Short-Physical Performance Battery (SPPB) score is associated with falls in older outpatients

• Published in: Aging clinical and experimental research Vol. 31; no. 10; pp. 1435 - 1442
• Main Authors: Lauretani, Fulvio, Ticinesi, Andrea, Gionti, Luciano, Prati, Beatrice, Nouvenne, Antonio, Tana, Claudio, Meschi, Tiziana, Maggio, Marcello
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.10.2019; Springer Nature B.V
• Subjects: Accidental Falls - statistics & numerical data; Aged; Aged, 80 and over; Cross-Sectional Studies; Falls; Female; Frailty; Geriatric Assessment - methods; Geriatrics; Geriatrics/Gerontology; Humans; Male; Medicine; Medicine & Public Health; Mental Status and Dementia Tests; Nutrition Assessment; Original Article; Outpatients; Physical Functional Performance; Physical Therapy Modalities; Risk assessment; Falls; Comprehensive geriatric assessment; Frailty; Balance
• ISSN: 1720-8319; 1594-0667; 1720-8319
• DOI: 10.1007/s40520-018-1082-y

Background The capacity of Short-Physical Performance Battery (SPPB) test to discriminate between fallers and non-fallers is controversial, and has never been compared with fall risk assessment-specific tools, such as Performance-Oriented Mobility Assessment (POMA). Aim To verify the association of SPPB and POMA scores with falls in older outpatients. Methods 451 older subjects (150 males, mean age 82.1 ± 6.8) evaluated in a geriatric outpatient clinic for suspected frailty were enrolled in this cross-sectional study. Self-reported history of falls and medication history were carefully assessed. Each participant underwent comprehensive geriatric assessment, including SPPB, POMA, Geriatric Depression Scale (GDS), mini-mental state examination (MMSE) and mini-nutritional assessment-short form (MNA-SF). Multivariate logistic regression and receiver-operating characteristic (ROC) analyses were performed to determine the factors associated with the status of faller. Results 245 (54.3%) subjects were identified as fallers. They were older and had lower SPPB and POMA test scores than non-fallers. At ROC analysis, SPPB (AUC 0.676, 95% CI 0.627–0.728, p  < 0.001) and POMA (AUC 0.677, 95% CI 0.627–0.726, p  < 0.001) scores were both associated with falls. At multivariate logistic regression models, SPPB total score (OR 0.83, 95% CI 0.76–0.92, p  < 0.001), POMA total score (OR 0.94, 95% CI 0.91–0.98, p  = 0.002) and SPPB balance score alteration (OR 2.88, 95% CI 1.42–5.85, p  = 0.004), but not POMA balance subscale score alteration, were independently associated with recorded falls, as also GDS, MMSE and MNA-SF scores. Conclusions SPPB total score was independently associated with reported falls in older outpatients, resulting non-inferior to POMA scale. The use of SPPB for fall risk assessment should be implemented.