking speed, with the highest effect size for the 4-m walking test. The presence of cardiopulmonary disease was negatively associated with walking speed as well, with the highest effect size for the 6-min walking test. In conclusion, in the clinically relevant population of elderly outpatients, walking speed and its interpretation depends on the assessment method, which therefore cannot be used interchangeably in clinical practice.

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“…Although the differences in physical performance measures between weight status groups were modest, they are at levels demonstrated to be clinically meaningful. 33,34 Perera et al 33 demonstrated that a change of 0.5 points on the original SPPB (range of 0-12 20 ) represents a small meaningful change, while a change of 1.0 points represents a substantial meaningful change. This would be equivalent to approximately a difference of 0.16 and 0.33 points, respectively, on the Health ABC SPPB.…”

Section: Discussionmentioning

confidence: 99%

The association between weight history and physical performance in the Health, Aging and Body Composition study

et al. 2007

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Objective: Although the association between current obesity and physical disability is well known, the cumulative effect of obesity is unknown. Using data from the Health, Aging and Body Composition study, we examined the association between weight history in young and middle adulthood and weight status in late adulthood with physical performance in late adulthood. Design: Longitudinal cohort study. Subjects: White and black men and women aged 70-79 years at study baseline (n ¼ 2803). Measures: Body mass index (BMI; kg/m 2 ) was calculated using recalled height at age 25 and weight at age 25 and 50 and measured height and weight at ages 70-79. Physical performance at ages 70-79 was assessed using a short physical performance battery (SPPB) and a 400-m walk test. Results: In this well-functioning cohort, approximately 24% of men and 8% of women reported being overweight or obese (BMI X25 kg/m 2 ) at age 25, 51% of men and 37% of women reported being overweight or obese at age 50, and 69% of men and 66% of women were overweight or obese at ages 70-79. Men and women who were obese (BMI X30 kg/m 2 ) at ages 25, 50 and 70-79 had significantly worse SPPB scores and 400-m walk times than those who were normal weight. Women who were overweight (BMI 25-29.9 kg/m 2 ) at ages 25, 50 and 70-79 also had significantly worse physical performance. Furthermore, men and women who had a history of being overweight or obese at ages 25 or 50 had worse physical performance compared to those who were normal weight throughout or who were overweight or obese at ages 70-79 but not in midlife or earlier.Conclusions: Maintaining a healthy body weight throughout adulthood may play a role in preventing or delaying the onset of physical disability.

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Meaningful Change and Responsiveness in Common Physical Performance Measures in Older Adults

Cited by 1,989 publications

References 28 publications

RETRACTED ARTICLE: Omega-3 fatty acid levels in red blood cell membranes and physical decline over 3 years: longitudinal data from the MAPT study

RETRACTED ARTICLE: Omega-3 fatty acid levels in red blood cell membranes and physical decline over 3 years: longitudinal data from the MAPT study

Walking speed in elderly outpatients depends on the assessment method

The association between weight history and physical performance in the Health, Aging and Body Composition study

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