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Background: Walking activity has been associated with reduction in the development of chronic disease, cognitive and physical function impairment, disability, and mortality. The objective of this study was to examine the relationship between walking activity and physical function over 9 years of follow-up among Mexican Americans aged 78 years and older. Methods: Participants (N = 998) were from the Hispanic Established Population for the Epidemiologic Study of the Elderly (2007–2016). Measures included walking activity duration and frequency, socio-demographics, body mass index, medical conditions, pain, depressive symptoms, limitation in activities of daily living, and the Mini-Mental State Examination. Low physical function was defined as scoring <7 on the Short Physical Performance Battery. At baseline, participants were grouped into nonwalkers (n = 653), walked <150 minutes/week (n = 144), and walked 150 minutes/week or more (n = 201). A Generalized Estimating Equation model was used to estimate the odds ratio and 95% CI of low physical performance as a function of walking activity status. Results: Compared with nonwalkers, participants walking < 150 minutes/week had lower odds (odds ratio = 0.66, 95% CI, 0.51–0.86) of low physical function over time, after controlling for all covariates, as did those walking ≥ 150 minutes/week (odds ratio = 0.54, 95% CI, 0.41–0.71). Conclusions: Mexican American older adults who engage in any walking activity are at reduced risk of low physical function, even those with disability. Interventions at the individual and community level are recommended to reduce physical function impairment, even in those with preexisting medical conditions or disability. [ABSTRACT FROM AUTHOR]

Purpose: Metformin (MTF) shows promise in protecting against physical decline in osteoarthritis (OA), but how it works remains unclear. We studied MTF's effects on gut permeability and its link to physical performance in OA patients. Methods: We studied four groups: control (n = 72), OA non-diabetic (n = 58), OA diabetic on MTF (n = 55), and OA diabetic on other anti-diabetics (n = 57). We measured zonulin levels, as intestinal permeability marker, hand-grip strength (HGS), Oxford knee scoring (OKS) to determine OA severity, and short performance physical battery (SPPB) to determine physical functions. Results: Patients suffering from OA showed a reduction in HGS and SPPB scores with raised plasma zonulin than controls, irrespective of disease severity. MTF decreased plasma zonulin levels and improved OKS, gait speed, HGS, and SPPB scores in OA patients. However, OA patients taking other anti-diabetic medications demonstrated higher levels of plasma zonulin, reduced HGS, and SPPB scores. Furthermore, a robust correlation of plasma zonulin and HGS, OKS, gait speed, and SPPB scores in OA patients on MTF was observed. Moreover, we found reduced oxidative stress and inflammation associated with these alterations in OA patients treated with MTF. Conclusion: MTF improves HGS and physical performance by lowering zonulin levels, preserving gut permeability in OA patients. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the longitudinal association of sleep with physical performance in a representative sample of non-institutionalised older adults residing in the municipality of São Paulo, Brazil. Prospective cohort study. The current longitudinal study used data extracted from the Health, Well-being, and Aging Study (Estudo Saúde Bem-Estar e Envelhecimento [SABE]). The study population consisted of individuals aged ≥60 years who participated in the study in 2010 or 2015. Dependent variables included the Short Physical Performance Battery (SPPB) and gait speed. Independent variables of interest were self-reported sleep difficulty, daytime sleepiness and sleep quality. The longitudinal association between sleep variables and the outcomes was evaluated using Generalised Estimating Equations (GEE) Models adjusted for covariates. All the variables, except age, sex and schooling, were assessed at baseline and follow-up visits (2010 and 2015). The analyses included 2205 observations from 1559 individuals. The population mean age was 72 years in 2010 and 71 years in 2015, with a higher prevalence of women in both years. Between 2010 and 2015, there was a decline in the SPPB score and gait speed. Daytime sleepiness was negatively associated with the SPPB score [Coef.: −0.38 (95% confidence interval {CI}: −0.56, −0.21)] and gait speed [Coef.: −0.03 (95% CI: −0.05, −0.01)]. Poor sleep quality was negatively associated with the SPPB score [Coef.: −0.29 (95% CI: −0.57, −0.01)] and gait speed [Coef.: −0.03 (95% CI: −0.06, −0.00)]. Daytime sleepiness and poor sleep quality are associated with compromised physical performance in non-institutionalised older adults, and this association remained consistent over time. [ABSTRACT FROM AUTHOR]

Background: Physical frailty (PF) is a syndrome of decreased physical function and reserves, preventing patients from coping with stressful events. PF screening tools in patients with liver cirrhosis (LC) can help evaluate the risk of complications and death. The aim of this study was to assess the performance of five screening tools in detecting PF and their ability to predict 18-month mortality in LC. Methods: The Short Physical Performance Battery (SPPB), Fried frailty phenotype (FFP), Clinical Frailty Scale (CFS) and 6-Minute Walk Test (6MWT) were compared with the Liver Frailty Index (LFI) as the method of reference. Patients with an LFI ≥ 4.5, SPPB ≤ 8, FFP ≥ 3, CFS ≥ 6 points, and those walking <250 m, were considered frail. Results: A total of 109 consecutive patients with stable LC were included [63.3% male, median age 62 years, (IQR 52–70), MELD 9 (7–14.5), 46.8% with decompensated LC (DC)]. PF was present in 23.9%, 27.5%, 41.3%, 13.8%, and 28.4% as assessed by the LFI, SPPB, FFP, CFS, and 6MWT, respectively. Cohen's kappa measurement of agreement of four of the tools with LFI was 0.568, 0.334, 0.439, and 0.502, respectively (p < 0.001 for each). Kaplan–Meier survival curves at 18 months showed higher mortality in frail patients compared to non-frail patients by any method (log rank p < 0.05). In the multivariate models, PF defined by any method emerged as an independent prognostic factor of 18-month mortality after adjustment for age, gender, and MELD-score. Conclusions: Patients characterized as frail by five screening tools were not identical. However, PF defined by either method was proven to be an independent poor prognostic factor for long-term mortality after adjustment for covariates. [ABSTRACT FROM AUTHOR]

Heart failure (HF) can cause metabolic imbalances, leading to anabolic resistance and increased energy expenditure, which often results in weight loss and cachexia. Comprehensive cardiac rehabilitation (CR), including exercise, nutritional support, and risk management, is crucial for enhancing the health and quality of life of patients with HF and is expected to play a central role in the prevention and treatment of HF-associated cachexia. However, the prevalence of cachexia in patients with HF undergoing comprehensive outpatient CR is currently unknown, and the detailed characteristics including of motor function of such patients remain undefined. Therefore, this cross-sectional study aimed to investigate the prevalence and characteristics of cachexia and the relationship between cachexia and lower limb motor function in patients with HF undergoing outpatient CR. This study included 115 consecutive patients with HF (43% male; mean age, 78 ± 8 years) who underwent comprehensive outpatient CR. The cachexia status was assessed according to the definition proposed by the Asian Working Group on Cachexia in 2023. The Short Physical Performance Battery (SPPB) and Mini Nutritional Assessment Short-Form (MNA-SF) were used to evaluate motor function of the lower limbs and nutritional status, respectively. Multivariate logistic regression analyses were used to examine the potential relationship between cachexia and low SPPB scores (≤ 9 points). The prevalence of cachexia was 30% in this study. Compared with those without cachexia, patients with cachexia were significantly older and showed notable reductions in body mass index, MNA-SF scores, handgrip strength, gait speed, and SPPB scores. A multivariate logistic regression analysis, adjusted for confounders, revealed that both age (odds ratio [OR], 1.129; 95% confidence interval [CI], 1.034–1.248; P = 0.016) and presence of cachexia (OR, 3.783; 95% CI, 1.213–11.796; P = 0.022) were independently associated with low SPPB scores. These findings highlight the importance of focusing on cachexia in patients with HF as part of a comprehensive outpatient CR and may be crucial in developing treatments to improve lower limb motor function in patients with HF who develops cachexia. [ABSTRACT FROM AUTHOR]

