Physical Performance Predictor Measures in Older Adults With Falls-Related Emergency Department Visits.

dc.contributor.author

Pua, Yong-Hao

dc.contributor.author

Matchar, David B

dc.date.accessioned

2021-05-05T06:26:22Z

dc.date.available

2021-05-05T06:26:22Z

dc.date.issued

2019-06

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2021-05-05T06:26:22Z

dc.description.abstract

OBJECTIVES:Identifying strong predictors for falls and mobility limitations in older adults with a falls-related emergency department visit is crucial. This study aimed to compare, in this clinical population, the incremental predictive value of the Short Physical Performance Battery (SPPB) component tests for incident falls, injurious falls, and mobility limitations. DESIGN AND MEASURES:Prospective cohort study. SETTING AND PARTICIPANTS:A total of 323 community-dwelling older adults with a falls-related emergency department visit participated. Baseline physical performance was measured by the SPPB standing balance test, sit-to-stand test, and habitual gait speed test. Six-month prospective fall rate and self-reported mobility limitations at 6 months post baseline assessment were also measured. An injurious fall was defined as a fall for which the participant sought medical attention or that restricted his or her daily activities for at least 48 hours. RESULTS:In multivariable proportional odds analyses adjusted for demographics and clinical covariates, higher levels of full-tandem balance and sit-to-stand performance were significantly associated with fewer incident falls (P = .04 and .02, respectively) and lower odds of mobility limitations (P = .05 and .03, respectively) and marginally associated with lower odds of injurious falls (P = .06 and .07, respectively). Habitual gait speed was the weakest predictor of falls but the strongest predictor (odds ratio 0.24, 95% confidence interval 0.08-0.70; P < .001) of mobility limitations. CONCLUSIONS/IMPLICATIONS:In high-fall-risk older adults, the SPPB balance and sit-to-stand tests predicted falls whereas the SPPB gait speed test was adept at predicting mobility limitations. No one test is best across all situations, so the choice of test will depend on the goal of the assessment.

dc.identifier

S1525-8610(18)30712-6

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1525-8610

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1538-9375

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https://hdl.handle.net/10161/22782

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eng

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Elsevier BV

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Journal of the American Medical Directors Association

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10.1016/j.jamda.2018.12.005

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Humans

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Gait

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Geriatric Assessment

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Risk Assessment

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Prospective Studies

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Accidental Falls

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Forecasting

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Aged

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Aged, 80 and over

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Emergency Service, Hospital

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Female

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Male

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Mobility Limitation

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Independent Living

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Physical Functional Performance

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Physical Performance Predictor Measures in Older Adults With Falls-Related Emergency Department Visits.

dc.type

Journal article

duke.contributor.orcid

Matchar, David B|0000-0003-3020-2108

pubs.begin-page

780

pubs.end-page

784

pubs.issue

6

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School of Medicine

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Duke Clinical Research Institute

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Duke Global Health Institute

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Pathology

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Medicine, General Internal Medicine

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Duke

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Institutes and Centers

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University Institutes and Centers

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Institutes and Provost's Academic Units

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Clinical Science Departments

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Medicine

pubs.publication-status

Published

pubs.volume

20

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