Citation

O'Hoski S, Bean JF, Ma J, So HY, Kuspinar A, Richardson J, Wald J, Beauchamp MK. Arch. Phys. Med. Rehabil. 2019; ePub(ePub): ePub.

Affiliation

School of Rehabilitation Science, McMaster University, Hamilton, ON. Electronic address: beaucm1@mcmaster.ca.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.apmr.2019.11.013

PMID

31891711

Abstract

OBJECTIVE: To explore the predictive ability of the short physical performance battery (SPPB), Late Life Function and Disability Instrument-Function component (LLFDI-function) and frailty phenotype, for falls, hospitalizations, emergency room (ER) visits and low self-rated health (SRH) over 1 and 2 years in older adults.

DESIGN: Secondary analysis of data from a longitudinal study, the Boston Rehabilitative Impairment Study of the Elderly. SETTING: Primary care. PARTICIPANTS: 391 adults ≥65 years old at risk for disability who completed ≥1 follow-up call. INTERVENTIONS: None. MAIN OUTCOME MEASURES: We computed separate logistic regression models using the SPPB, LLFDI-function and frailty phenotype as independent variables, and falls, hospitalizations, ER visits and SRH over 1 and 2 years as dependent variables. Receiver operating characteristic (ROC) curves were constructed and the areas under the curves (AUCs) calculated.

RESULTS: Participants had a mean age of 76.5 (7.1) years. The SPPB, LLFDI-function and frailty phenotype all predicted hospitalizations and low SRH over a 1- and 2-year timeframe (OR min-max 1.35-1.51 and 1.67-3.07, respectively). Over 2 years, the SPPB predicted ER visits (OR 1.28) and the LLFDI-function predicted falls (OR 1.31). The LLFDI-function predicted low SRH better than the frailty phenotype over 1 year. There were no differences between the measures for any of the other outcomes.

CONCLUSION: The SPPB, LLFDI-function and frailty phenotype had similar accuracy for predicting falls, hospitalizations, ER visits and low SRH over 1 and 2 years among older primary care patients at risk for disability. As a result, when considering the optimal screening tool for older adults, the choice between a measure of function and frailty may ultimately depend on clinical preference and context.

Copyright © 2019. Published by Elsevier Inc.

Language: en

Keywords

elderly; falls; frailty; hospitalization; primary care