Alterations in the body's nutritional status or composition may be observed as the kidney disease advances, which could influence the kidney's functional capacity and, consequently, could increase the risk of mortality. The aim of the study is to determine the influence of functional capacity on mortality assessed by different functional tests in patients with advanced chronic kidney disease (ACKD). A prospective observational study was designed, which included 225 patients followed for 8 years in a CKD clinic. The study assessed functional capacity by using a range of tests, which included the Short Physical Performance Battery, the 6 minutes walking gait test, the timed up and go, and the four versions of the sit-to-stand test. Additionally, body composition and nutritional conditions were considered, taking into consideration various biochemical indicators such as albumin, prealbumin, c-reactive protein (CRP), lymphocytes, and transferrin, muscle strength, comorbidity, and frailty. The relationship between functionality and all-cause mortality was investigated using a Cox proportional hazard model. A total of fifty patients died during the duration of the study. Patients who performed worse on the function and muscle strength tests showed a worse body composition and nutritional status, and exhibited a reduced life expectancy. Inflammation (CRP) was associated with an increased risk of mortality (model 1: hazard ratio (HR) = 1.246; 95% confidence interval (95% CI = 1.014–1.531; model 2: HR = 1.333; 95% CI = 1.104–1.610). Good functional capacity as determined by the SPPB test decreased the risk of mortality (model 1: HR = 0.764; 95% CI = 0.683–0.855; model 2 HR = 0.778; 95% CI = 0.695–0.872). Cut-off points of maximum sensitivity and specificity for mortality were obtained with different tests. The study demonstrated that functional capacity influences mortality in patients with ACKD, being higher in those patients with impaired functionality regardless of the test used, although the SPPB allows a larger number of patients to be assessed. Therefore, it is essential to incorporate the assessment of functionality into the comprehensive care of patients with CKD. [ABSTRACT FROM AUTHOR]

Sarcopenia is related to disease severity in chronic kidney disease (CKD) patients; however, its pathophysiology remains poorly known. We investigated the associations of biomarkers of intestinal leak with sarcopenia in various stages of CKD. We recruited 61–76-year-old male controls and patients with various stages of CKD (n = 36–57/group) for measuring plasma lipopolysaccharide-binding protein (LBP) and zonulin (markers of intestinal leak), handgrip strength (HGS), skeletal mass index (SMI), and gait speed (markers of sarcopenia), and short physical performance battery (SPPB; marker of physical capacity). CKD stages 4 and 5 were associated with lower HGS, SMI, gait speed, and cumulative SPPB scores and a higher sarcopenia prevalence than controls and patients with CKD stages 1 and 2 (all p < 0.05). CKD patients (stages 1 and 2) had elevated plasma zonulin and LBP when compared with CKD stages 4 and 5. Plasma zonulin and LBP exhibited significant correlations with renal function, HGS, gait speed, SPPB scores, and oxidative stress markers in CKD stages 4 and 5 (all p < 0.05). However, similar relations were not found in early CKD. Collectively, intestinal leak may be contributing to sarcopenia and physical disability in the advanced stages of CKD. [ABSTRACT FROM AUTHOR]

Background The decline of physical function during chemotherapy predicts poor quality of life and premature death. It is unknown if resistance training prevents physical function decline during chemotherapy in colon cancer survivors. Methods This multicenter trial randomly assigned 181 colon cancer survivors receiving postoperative chemotherapy to home-based resistance training or usual care control. Physical function outcomes included the short physical performance battery, isometric handgrip strength, and the physical function subscale of the Medical Outcomes Short-Form 36-item questionnaire. Mixed models for repeated measures quantified estimated treatment differences. Results At baseline, participants had a mean (SD) age of 55.2 (12.8) years; 67 (37%) were 60 years or older, and 29 (16%) had a composite short physical performance battery score of no more than 9. Compared with usual care control, resistance training did not improve the composite short physical performance battery score (estimated treatment difference = −0.01, 95% confidence interval [CI] = −0.32 to 0.31; P  = .98) or the short physical performance battery scores for balance (estimated treatment difference = 0.01, 95% CI = −0.10 to 0.11; P  = .93), gait speed (estimated treatment difference = 0.08, 95% CI = −0.06 to 0.22; P  = .28), and sit-to-stand (estimated treatment difference = −0.08, 95% CI = −0.29 to 0.13; P  = .46). Compared with usual care control, resistance training did not improve isometric handgrip strength (estimated treatment difference = 1.50 kg, 95% CI = −1.06 to 4.05; P  = .25) or self-reported physical function (estimated treatment difference = −3.55, 95% CI = −10.03 to 2.94); P  = .28). The baseline short physical performance battery balance score (r  =   0.21, 95% CI = 0.07 to 0.35) and handgrip strength (r  =   0.23, 95% CI = 0.09 to 0.36) correlated with chemotherapy relative dose intensity. Conclusion Among colon cancer survivors with relatively high physical functioning, random assignment to home-based resistance training did not prevent physical function decline during chemotherapy. Clinical Trial Registration NCT03291951. [ABSTRACT FROM AUTHOR]

Key summary points: Aim: Our objective was to study the predictive value of the Short Physical Performance Battery (SPPB) in the cohort of the SCOPE project on falls, injurious falls, and possible difference of prediction between indoors and outdoors falls. Findings: No association of SPPB and falls was found in models adjusted for age, sex, marital status, number of medications, quality of life, handgrip strength, and muscle mass. While SPPB fails to differentiate between injurious and non-injurious falls (p = 0.48), a lower SPPB score was associated with falls at home (p < 0.01) after 24 months. Message: SBPP was not able to significantly predict the risk of falling as well as experiencing an injurious fall. Introduction: Falls and fall-related injuries in older persons are a major public health problem. Our objective was to study the predictive value of the Short Physical Performance Battery (SPPB) in the cohort of the SCOPE project on falls, injurious falls, and possible difference of prediction between indoors and outdoors falls. Methods: For this sub-study of the SCOPE project participants reporting no falls at baseline, and survey data on falls at the 12-month and 24-month follow-up were included. Participant´s characteristics were assessed during the baseline interview and medical examinations. Falls as well as injurious falls and fall circumstances were obtained self-reported. SPPB and its association with fallers vs. no fallers at 12 and at 24 months were studied with logistic regression models. Results: The 1198 participants had a median age of 79 years (77–82), and a median SPPB of 10 (8–11), with a 52.5% of female. A total of 227 and 277 falls (12- and 24- month visits, respectively) were reported. In the crude model, the SPPB sum scores (p < 0.001) as well as most single item scores were significant different between fallers and non-fallers over time. However, the association was attenuated in models adjusted for age, sex, marital status, number of medications, quality of life, handgrip strength, and muscle mass [e.g., 12 months; OR 0.94 (0.87–1.02)]. While SPPB fails to differentiate between injurious and non-injurious falls (p = 0.48), a lower SPPB score was associated with falls at home (p < 0.01) after 24 months. Conclusion: SBPP was not able to significantly predict the risk of falling as well as experiencing an injurious fall. Trial registration: This study was registered prospectively on 25th February 2016 at clinicaltrials.gov (NCT02691546). [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess the feasibility of implementing both electronic and in-person assessments to assess falls risk in an older adult secondary fracture clinic. Electronic data capture feasibility was defined as the proportion of patients that completed the electronic questionnaires prior to their clinic visit. In-clinic feasibility was defined in two ways: (1) the proportion of patients that consented to participate at their clinic visit; (2) time to complete testing. Patients were contacted electronically through their health system portal for electronic consent. Patients were invited to complete consent, the STopping Elderly Accidents, Deaths, and Injuries (STEADI) falls risk assessment tool, and the visual analog scale (VAS) for pain. The Short Physical Performance Battery (SPPB) was performed at the clinic visit. A total of 310 patients were contacted electronically. No patients (0%) provided consent through their health portal. Of the 310 patients, 200 (65%) consented in person (Ineligible: 67 [21%]; Declined: 43 [14%]), resulting in an 82% response rate. In-person data collection took a median of 38.48 (Range: 12.34–54.30) minutes to complete. It was not feasible to contact and collect older adult patient data electronically prior to clinic; but, was feasible to obtain these patient-reported outcomes and physical performance data in person. [ABSTRACT FROM AUTHOR]

Background: Prognostic risk stratification in older adults with type 2 diabetes (T2D) is important for guiding decisions concerning advance care planning. Materials and methods: A retrospective longitudinal study was conducted in a real-world sample of older diabetic patients afferent to the outpatient facilities of the Diabetology Unit of the IRCCS INRCA Hospital of Ancona (Italy). A total of 1,001 T2D patients aged more than 70 years were consecutively evaluated by a multidimensional geriatric assessment, including physical performance evaluated using the Short Physical Performance Battery (SPPB). The mortality was assessed during a 5-year follow-up. We used the automatic machinelearning (AutoML) JADBio platform to identify parsimonious mathematical models for risk stratification. Results: Of 977 subjects included in the T2D cohort, the mean age was 76.5 (SD: 4.5) years and 454 (46.5%) were men. The mean follow-up time was 53.3 (SD:15.8) months, and 209 (21.4%) patients died by the end of the follow-up. The JADBio AutoML final model included age, sex, SPPB, chronic kidney disease, myocardial ischemia, peripheral artery disease, neuropathy, and myocardial infarction. The bootstrap-corrected concordance index (c-index) for the final model was 0.726 (95% CI: 0.687--0.763) with SPPB ranked as the most important predictor. Based on the penalized Cox regression model, the risk of death per unit of time for a subject with an SPPB score lower than five points was 3.35 times that for a subject with a score higher than eight points (P-value <0.001). Conclusion: Assessment of physical performance needs to be implemented in clinical practice for risk stratification of T2D older patients. [ABSTRACT FROM AUTHOR]

