Role of physical performance measures for identifying functional disability among Chinese older adults: Data from the China Health and Retirement Longitudinal Study

Abstract

Background Functional disability is a common health burden in older adults and follows a hierarchical pattern. Physical performance measures are useful for the objective estimation of functional disability. This study primarily aimed to compare the validity of handgrip strength and gait speed, alone and in combination, for recognizing the functional disability among Chinese older adults. This study also aimed to stratify the functional disability according to the criterion-referenced values of handgrip strength and gait speed. Methods We selected 6127 respondents from the 2011 wave of the China Health and Retirement Longitudinal Study. Here, we defined functional disability as needing any help in any items of activities of daily living (ADL) and instrumental activities of daily living (IADL). To assess the validity of physical performance measures alone and in combination for the recognition of functional disability, we conducted the receiver operating characteristic analysis. Results Compared with handgrip strength, the gait speed could better discriminate ADL disability and showed a satisfactory discriminant validity (area under the curve ≥ 0.7) in men. However, this finding was not found in the recognition of IADL disability. When combining these two measures, the parallel test showed a high sensitivity with a poor specificity, whereas the serial test showed a perfect specificity with a poor sensitivity. Conclusion We developed the hierarchical cut-off values of handgrip strength and gait speed for identifying and stratifying the functional disability among Chinese adults over 60 years old. The speed test was superior to handgrip strength in identifying ADL disability. The parallel tests of those with high sensitivity perhaps could help identify the functional disability. Further work on cost-utility analysis is warranted.

Sarcopenia prevalence and associated factors among older Chinese population: Findings from the China Health and Retirement Longitudinal Study

“…CHARLS used multistep probability sampling strategy, selecting 150 representative counties and 450 villages/urban communities from 28 provinces. The detailed methodology description and core questionnaire of the CHARLS have been described in previous studies [ 9 – 11 ]. The national baseline survey for the CHARLS began in 2011, and the respondents were followed every two years by using a face-to-face computer-assisted personal interview.…”

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Development of a model for predicting the 4-year risk of symptomatic knee osteoarthritis in China: a longitudinal cohort study

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“…Likewise, another longitudinal study of 2270 Mexican Americans aged at least 65 years found that those who were considered weak had a 1.25 higher hazard (p < 0.0001) for incident BADL disability compared to persons who were not weak and did not have diabetes over a 19-year study period. 71 Zhang et al 72 examined the association between weakness and BADL disability in 6127 Chinese adults aged at least 45 years and found that those who were considered weak had 2.26 greater odds (p < 0.001) for BADL disability compared to those who were not weak. McGrath et al 73 investigated the association between HGS and individual BADLs in 17,747 Americans aged at least 50 years during an 8-year study period and found every 5-kg decrease in HGS was associated with a 1.20 higher hazard for an eating limitation, 1.14 higher hazard for a walking limitation, 1.14 higher hazard for a bathing limitation, 1.09 higher hazard for a dressing limitation, 1.08 higher hazard for a transferring limitation, and 1.06 higher hazard for a toileting limitation (p < 0.05 for all).…”