Short physical performance battery as a predictor of mortality in community-dwelling older adults: a longitudinal study in the Brazilian Amazon region

Abstract

Background The Short Physical Performance Battery (SPPB) is an instrument for assessing physical performance widely used in research among the elderly in multiple settings. We did not find Brazilian longitudinal studies that aimed to analyze the predictive capacity and accuracy of the SPPB among community-dwelling older adults and no systematic reviews were found on the accuracy of the SPPB in predicting mortality in community- dwelling older adults. This study aimed to analyze the capacity and accuracy of the SPPB for predicting mortality in community-dwelling older adults, as well as to determine cut-off points for men and women. Method Longitudinal observational study conducted with 411 (70.1 ± 7.25 years) community-dwelling older adults, between 2017 and 2020 (37.7 ± 6.24 months). Physical performance was evaluated using the SPPB and information on the all-cause mortality rate was also recorded. Multivariate Cox regression analyses and curves were performed using the Kaplan–Meier method. Receiver Operating Characteristic (ROC) curves were constructed, with the parameters of area under the ROC curve (AUC) to determine cutoff points for discriminating mortality, considering a significance level of 5% (p < 0.05) and 95% confidence interval (CI) 95%. Results Older adults with very low and low physical performance in the SPPB, showed higher risks of mortality (HR = 9.67; 95% CI [1.20–77.65]; HR = 4.06; 95% CI [1.09–15.01]), respectively. In the subtest’s analysis, older adults with low performance in the balance (HR = 0.54; 95% CI [0.36–0.81]) and gait speed tests (HR = 0.50; 95% CI [0.33–0.76]) showed greater risks of dying. The same was reproduced for categories in each test (participants that scored 2 points in the balance test had an HR = 5.86; 95% CI [1.84–18.61] and 2 points in the gait speed test, HR = 5.07; 95% CI [1.76–14.58]. The cutoff point ≤ 9 in the SPPB set the discriminator criterion for mortality in older people of both sexes. Conclusions The SPPB, as well as the balance and gait speed subtests were predictors of mortality, and the SPPB is accurate in predicting mortality among community-dwelling older adults.

Performance in a Balance Test and Prediction of All-Cause Mortality in Community-Dwelling Elderly Ambulatory Individuals: A Systematic Review and Meta-analysis

“…A total of 11,713 articles were screened, and finally, 15 (Araujo, et al, 2022; Blain et al, 2010; Cao et al, 2021; Cesari et al, 2008; Cesari et al, 2009; Idland et al, 2013; Keevil et al, 2018; Ma et al, 2018; Molari et al, 2021; Nofuji et al, 2016; Panas et al, 2013; Rolland et al, 2006; Silva et al, 2022; Takata et al, 2007; Takata et al, 2012) were included in the analysis (15 for qualitative analysis and 14 for quantitative analysis) (Figure 1). Table 1 provides a detailed enumeration of the characteristics of the individual studies that were included for evidence synthesis.…”

“…(b) Forest plot showing the pooled HR of the association between an inability to perform a balance test and mortality including studies that reported unadjusted HRs. For the Silva et al, 2022 study, the upper boundary of the 95% confidence interval of HR was approximated to the nearest decimal.

Figure 3.(a) Contour-enhanced funnel plot indicating the presence of publication bias including studies reporting adjusted HRs. (b) Bubble plot including studies reporting adjusted HRs showed that the association with mortality was correlated with progressive age.

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“…(b) Forest plot showing the pooled HR of the association between an inability to perform a balance test and mortality including studies that reported unadjusted HRs. For the Silva et al, 2022 study, the upper boundary of the 95% confidence interval of HR was approximated to the nearest decimal.…”

Implementing regular physical activity for older individuals in the family strategy program using the RE-AIM framework to ensure feasibility and sustainability: EISI study protocol

“…The total SPPB score will be the sum of the scores from all three tests, ranging from 0 to 12. Participants will be classified as having poor (0–3), low (4–6), moderate (7–9), or good (10–12) physical capacity based on their total score [ 48 ].…”

Physical performance and muscle strength rather than muscle mass are predictor of all-cause mortality in hemodialysis patients

“…The SPPB consists of three sequential tests that assess semi-tandem and tandem balance test, gait speed, and 5-sit-to-stand test. The total score ranges from 0 to 12 points, and 12 showing the best physical function performance to 0 showing inability to do the tests (26). All these physical performance tests were performed before a dialysis session.…”