• This study provides information regarding the test-retest reliability of the SPPB in older adults with mild cognitive impairment. • The test-retest reliability for the SPPB score is sufficient (> 0.7) for group-comparisons. • The test-retest reliability for the subscale performance are acceptable (> 0.9) for individual-level measurements over time. • The MDC values provide clinicians and researchers with the thresholds for determining real improvement (beyond random measurement error). Reliability of the Short Physical Performance Battery (SPPB) are rarely examined among older adults with mild cognitive impairment (MCI). This study aimed to investigate the test-retest reliability and minimal detectable change (MDC) of the SPPB in older adults with MCI. Participants included 100 older adults with MCI. The SPPB was assessed with the first 2 assessments separated by a 20-min interval and the third separated by a 1-week interval. The intraclass correlation coefficient (ICC) and MDC values were estimated. The intraday ICC was 0.73 for the SPPB score, 0.90 for the 4-m walk time (4mwt), and 0.95 for the 5-times chair stand time (5cst); the corresponding interday ICC values were 0.76, 0.89, and 0.91, respectively. The MDC values ranged from 1.1 to 1.2 for the SPPB score, from 0.77 to 0.80 s for the 4mwt, and from 1.32 to 1.77 for the 5cst. The SPPB had satisfactory reliability among older adults with MCI. The test-retest reliability of the SPPB is sufficient (>0.7) for group comparisons. Moreover, the test-retest reliability for the 4mwt and 5cst subscale performances is acceptable (> 0.9) for individual-level measurements over time. [ABSTRACT FROM AUTHOR]

BackgroundObjectiveMethodsResultsConclusionClinical Trial NumberPractical, applicable, valid, and reliable tools are needed to assess physical performance in patients with Total Knee Arthroplasty (TKA) in a variety of settings, including routine clinical assessment, research studies, and community-based programs.The aim of this study is to evaluate the validity and reliability of the Short Physical Performance Battery (SPPB) among patients with TKA.We included 45 patients who underwent TKA surgery (mean age 68.89 ± 9.26). The SPPB, Timed up and go (TUG) test and, Hospital for Special Surgery (HSS) Knee Score were administered to the patients. SPPB was performed twice on the same day with 1 h rest.The ICC(2,1) coefficient, MDC95 and SEM values were 0.97, 1.02 and 0.37 respectively. The Pearson correlation coefficient of the SPPB with the TUG and HSS was −.78, and 0.74 respectively.SPPB has excellent reliability, and strong validity in assessing physical performance in patients with TKA. SPPB can identify even minimal detectable difference in physical performance and can be reliably used to monitor patient outcomes in the postoperative period for a comprehensive assessment of TKA in many physical performance domains, including balance, walking speed, and lower extremity strength.NCT06201637 [ABSTRACT FROM AUTHOR]

Introduction: There are several tests that provide information about physical fitness and functionality in older adults. The aims of this study were: (i) to analyze the differences between sex and age in functional, strength and cardiorespiratory tests; and (ii) to study the correlations between functional, strength and cardiorespiratory tests according to sex and age. Methods: A total of 171 older adults (72.09 ± 13.27 kg; 1.59 ± 0.09m; 72.72 ± 6.05 years) were divided according to sex (men: n = 63; women: n = 108) and age (≥60 <70: n=65; ≥70 <80: n=89; ≥80: n = 18). Anthropometry, body composition, upper limb strength (hand grip; HG), lower limb strength (countermovement jump; CMJ), cardiorespiratory capacity (6min walking test; 6MWT), timed up and go test (TUG) and Short Physical Performance Battery (SPPB) were assessed. Results: Men showed higher values in CMJ height, HG and expired volume (VE) (p < 0.05). There were no significant differences between sexes in TUG and SPPB. Regarding age, there were significant differences in CMJ, VE and peak oxygen uptake (VO2peak), TUG, gait speed, chair and stand test and SPPB total (p < 0.05). The test times were higher in older people. Regarding correlations, the TUG showed significant correlations in all strength and cardiorespiratory tests, regardless of sex and age. The CMJ correlated more significantly with functional tests compared to HG. Discussion: There were sex and age differences in functional, strength, and cardiorespiratory tests. The execution of quick and low-cost tests such as the CMJ and TUG could provide information on overall physical fitness in older adults. [ABSTRACT FROM AUTHOR]

Background This study aimed to investigate the factors associated with reduced short physical performance battery (SPPB) scores in patients with advanced or recurrent solid tumors. Materials and Methods This cross-sectional observational study was conducted at the Kansai Electric Power Hospital. We recruited patients who had received chemotherapy or radiotherapy. At the start of rehabilitation, we evaluated lower limb muscle strength (motricity index), physical function (SPPB), physical activity (International Physical Activity Questionnaire), symptoms (Edmonton Symptom Assessment System Revised Japanese version), and the modified Glasgow prognostic score (mGPS). Univariate logistic regression analysis was performed to investigate the factors associated with reduced SPPB scores, and multivariate logistic regression analysis was performed for items with significant differences. Results Seventy-one patients were included in this study. Univariate logistic regression analysis revealed that age, history of surgery, history of chemotherapy, physical activity, muscle strength, pain, lack of appetite, and mGPS were factors associated with reduced SPPB scores. A history of surgery, physical activity, and muscle strength were independent factors associated with reduced SPPB scores in the multivariate logistic regression analysis. Conclusions Muscle strength, physical activity, and history of surgery influence the decline in physical function. Even in advanced or recurrent cases, interventions that focus on physical activity and muscle strength are required.

Abstract Aims Iron deficiency (ID) is common in patients with heart failure (HF) and is reportedly associated with exercise intolerance and impaired quality of life. Iron supplementation therapy in HF patients with ID improves exercise capacity. Conversely, protective roles of iron depletion in the development of diabetes mellitus (DM) and its complications have been proposed. This study aimed to determine the impact of ID on physical function in HF patients with and without DM. Methods and results We enrolled consecutive patients who were admitted to our institute for HF diagnosis and management. The short physical performance battery (SPPB) was used to evaluate physical function, and low physical function was defined as an SPPB score of

Sarcopenia is characterized by skeletal muscle quantitative and qualitative alterations. A marker of collagen turnover, procollagen type III N-terminal peptide (P3NP), seems to be related to those conditions. This study aims to assess the predictive role of P3NP in muscle density and physical performance changes. In the InCHIANTI study, a representative sample from the registry lists of two towns in Tuscany, Italy, was recruited. Baseline data was collected in 1998, and follow-up visits were conducted every 3 years. Out of the 1453 participants enrolled at baseline, this study includes 1052 participants. According to P3NP median levels, population was clustered in two groups; 544 (51.7%) of the 1052 subjects included were classified in the low median levels (LM-P3NP); at the baseline, they were younger, had higher muscle density, and performed better at the Short Physical Performance Battery (SPPB), compared to the high-median group (HM-P3NP). LM-P3NP cases showed a lower risk to develop liver chronic diseases, CHF, myocardial infarction, and osteoarthritis. HM-P3NP levels were associated with a longitudinal reduction of muscle density, and this effect was potentiated by the interaction between P3NP and leptin. Moreover, variation in physical performance was inversely associated with high level of P3NP, and directly associated with high fat mass, and with the interaction between P3NP and muscle density. Our data indicate that P3NP is associated with the aging process, affecting body composition, physical performance, and clinical manifestations of chronic degenerative age-related diseases. [ABSTRACT FROM AUTHOR]

Aims: Iron deficiency (ID) is common in patients with heart failure (HF) and is reportedly associated with exercise intolerance and impaired quality of life. Iron supplementation therapy in HF patients with ID improves exercise capacity. Conversely, protective roles of iron depletion in the development of diabetes mellitus (DM) and its complications have been proposed. This study aimed to determine the impact of ID on physical function in HF patients with and without DM. Methods and results: We enrolled consecutive patients who were admitted to our institute for HF diagnosis and management. The short physical performance battery (SPPB) was used to evaluate physical function, and low physical function was defined as an SPPB score of <10 points as individuals with SPPB scores of <10 points are most likely to be classified as frail and are at high risk for disability and future adverse events, including death. ID was defined as serum ferritin < 100 or 100–299 ng/mL when transferrin saturation (TSAT) was <20% according to the HF guidelines. Among the 562 HF patients (72 ± 14 years old; 56% male), 329 patients (58%) and 191 patients (34%) had ID and low physical function, respectively. Multivariate logistic regression analysis showed that TSAT as a continuous variable, but not ID, was a predictor of low physical function (odds ratio: 0.980, P = 0.024). Subgroup analysis showed that a significant association between low TSAT and low physical function was lost in HF patients with DM (P for interaction < 0.001). A spline dose–response curve for the relationship between TSAT and risk of low physical function with adjustments for covariates associated with low physical function in non‐DM patients was almost linear with an increase in the risk of low physical function as the TSAT increased, but such a relationship was not found in the analyses of DM patients. A lack of close TSAT–SPPB relationship in HF patients with DM was confirmed also in a propensity‐score‐matched cohort. Conclusions: TSAT as a continuous variable, but not ID, was independently associated with physical function in HF patients, and a significant association was lost in patients with HF and DM, suggesting a limited impact of iron supplementation therapy in HF patients with DM. [ABSTRACT FROM AUTHOR]

