ABSTRACT
BACKGROUND: It is important to identify the relevant parameters of physical performance to prevent early functional decline and to prolong independent living. The aim of this study is to describe the development of physical performance in a healthy community-dwelling older cohort aged 70+ years using comprehensive assessment over two years and to subsequently identify the most relevant predictive tests for physical decline to minimize assessment. METHODS: Physical performance was measured by comprehensive geriatric assessment. Predictors for the individual decline of physical performance by Principal Component and k-means Cluster Analysis were developed, and sensitivity and specificity determined accordingly. RESULTS: 251 subjects (Ø 75.4 years) participated in the study. Handgrip strength was low in 21.1%. The follow-up results of tests were divergent. Handgrip strength [- 16.95 (SD 11.55)] and the stair climb power test (power) [- 9.15 (SD 16.84)] yielded the highest percentage changes. Four most relevant tests (handgrip strength, stair climb power time, timed up & go and 4-m gait speed) were identified. A predictor based on baseline data was determined (sensitivity 82%, specificity 96%) to identify subjects characterized by a high degree of physical decline within two years. DISCUSSION: Although the cohort of older adults is heterogeneous, most of the individuals in the study exhibited high levels of physical performance; only a few subjects suffered a relevant decline within the 2-year follow-up. Four most relevant tests were identified to predict relevant decline of physical function. CONCLUSION: In spite of ceiling effects of the geriatric assessment in high-performers, we assume that it is possible to predict an individual's risk of physical decline within 2 years with four tests of a comprehensive geriatric assessment.
Subject(s)
Geriatric Assessment , Independent Living , Aged , Hand Strength , Humans , Physical Functional Performance , Walking SpeedABSTRACT
BACKGROUND AND OBJECTIVE: Sensor technology, in particular wearable inertial sensors, has the potential to help researchers objectively assess the functionality of older adults. The following review provides an overview about the possible use of sensor technology to detect and prevent pre-frailty and frailty. METHOD: A systematic literature search in PubMed and the Cochrane Library was conducted. Articles were selected according to the following criteria: frail and/or pre-frail population, use of wearable and non-wearable sensor technology to measure or enhance human movements or activities of daily living and a focus on frailty assessment. RESULTS: A total of 28 publications were found. Sensor-derived parameters obtained during assessment of gait, functional performances and physical activity were reported to be relevant for screening and monitoring pre-frailty and frailty; however, current findings are limited to cross-sectional studies, which do not allow establishment of a causal relationship between motor performance, physical activity and specific frailty states. No study monitored specific activities of daily living. DISCUSSION: Outcome variables from technology-based assessment seem to provide valuable information for frailty assessment. Strenuous testing conditions as well as increased variability in gait, functional performance and physical activity may be useful in identifying frailty. Outcome variables derived from gait, motor assessment and physical activity must still be validated in large cohorts and under daily living conditions in order to develop robust screening tools for pre-frailty and frailty. Further research should focus on specific activities of daily living in pre-frail or frail older adults and technology-based approaches for intervention and prevention.