The physical function of older patients with heart failure (HF) is likely to decline, and the Short Physical Performance Battery (SPPB) is widely used for its evaluation. No study has analyzed the SPPB by using Rasch model in these patients. The aim of this study was to examine the structural validity and item response of the SPPB in older inpatients with HF. In this multicenter cross-sectional study, we investigated 106 older inpatients with HF. We evaluated the SPPB's rating scale structure, unidimensionality, and measurement accuracy (0 = poor performance to 4 = normal performance). The SPPB rating scale fulfilled the category functioning criteria. All items fit the underlying scale construct. The SPPB demonstrated adequate reliability (person reliability = 0.81) and separated persons into four strata: those with very low, low, moderate, and high physical performance. Item-difficulty measures were −0.59 to 0.96 logits, and regarding the person ability-item difficulty matching for the SPPB, the item was somewhat easy (the mean of person ability = 0.89 logits; mean of item difficulty = 0.00). The SPPB has strong measurement properties and is an appropriate scale for quantitatively evaluating physical function in older patients with HF. For older adults with heart failure (HF), the Short Physical Performance Battery (SPPB) is often used to measure physical performance. Rasch analysis revealed that SPPB had strong measurement properties in older adults with HF. This result may help rehabilitation professionals use the SPPB as a physical performance scale in clinical practice to aid decision-making in intervention planning. [ABSTRACT FROM AUTHOR]

Background Type 2 diabetes mellitus (T2DM) and frailty are associated with functional decline in older population. Objective To explore the individual response to a multimodal intervention on functional performance. Design A cluster-randomised multicentre clinical trial. Setting Outpatients in hospital or primary care. Subjects 843 (77.83 years, 50.65% men) prefrail and frail individuals ≥70 years with T2DM. Methods Participants were allocated to usual care group (UCG) or a multicomponent intervention group (IG): 16-week progressive resistance training, seven nutritional and diabetological educational sessions and achievement of glycated haemoglobin (7–8%) and blood pressure (<150 mmHg) targets. Functional performance was assessed with the Short Physical Performance Battery (SPPB) at 1 year. We used multivariate binomial and multinomial logistic regression models to explore the effect of the IG, and adherence on the outcomes studied, in several adjusted models. Results 53.7% in the IG versus 38.0% in the UCG improved by at least 1 point in their SPPB score [OR (95% CI): 2.07 (1.43, 2.98), P value <0.001]. Age, SPPB score and number of frailty criteria met decreased the probability of improving the SPPB score. Factors associated with worsening were pertaining to IG (decreased), age, SPPB score and the number of frailty criteria (increased). An adherence ≥84% was needed to achieve benefits, reaching the peak in the probability of improving SPPB when this was ≥85% [OR(95%CI): 2.38 (1.29, 4.79), P value 0.014]. Conclusions Factors predicting the likelihood of improvement in a multimodal programme in pre-frail and frail older adults with diabetes are age, basal SPPB score, the number of frailty criteria and adherence. [ABSTRACT FROM AUTHOR]

Background Fragmentation of services increases health and social care burden as people live longer with higher prevalence of diseases, frailty and dependency. Local evidence for implementing person-centred integrated care is urgently needed to advance practice and policies to achieve healthy ageing. Objective To test the feasibility and impact of World Health Organization's (WHO) Integrated Care for Older People (ICOPE) approach in China. Design A randomised controlled trial examining the feasibility of implementing ICOPE approach, evaluating its impact on health outcomes and health resource utilisation. Setting Primary care setting in urban and suburban communities of Chaoyang District, Beijing, China. Subjects Community-dwelling older adults screened as at-risk of functional declines and randomised into intervention (537) and control (1611) groups between September 2020 and February 2021. Methods A 6-month intervention program following WHO's ICOPE care pathways implemented by integrated care managers compared to standard available care. Results After 1 to 1 propensity score matching, participants in intervention and control groups (totally 938) had comparable baseline characteristics, demonstrated feasibility of implementing ICOPE with satisfaction by participants (97–99%) and providers (92–93%). All outcomes showed improvements after a 6-month intervention, while statistically significant least-squares mean differences (control-intervention) in vitality (Mini-Nutritional Assessment Short Form to measure vitality, −0.21, 95% CI, −0.40–0.02), mobility (Short Physical Performance Battery to measure mobility, −0.29, 95% CI, −0.44–0.14) and psychological health (Geriatric Depression Scale five items to measure psychological health, 0.09, 95% CI, 0.03–0.14) were observed (P  < 0.05). Conclusions It is feasible to localise and implement WHO's ICOPE approach in regions with fragmented resources such as China. Preliminary evidence supports its acceptance among key stakeholders and impact on health outcomes. [ABSTRACT FROM AUTHOR]

Background: Maintaining physical performance in older age is critical. The Short Physical Performance Battery (SPPB) is one of many tools available to measure physical performance in older people. Purpose: Describe the psychometric properties of the SPPB. Methods: Using a systematic review methodology, quantitative studies addressing the validity, reliability, and sensitivity of the SPPB in populations 60 years or older were included. We searched 8 databases: MEDLINE, CINAHL, Cochrane, Ageline, Amed, Embase, Scopus, and Emcare, as well as gray literature. Two researchers independently screened, appraised, and extracted data from the literature, following which a descriptive synthesis was undertaken. Results: Twenty-eight studies with varying methodological quality were included. Floor and ceiling effects were reported in 4 studies, generally related to very high or very low functioning adults. Nineteen studies investigated validity with varying correlations between the SPPB and other physical performance assessment tools. Ten studies reported good to excellent reliability (intraclass correlation coefficient ranging 0.82-0.92). Minimum detectable change indicates low sensitivity (ranging 0.7-3.42). Discussion: Evidence from the literature indicates that the SPPB is a reliable and valid measure of physical performance in adults older than 60 years. However, the SPPB has a narrow scope and is most appropriate for frail older adults who can ambulate and are cognitively able to follow instructions. It has limited applicability for specific populations such as people with dementia who have difficulty following instructions. Targeted training for users may improve its usability and success in clinical practice. Conclusions: Clinicians should be mindful that while the SPPB has good validity and reliability, it has limited applicability for people with dementia and is not particularly sensitive to change. In practice, this means that it provides a good snapshot of a client's physical performance compared with the rest of the older population; it is less useful for tracking changes to physical performance over time. [ABSTRACT FROM AUTHOR]

Purpose: Pulmonary rehabilitation both before and after lung transplant is associatedwith improved functional exercise capacity and physical quality of life. There is wide variation in rehabilitation program provision. This study's aim was to compare the effects of group versus individual rehabilitation. Methods: Individuals who completed pre- and/or posttransplant outpatient rehabilitation at a single, academic, medical center between March 2019 and March 2021were included in this study. Noninferiority analysiswas used to assess differences in change in 6-minute walk distance (6MWD) between group and individual rehabilitation. Multivariable linear regression models examined 6MWD, Short Physical Performance Battery (SPPB), Ferrans and Powers Quality of Life Index Pulmonary Version (QLI), Center for Epidemiological Studies-Depression Scale (CESD), and San Diego Shortness of Breath Questionnaire (SOBQ). Results: Preoperatively, 93 patients completed group and 81 completed individual rehabilitation. Postoperatively, 110 completed group and 105 completed individual rehabilitation. Individual rehabilitationwas noninferior to group rehabilitation (α = 0.05). In addition, there was no significant difference in changes in 6MWD, SPPB, QLI, CESD, or SOBQ, between cohorts pre- and postoperatively (all P > 25). Conclusions: Individual rehabilitation seems to be an acceptable alternative to group rehabilitation for lung transplant candidates and recipients. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsConclusion\nIMPLICATIONS FOR REHABILITATIONTo assess the inter-reliability of the Short Physical Performance Battery (SPPB), the 1-min Sit to Stand test (1-MSTS), and the Chester Step Test (CST) via remote assessment in post-COVID-19 patients after hospitalization.Twenty-five post-COVID-19 patients randomly performed the functional tests via remote assessment using a software platform at home and via face-to-face assessment at the rehabilitation center 24–72 h apart. One day before the remote assessment, all participants had a 1-h guidance session regarding the platform use, safety instructions, and home equipment preparation.Participants completed all tests for both assessment procedures without experience of adverse events. The mean age was 53 (SD = 10) years old, and the median days of hospitalization were 23 (IQR = 10–33). The inter-reliability was moderate for the total score in the SPPB: Cohen’s kappa = 0.545 (95% CI: 0.234 to 0.838), excellent for the number of repetitions in the 1-MSTS: ICC = 0.977 (95% CI: 0.948 to 0.990) and good for the total number of steps in the CST: ICC = 0.871 (95% CI: 0.698 to 0.944).Remote functional assessments for SPPB, 1-MSTS, and CST indicated moderate to excellent inter-reliability in post-COVID-19 patients after hospitalization.Functional performance assessment in post-COVID-19 patients is considered important throughout the whole process of rehabilitation.The face-to-face assessment is the standard practice in the rehabilitation clinical setting however, new approaches by distance assessment are proposed when physical attendance is not feasible.The Short Physical Performance Battery (SPPB), the 1-minute Sit to Stand test (1-MSTS), and the Chester Step Test (CST) showed moderate to excellent reliability when performed remotely at home in post-COVID-19 patients after hospitalization.Functional performance assessment in post-COVID-19 patients is considered important throughout the whole process of rehabilitation.The face-to-face assessment is the standard practice in the rehabilitation clinical setting however, new approaches by distance assessment are proposed when physical attendance is not feasible.The Short Physical Performance Battery (SPPB), the 1-minute Sit to Stand test (1-MSTS), and the Chester Step Test (CST) showed moderate to excellent reliability when performed remotely at home in post-COVID-19 patients after hospitalization. [ABSTRACT FROM AUTHOR]

Background: In order to be used safely, accurately and reliably, measuring instruments in the health field must first be validated, for which the study of their psychometric properties is necessary. The Short Physical Performance Battery (SPPB) tool is a widely used clinical assessment test that has been approved for usage across several nations, languages and demographics. Finding SPPB's psychometric properties for a sample of institutionalized older individuals is the aim of this research. Methods: This is a multicenter, retrospective and observational study of the psychometric properties of the Short Physical Performance Battery tool with a convenience sample of 194 institutionalized older adults. Reliability (internal consistency) and validity (construct validity and convergent validity) tests were performed. Results: The results show a very good internal consistency, construct validity and convergent validity. In addition, the factorial structure of the SPPB is provided, which reflects that it is a unidimensional scale. Conclusions: In conclusion, the Short Physical Performance Battery is a valid and reliable tool for use with institutionalized older adults. Its use is recommended as part of the Comprehensive Geriatric Assessment for the evaluation of the physical or functional sphere. This study was not registered. [ABSTRACT FROM AUTHOR]

BackgroundPrognostic risk stratification in older adults with type 2 diabetes (T2D) is important for guiding decisions concerning advance care planning.Materials and methodsA retrospective longitudinal study was conducted in a real-world sample of older diabetic patients afferent to the outpatient facilities of the Diabetology Unit of the IRCCS INRCA Hospital of Ancona (Italy). A total of 1,001 T2D patients aged more than 70 years were consecutively evaluated by a multidimensional geriatric assessment, including physical performance evaluated using the Short Physical Performance Battery (SPPB). The mortality was assessed during a 5-year follow-up. We used the automatic machine-learning (AutoML) JADBio platform to identify parsimonious mathematical models for risk stratification.ResultsOf 977 subjects included in the T2D cohort, the mean age was 76.5 (SD: 4.5) years and 454 (46.5%) were men. The mean follow-up time was 53.3 (SD:15.8) months, and 209 (21.4%) patients died by the end of the follow-up. The JADBio AutoML final model included age, sex, SPPB, chronic kidney disease, myocardial ischemia, peripheral artery disease, neuropathy, and myocardial infarction. The bootstrap-corrected concordance index (c-index) for the final model was 0.726 (95% CI: 0.687–0.763) with SPPB ranked as the most important predictor. Based on the penalized Cox regression model, the risk of death per unit of time for a subject with an SPPB score lower than five points was 3.35 times that for a subject with a score higher than eight points (P-value

Introduction: There are several tests that provide information about physical fitness and functionality in older adults. The aims of this study were: (i) to analyze the differences between sex and age in functional, strength and cardiorespiratory tests; and (ii) to study the correlations between functional, strength and cardiorespiratory tests according to sex and age.Methods: A total of 171 older adults (72.09 ± 13.27 kg; 1.59 ± 0.09 m; 72.72 ± 6.05 years) were divided according to sex (men: n = 63; women: n = 108) and age (≥60

Background: In order to be used safely, accurately and reliably, measuring instruments in the health field must first be validated, for which the study of their psychometric properties is necessary. The Short Physical Performance Battery (SPPB) tool is a widely used clinical assessment test that has been approved for usage across several nations, languages and demographics. Finding SPPB’s psychometric properties for a sample of institutionalized older individuals is the aim of this research. Methods: This is a multicenter, retrospective and observational study of the psychometric properties of the Short Physical Performance Battery tool with a convenience sample of 194 institutionalized older adults. Reliability (internal consistency) and validity (construct validity and convergent validity) tests were performed. Results: The results show a very good internal consistency, construct validity and convergent validity. In addition, the factorial structure of the SPPB is provided, which reflects that it is a unidimensional scale. Conclusions: In conclusion, the Short Physical Performance Battery is a valid and reliable tool for use with institutionalized older adults. Its use is recommended as part of the Comprehensive Geriatric Assessment for the evaluation of the physical or functional sphere. This study was not registered.

Background/Aims: This study aimed to investigate whether pretransplant frailty can predict postoperative morbidity and mortality after liver transplantation (LT) in patients with cirrhosis.Methods: We retrospectively reviewed 242 patients who underwent LT between 2018 and 2020 at a tertiary hospital in Korea.Results: Among them, 189 patients (78.1%) received LT from a living donor. Physical frailty at baseline was assessed by the Short Physical Performance Battery (SPPB), by which patients were categorized into two groups: frail (SPPB

Abstract Background An accurate evaluation of cognitive function, physical health, and psychological health is fundamental for assessing health problems in the elderly population, and it is important to identify the necessity of early therapeutic intervention. The objective of this study was to evaluate the states of mental and physical functions and to investigate the relationships between sociodemographic features and these functions in a community-dwelling elderly population. Methods This community-based cross-sectional study was conducted in a suburban district of Shanghai, China. A total of 1025 participants aged 60–89 years underwent investigations of demographic and lifestyle features and a multidimensional geriatric evaluation comprising the Montreal Cognitive Assessment (MoCA), Short Physical Performance Battery (SPPB), and Geriatric Depression Scale (GDS). Results The results of the multivariate linear regression models demonstrated that the MoCA and SPPB scores decreased with advancing age (all P

Abstract Aim To investigate the risk factors for postoperative delirium among elderly patients undergoing elective surgery for gastroenterological cancer. Methods From May 2020 to March 2022, patients ≥75 years old with gastroenterological cancer who underwent radical surgery were enrolled. The geriatric assessment, including evaluations of frailty, physical function, nutrition status, and cognitive function, was conducted preoperatively. The confusion assessment method was used to diagnose postoperative delirium. A multivariate logistic regression analysis was used to determine risk factors for postoperative delirium. Results A total of 158 patients were eligible for inclusion in this study. Of these 53 patients (34%) developed postoperative delirium. In the univariate analysis, the age, regular use of sleeping drugs and benzodiazepine, Charlson Comorbidity Index score, performance status, Fried's frailty score, Vulnerable Elders Survey‐13 score, grip weakness, Short Physical Performance Battery (SPPB) score, Mini Nutritional Assessment Short‐Form score, and Mini‐Mental State Examination score were statistically associated with the incidence of postoperative delirium. In the multivariate analysis, a SPPB score ≤9, Mini Nutritional Assessment score ≤11, a Mini‐Mental State Examination score ≤24, and regular use of benzodiazepine were found to be independent preoperative risk factors for postoperative delirium. Conclusion Certain findings during the preoperative geriatric assessment, especially low SPPB, Mini Nutritional Assessment Short‐Form and Mini‐Mental State Examination scores, and regular use of benzodiazepine were risk factors for postoperative delirium in elderly patients undergoing gastroenterological surgery.

Alterations in the body’s nutritional status or composition may be observed as the kidney disease advances, which could influence the kidney’s functional capacity and, consequently, could increase the risk of mortality. The aim of the study is to determine the influence of functional capacity on mortality assessed by different functional tests in patients with advanced chronic kidney disease (ACKD). A prospective observational study was designed, which included 225 patients followed for 8 years in a CKD clinic. The study assessed functional capacity by using a range of tests, which included the Short Physical Performance Battery, the 6 minutes walking gait test, the timed up and go, and the four versions of the sit-to-stand test. Additionally, body composition and nutritional conditions were considered, taking into consideration various biochemical indicators such as albumin, prealbumin, c-reactive protein (CRP), lymphocytes, and transferrin, muscle strength, comorbidity, and frailty. The relationship between functionality and all-cause mortality was investigated using a Cox proportional hazard model. A total of fifty patients died during the duration of the study. Patients who performed worse on the function and muscle strength tests showed a worse body composition and nutritional status, and exhibited a reduced life expectancy. Inflammation (CRP) was associated with an increased risk of mortality (model 1: hazard ratio (HR) = 1.246; 95% confidence interval (95% CI = 1.014–1.531; model 2: HR = 1.333; 95% CI = 1.104–1.610). Good functional capacity as determined by the SPPB test decreased the risk of mortality (model 1: HR = 0.764; 95% CI = 0.683–0.855; model 2 HR = 0.778; 95% CI = 0.695–0.872). Cut-off points of maximum sensitivity and specificity for mortality were obtained with different tests. The study demonstrated that functional capacity influences mortality in patients with ACKD, being higher in those patients with impaired functionality regardless of the test used, although the SPPB allows a larger number of patients to be assessed. Therefore, it is essential to incorporate the assessment of functionality into the comprehensive care of patients with CKD.

Objectives: To examine the efficacy of an the intervention Stand Up Now (SUN) to reduce sedentary behavior (SB) and improve physical function and mobility. Methods: SUN included two groups: (a) focused on reducing total SB (SUNSL) and (b) focused on increasing sit-to-stand (STS) transitions (SUNSTS). The participants (N = 71; Mage = 87 ± 7 years) had 12 weekly health coaching sessions. SB, physical function, and mobility were measured at the baseline, 6, and 12 weeks via the activPAL, Short Physical Performance Battery, and the 8-foot up and go, respectively. Linear mixed models examined the outcome variables over time. Results: Both groups decreased sedentary time (1.3 ± 0.3 hr, p <.001), increased standing time (0.5 ± 0.2 hr, p <.02), and improved physical function (1.5 ± 0.4 points, p <.001) from the baseline to 6 weeks, and they maintained it at 12 weeks. SUNSTS increased STS transitions (5.4 ± 4.1, p <.001), while SUNSL had no changes (0.5 ± 3.1, p >.9). There were no changes in mobility for either group (0.5 ± 1.5 s, p >.05). Discussion: SUN demonstrates the efficacy to improve SB and physical function in older adults. [ABSTRACT FROM AUTHOR]

Introduction: Physical frailty is a syndrome characterised by deterioration in multiple physiological domains, including muscle mass and strength, flexibility, balance, neuromuscular coordination, and cardiovascular function. Evidence suggests that regular exercise provides substantial health benefits, reducing the risk of many chronic diseases and medical costs, especially for frail older adults. However, the effect of exercise on functional status in this population is not well explored. Need of the study: Population aging in India is rapidly accelerating, and frailty is a significant clinical condition associated with aging. Frailty increases the risk of institutionalisation, morbidity, and mortality. Regular exercise has been shown to improve functional fitness in older adults, but exercises performed while standing unaided can be challenging for individuals with compromised balance and mobility. Chair Suryanamaskar, a form of exercise performed while seated, may be an alternative mode of exercise for this population. Although aerobic and resistance exercises have shown benefits, there is growing interest in exploring the potential benefits of a multicomponent intervention for frail older adults. Aim: The aim of this study is to investigate the effect of chair Suryanamaskar with strength training on functional fitness in community-dwelling frail older adults. Materials and Methods: The study will be conducted from March 2021 to March 2024. This two-group parallel singleblind randomised controlled trial will take place at MAEER's Physiotherapy College in TalegaonDabhade, Maharashtra, India. Approximately 400 older adults will be screened for frailty using the Short Physical Performance Battery (SPPB) test. Participants with an SPPB score ≤7 will be considered frail and a total of 108 participants aged 65-84 years will be recruited based on inclusion and exclusion criteria. The participants will be equally divided into two groups (54 participants in each group) using computer-generated random tables. The experimental group (group A) will receive a 45-minute Chair Suryanamaskar with strength training protocol three times a week for 12 weeks. Before the study begins, participants will have two practice sessions of 20 minutes each to become familiar with Chair Suryanamaskar. The control group (group B) will participate in two 20-minute health education program sessions and receive weekly telephonic follow-ups to monitor for adverse events. Additionally, a health education program booklet will be provided. The primary outcome of the study is the Senior Fitness Test (SFT). Assessments will be conducted at baseline (0 weeks) and post-intervention (12 weeks). Intentionto-treat analyses with mixed linear modeling will be used for statistical analysis.

Katsoulis, K and Amara, CE. The effects of power training frequency on muscle power and functional performance in older women: a randomized controlled trial. J Strength Cond Res 37(11): 2289-2297, 2023--Low-intensity power training (PT) has emerged as an effective method for improving muscle power and functional performance in older adults. However, effects of low training frequencies are less understood and could expand the repertoire of exercise prescription, particularly in older women who experience greater functional disability with age compared with men. This study investigated the impact of frequency of low-intensity (40% of 1 repetition maximum, 1RM) PT on lower-body power and functional performance in healthy older women. Women (74 6 4 years) were randomized to 12 weeks of PT of 1 (PT1, n 5 14), 2 (PT2, n 5 17), or 3 (PT3, n 5 17) d·wk21 or wait control (CON, n 5 15). Measures included leg press 1RM, knee extension power (KEP), and functional performance (stair climb power, stair climb time, 30-second chair stands, 400-m walk, Short Physical Performance Battery). There were no differences between the frequency of training in changes in leg press 1RM, KEP, or functional performance after 12 weeks. Pre-post data for individual training groups revealed that leg press 1RM improved in all PT groups (20-33%, p, 0.05). Furthermore, KEP improved in PT2 and PT3 by 10 and 12%, respectively, and all PT groups improved in the 30-second chair stands and Short Physical Performance Battery (6-22%), whereas PT1 and PT3 improved in the 400-m walk and PT2 improved in stair climb power and stair climb time after training (4-7%, p ,0.05). One to 3 weekly low-intensity PT sessions can improve functional performance, although improvements in both functional performance and power might require 2 or 3 sessions per week in older healthy women. [ABSTRACT FROM AUTHOR]

This study aimed to determine which performance assessment tools included in Comprehensive Geriatric Assessment (CGA) are the most sensitive for the functional approach in the initial evaluation and during the therapy of old adults diagnosed with Diffuse Large B-Cell Lymphoma (DLBCL). We prospectively recruited 31 patients aged 70 years or older presenting for an initial consultation in the Hematology Clinic of a tertiary hospital. We implemented an updated physical performance evaluation as part of CGA at baseline and during treatment. Baseline characteristics of the sample were compared according to age, Geriatric 8 (G8), frailty, Short Physical Performance Battery (SPPB), and sarcopenia measured by hand grip strength (HGS). Functional changes were monitored during the treatment period using HGS, gait speed (GS) and SPPB. The mean age was 79.0 (5.5) years and 51.6% of the sample was frail; 65,5% were treated with standard chemotherapy and 35,5% with a therapeutic regimen with attenuated doses. All the assessment tools included in CGA found functional differences at baseline when the sample was stratified and compared according to frailty, sarcopenia, and SPPB, but not according to G8 score and age. Only SPPB was able to detect functional differences between groups stratified by age at baseline. GS was the only score that identified clinically significant functional changes during the treatment. In conclusion, HGS and SPPB are appropriate performance scores to complete the functional approach in the initial hematologic evaluation, and GS is a promising option to detect functional decline during therapy in old adults with DLBCL. [ABSTRACT FROM AUTHOR]

Background: An accurate evaluation of cognitive function, physical health, and psychological health is fundamental for assessing health problems in the elderly population, and it is important to identify the necessity of early therapeutic intervention. The objective of this study was to evaluate the states of mental and physical functions and to investigate the relationships between sociodemographic features and these functions in a community-dwelling elderly population. Methods: This community-based cross-sectional study was conducted in a suburban district of Shanghai, China. A total of 1025 participants aged 60–89 years underwent investigations of demographic and lifestyle features and a multidimensional geriatric evaluation comprising the Montreal Cognitive Assessment (MoCA), Short Physical Performance Battery (SPPB), and Geriatric Depression Scale (GDS). Results: The results of the multivariate linear regression models demonstrated that the MoCA and SPPB scores decreased with advancing age (all P < 0.01). However, the GDS score did not exhibit an age-related decrease (P = 0.09). Both sex and living alone influenced the MoCA score (P < 0.01 and P = 0.04, respectively), SPPB score (P < 0.01 and P = 0.04, respectively), and GDS score (P < 0.01 and P < 0.01, respectively). A higher education level was related to better MoCA and SPPB scores (all P < 0.01). Furthermore, age and sex had interactive effects on the MoCA score (P = 0.03) and SPPB score (P < 0.01). The kernel-weighted local polynomial smoothing curves exhibited similar trends. Conclusions: It is imperative to develop a more sensitive evaluation of physical function, and to encourage various intellectually and emotionally stimulating social activity strategies to promote healthy aging, especially in elderly women and those living alone who have a low education level. [ABSTRACT FROM AUTHOR]

Purpose: To determine which standardized physical performance tests are being used specifically in the assessment of adult patients before, during, or after undergoing treatment for hematologic malignancy and which of these functional tests have been demonstrated to have a correlation with key objective clinical outcome measures including mortality, progression-free survival, complete remission, hospital readmissions, emergency department visits, and hospital length of stay. Methods: PubMed/MEDLINE electronic databases were searched up to June 2021. Searches were restricted to English language. All resulting studies from the electronic database search were assessed by two reviewers for original research with physical performance data exclusive to patients with hematological malignancy. Studies with confounding intervention or the inclusion of pediatric patients were excluded. The quality of the remaining studies was assessed using PRISMA guidelines and Tooth Criteria by two reviewers, using a third reviewer to resolve any discrepancies. The main characteristics of each article, including sample size, population characteristics, physical performance testing methods, and significant and non-significant findings were extracted and compared. Additionally, one reviewer performed a literature review of the safety of physical performance testing. Results: One thousand two hundred fifty-six screened database results resulted in 14 studies included in the systematic review. All studies scored ≥ 0.59 on the Tooth Criteria, indicating moderate to high quality of reporting. Our review found six recurring measures of objective physical function assessed for correlation with clinical outcomes, primarily morbidity and mortality. The heterogeneity of each study precluded aggregate data analysis. Conclusions: This review was a first step in evaluating which objective physical performance tests are best suited for identifying functional impairment before, during, and after oncologic treatment for adults with blood cancers. Additional studies are needed to determine the optimal objective functional measures to use as a guide in clinical decision-making in the hematologic patient population. [ABSTRACT FROM AUTHOR]

People with intellectual disability have poor balance skills and greater fall risk. The Short Physical Performance Battery (SPPB) provides comprehensive information on functional status and can predict fall risk. However, the reliability and validity of the SPPB have not been evaluated in people with intellectual disability. Seventy-eight adults with intellectual disability were assessed using the SPPB twice. Reliability was analysed with intraclass correlation coefficient and validity was assessed against the Timed Up & Go (TUG) test and the stabilometric test using Spearman's rho. Reliability was moderate to high in all SPPB components except for the semi-tandem and full tandem positions. The SPPB summary score indicated moderate test–retest reliability and showed mostly significant moderate associations with the TUG and poor agreement with the stabilometric test. The SPPB summary score indicated high internal consistency, moderate reliability, and moderate validity when applied to adults with intellectual disability. [ABSTRACT FROM AUTHOR]

• Older Black men exhibit greater prevalence of functional disability, mobility, and mortality. • Performance-based assessments reveal a complex interplay of health and biopsychosocial factors. • Nurses can play a crucial role in enhancing function and reducing pain in older Black men. The purpose of this paper is to describe physical function and performance scores and examine the relationships between measures of physical performance in older Black men with low back pain. The Mobility, Aging, Pain, and Disparities study used a cross-sectional, observational design to objectively measure physical performance on the Short Physical Performance Battery (SPPB), the Back Performance Scale (BPS), and the 400-meter Walk Test along with subjective ratings of pain intensity in the past 24 hours. Sixty community-based Black men aged 61-87 (x̄= 70 ± 6) years had an average BPS score of 7.0 ± 4 and total score on the SPPB 8.5 ± 2.1. Average 400-meter Walk time was 6.3 ± 3.1 minutes. Men's average pain intensity in the past 24 hours was 5.7 ± 2, indicating moderate pain. In conclusion, older Black men with low back pain demonstrated low physical function scores and a higher level of disability. [ABSTRACT FROM AUTHOR]

Aim: To investigate the risk factors for postoperative delirium among elderly patients undergoing elective surgery for gastroenterological cancer. Methods: From May 2020 to March 2022, patients ≥75 years old with gastroenterological cancer who underwent radical surgery were enrolled. The geriatric assessment, including evaluations of frailty, physical function, nutrition status, and cognitive function, was conducted preoperatively. The confusion assessment method was used to diagnose postoperative delirium. A multivariate logistic regression analysis was used to determine risk factors for postoperative delirium. Results: A total of 158 patients were eligible for inclusion in this study. Of these 53 patients (34%) developed postoperative delirium. In the univariate analysis, the age, regular use of sleeping drugs and benzodiazepine, Charlson Comorbidity Index score, performance status, Fried's frailty score, Vulnerable Elders Survey‐13 score, grip weakness, Short Physical Performance Battery (SPPB) score, Mini Nutritional Assessment Short‐Form score, and Mini‐Mental State Examination score were statistically associated with the incidence of postoperative delirium. In the multivariate analysis, a SPPB score ≤9, Mini Nutritional Assessment score ≤11, a Mini‐Mental State Examination score ≤24, and regular use of benzodiazepine were found to be independent preoperative risk factors for postoperative delirium. Conclusion: Certain findings during the preoperative geriatric assessment, especially low SPPB, Mini Nutritional Assessment Short‐Form and Mini‐Mental State Examination scores, and regular use of benzodiazepine were risk factors for postoperative delirium in elderly patients undergoing gastroenterological surgery. This single‐center retrospective study analyzes 158 patients over 75 years old who underwent radical gastroenterological cancer and identifies preoperative risk factors for postoperative delirium. This study revealed that SPPB score ≤9, Mini Nutritional Assessment Short‐Form score ≤11, Mini‐Mental State Examination score ≤24, and regular use of benzodiazepine were independent preoperative risk factors for postoperative delirium, respectively. This study is the first to show that the preoperative SPPB score is associated with postoperative delirium in the field of gastroenterological surgery. [ABSTRACT FROM AUTHOR]

Yasutomo Tanaka,1,2 Masatoshi Hanada,1,2 Chika Kitagawa,3 Kazuaki Suyama,4 Ryota Shiroishi,5 Naoto Rikitomi,3 Toru Tsuda,6 Yoshiaki Utsunomiya,5 Takako Tanaka,1 Kazuya Shingai,1 Yorihide Yanagita,7 Ryo Kozu1,2 1Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; 2Department of Rehabilitation Medicine, Nagasaki University Hospital, Nagasaki, Japan; 3Nagasaki Pulmonary Rehabilitation Clinic, Nagasaki, Japan; 4Tagami Hospital, Nagasaki, Japan; 5Utsunomiya Medical Clinic, Fukuoka, Japan; 6Kirigaoka Tsuda Hospital, Fukuoka, Japan; 7Department of Physical Therapy, School of Health Science, Toyohashi Sozo University, Aichi, JapanCorrespondence: Ryo Kozu, Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8520, Japan, Tel/Fax +81 95 819 7963, Email ryokozu@nagasaki-u.ac.jpPurpose: Assessment for frailty is important as it enables timely intervention to prevent or delay poor prognosis in chronic obstructive pulmonary disease (COPD). The aims of this study, in a sample of outpatients with COPD, were to (i) assess the prevalence of physical frailty using the Japanese version of the Cardiovascular Health Study (J-CHS) criteria and the Short Physical Performance Battery (SPPB) and the degree of agreement between the findings of the two assessments and (ii) identify factors associated with the disparity in the results obtained with these instruments.Patients and Methods: This was a multicenter cross-sectional study of individuals with stable COPD enrolled in four institutions. Frailty was assessed using the J-CHS criteria and the SPPB. Weighted Cohen’s kappa (k) statistic was performed to investigate the magnitude of agreement between the instruments. We divided participants into two groups depending on whether there was agreement or non-agreement between the results of the two frailty assessments. The two groups were then compared with respect to their clinical data.Results: A total of 103 participants (81 male) were included in the analysis. The median age and FEV1 (%predicted) were 77 years and 62%, respectively. The prevalence of frailty and pre-frail was 21% and 56% with the J-CHS criteria and 10% and 17% with the SPPB. The degree of agreement was fair (k = 0.36 [95% CI: 0.22– 0.50], P< 0.001). There were no significant differences in the clinical characteristics between the agreement group (n = 44) and the non-agreement group (n = 59).Conclusion: We showed that the degree of agreement was fair with the J-CHS criteria detecting a higher prevalence than the SPPB. Our findings suggest that the J-CHS criteria may be useful in people with COPD with the aim of providing interventions to reverse frailty in the early stages.Keywords: cardiovascular health study, Short Physical Performance Battery, chronic lung disease, physical function

Physical activity (PA) and sedentary behavior may contribute to physical function in adults with intellectual disability (ID). This study examined whether objectively measured PA and sedentary behavior levels are associated with physical performance in adults with ID. Fifty-eight adults with ID (29 women and 29 men, age 44 ± 14 years) underwent a measurement of physical performance with the Short Physical Performance Battery (SPPB) and PA and sedentary time using a hip-worn accelerometer (wGT3X-BT; ActiGraph, Pensacola, FL). Moderate PA and age were significantly associated with the SPPB score (r =.39 and.34, respectively; p <.01). A hierarchical-regression model with moderate PA and age as independent variables indicated that moderate PA was a significant predictor of SPPB (p <.001; R2 =.153), but age was not (p =.123; R2 change =.036). Overall, moderate PA was significantly associated with the SPPB score, even after accounting for age, in adults with ID. [ABSTRACT FROM AUTHOR]

Introduction: Physical frailty is a syndrome characterised by deterioration in multiple physiological domains, including muscle mass and strength, flexibility, balance, neuromuscular coordination, and cardiovascular function. Evidence suggests that regular exercise provides substantial health benefits, reducing the risk of many chronic diseases and medical costs, especially for frail older adults. However, the effect of exercise on functional status in this population is not well explored. Need of the study: Population aging in India is rapidly accelerating, and frailty is a significant clinical condition associated with aging. Frailty increases the risk of institutionalisation, morbidity, and mortality. Regular exercise has been shown to improve functional fitness in older adults, but exercises performed while standing unaided can be challenging for individuals with compromised balance and mobility. Chair Suryanamaskar, a form of exercise performed while seated, may be an alternative mode of exercise for this population. Although aerobic and resistance exercises have shown benefits, there is growing interest in exploring the potential benefits of a multicomponent intervention for frail older adults. Aim: The aim of this study is to investigate the effect of chair Suryanamaskar with strength training on functional fitness in community-dwelling frail older adults. Materials and Methods: The study will be conducted from March 2021 to March 2024. This two-group parallel single-blind randomised controlled trial will take place at MAEER’s Physiotherapy College in Talegaon Dabhade, Maharashtra, India. Approximately 400 older adults will be screened for frailty using the Short Physical Performance Battery (SPPB) test. Participants with an SPPB score ≤7 will be considered frail and a total of 108 participants aged 65-84 years will be recruited based on inclusion and exclusion criteria. The participants will be equally divided into two groups (54 participants in each group) using computer-generated random tables. The experimental group (group A) will receive a 45-minute Chair Suryanamaskar with strength training protocol three times a week for 12 weeks. Before the study begins, participants will have two practice sessions of 20 minutes each to become familiar with Chair Suryanamaskar. The control group (group B) will participate in two 20-minute health education program sessions and receive weekly telephonic follow-ups to monitor for adverse events. Additionally, a health education program booklet will be provided. The primary outcome of the study is the Senior Fitness Test (SFT). Assessments will be conducted at baseline (0 weeks) and post-intervention (12 weeks). Intention-to-treat analyses with mixed linear modeling will be used for statistical analysis. [ABSTRACT FROM AUTHOR]

Cardiac rehabilitation (CR) improves clinical and functional recovery in older patients after acute cardiac syndromes, whose outcome is influenced by cardiac disease severity, but also by comorbidity and frailty. The aim of the study was to analyze the predictors of physical frailty improvement during the CR program. Data were collected in all patients aged > 75 years consecutively admitted from 1 January to December 2017 to our CR, consisting of 5-day-per-week of 30-min session of biking or calisthenics on alternate days for 4 weeks. Physical frailty was measured with short physical performance battery (SPPB) at the entry and the end of CR. Outcome was represented by an increase of at least 1 point in the SPPB score from baseline to the end of the CR program. In our study population of 100 patients, mean age 81 years, we demonstrated that a strong predictor of improvement in SPPB score was the poorer performance in the test at baseline; for Δ-1 point of score, we registered an OR 2.50 (95% CI = 1.64–3.85; p = 0.001) of probability to improve the physical performance at the end of CR. Interestingly those patients with worse performance at SPPB balance and chair standing task showed greater probability of ameliorating their physical frailty profile at the end of CR. Our data strongly suggest that CR program after acute cardiac syndrome produces a significant physical frailty improvement in those patients with worse frailty phenotype with an impairment in chair standing or balance at entry. [ABSTRACT FROM AUTHOR]

Background: Hypertension and skeletal muscle decline are common findings in patients with Alzheimer's disease (AD). Angiotensin-converting enzyme (ACE) inhibitors preserve skeletal muscle and physical capacity; however, the driving mechanisms are poorly understood. Objective: We investigated the effects of ACE inhibitors on the neuromuscular junction (NMJ) with relevance to skeletal muscle and physical capacity in AD patients and age-matched controls. Methods: We evaluated controls (n = 59) and three groups of AD patients, including normotensive (n = 51) and patients with hypertension taking ACE inhibitors (n = 53) or other anti-hypertensive medications (n = 49) at baseline and one year later. We measure plasma c-terminal agrin fragment-22 (CAF22) as a marker of NMJ degradation, handgrip strength (HGS), and Short Physical Performance Battery (SPPB) as markers of physical capacity. Results: At baseline AD patients demonstrated lower HGS and SPPB scores and higher CAF22 levels than controls, irrespective of the hypertension status (all p < 0.05). The use of ACE inhibitors was associated with higher HGS and relative maintenance of SPPB scores, gait speed, and plasma CAF22 levels. Conversely, other anti-hypertensive medications were associated with an unaltered HGS, reduced SPPB scores and elevated plasma CAF22 levels (both p < 0.05). We also found dynamic associations of CAF22 with HGS, gait speed, and SPPB in AD patients taking ACE inhibitors (all p < 0.05). These changes were associated with reduced oxidative stress in AD patients taking ACE inhibitors (p < 0.05). Conclusion: Altogether, ACE inhibitors are associated with higher HGS, preserved physical capacity, and the prevention of NMJ degradation in hypertensive AD patients. [ABSTRACT FROM AUTHOR]

Background: Adults with intellectual disabilities often experience mobility limitations. Baduanjin, a mindfulness‐based exercise intervention, can exert positive effects on functional mobility and balance. This study examined the impact of Baduanjin on physical functioning and balance of adults with intellectual disabilities. Method: Twenty‐nine adults with intellectual disabilities participated in the study. Eighteen received a Baduanjin intervention for 9‐months; 11 participants did not receive any intervention (comparison group). Physical functioning and balance were assessed using the short physical performance battery (SPPB) and stabilometry. Results: Participants in the Baduanjin group experienced significant changes in the SPPB walking test (p =.042), chair stand test (p =.015), and SPPB summary score (p =.010). No significant changes between groups were observed in any of the variables assessed at the end of the intervention. Conclusions: Baduanjin practice may cause significant, albeit small, improvements in physical functioning of adults with intellectual disabilities. [ABSTRACT FROM AUTHOR]

Abstract Background Population-based studies on physical performance provide important information on older people’s health but rarely include the oldest and least-healthy segment of the population. The aim of this study was to provide representative estimates of physical performance by age, sex, and educational level based on recent data from a population-based health study in Norway that includes older people with a wide range in age and function. Methods In the fourth wave of the Trøndelag Health Study (2017–2019), all participants aged 70 + were invited to an additional examination of physical performance assessed by the Short Physical Performance Battery (SPPB), either by attending a testing station or by visits from ambulatory teams. The distribution and variation in SPPB total and subscores, as well as gait speed, are presented by sex, age, and educational level. Results The SPPB was registered in 11,394 individuals; 54.8% were women; the age range was 70–105.4 years, with 1,891 persons aged 85 + . SPPB scores decreased by 0.27 points (men) and 0.33 points (women) for each year of age, and gait speed by 0.02 m/sec (men) and 0.03 m/sec (women). Using a frailty cut-off for gait speed at

The Short Physical Performance Battery (SPPB) is a well-established tool to assess the lower extremity physical performance status. The purpose of this study is to examine the impact of brain natriuretic peptide (BNP) levels and SPPB scores on short-term readmission in older patients with heart failure (HF). This prospective cohort study enrolled 325 patients with HF who were hospitalized for acute decompensated HF between November 2017 and December 2021. Variables were analyzed using the Cox proportional hazards model, receiver operating characteristic (ROC) curve, and Kaplan–Meier analysis. The 107 patients who met the inclusion criteria were divided into readmission (within 90 days of discharge; n = 25) and non-readmission (n = 82) groups. Multivariate analysis revealed that BNP level and SPPB score were independent risk factors for readmission within 90 days after discharge. Patients were classified into three groups according to the BNP and SPPB cutoff values calculated using ROC curves. The risk of readmission was significantly higher in Group 3 (BNP ≥ 384 pg/mL and SPPB ≤ 7 points) than in Group 1 (BNP < 384 pg/mL and SPPB > 7 points; hazard ratio: 27.68, 95% confidence interval: 3.672 − 208.700, P = 0.0012). Our study showed that HF patients with high BNP levels and low SPPB scores have a dramatically increased risk of readmission within 90 days of discharge. [ABSTRACT FROM AUTHOR]