K. Fukui1,2, Y. URABE1, N. Maeda1, S. Sakai1,2, T. Tashiro1, T. Shima2, M. Niitani2
1Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan, 2Niitani Clinic, Kure, Japan
Background: There are many elderly people who need care after they become frailty. The early detection and prevention of frailty is required in the world. The Short Physical Performance Battery (SPPB) developed by Guralnik et al., has been shown to detect early stages of frailty (Verghese et al., 2010). However, it is not widely used in Japan, this is mainly because it is too easy for elderly Japanese to achieve a perfect score. Therefore, it was necessary to modify this tool for high-functioning elderly adults, for example Japanese. Although SPPB based on a community-based (SPPB-com) developed by Makizako et al., (2017) to evaluate high-functioning elderly adults, no research has yet been undertaken to define the criteria for ‘frailty’ regarding this specific population.
Purpose: This study aimed to compare the capability of SPPB and SPPB-com to distinguish across the categories of non-frailty, pre-frailty and frailty.
Methods: A total of 132 elderly outpatients aged ≥65 years were participated in this study. Frailty was measured using the Kihon Checklist score (points) and divided into three groups (no-frailty, pre-frailty and frailty). Participants were assessed using the SPPB (0–12 points) and SPPB-com (0–10 points) instruments. For the 3-group analysis of variance, the Bonferroni post hoc test was used. Discriminant analysis using the forward stepwise procedure was performed to estimate frailty groups. Receiver operating characteristics analysis was employed to calculate the area under the curve (AUC) and to determine the optimal cut-off point, which would best discriminate non-frailty from frailty respondents. A significance level was set at 5%.
Results: There were 28 participants (21.2%) in the non-frailty group, 41 (31.1%) in the pre-frailty group and 63 (47.7%) in the frailty group. The SPPB score were significant different between the non-frailty group (11.5 ± 1.3) and frailty group (8.7 ± 2.6) (p<0.01), but not significant different between pre-frailty group and others (p = 0.04). On the other hand, the SPPB-com score were significant different among non-frailty group (6.3 ± 1.4), pre-frailty group (4.9 ± 1.4) and frailty group (3.7 ± 1.1) (p<0.01). The SPPB-com score could classify the participants into non-frailty, pre-frailty or frailty groups with an accuracy of 62.5% following validation. The SPPB-com score, with a cut-off point of only 5, gave the best trade-off between sensitivity and specificity, with an AUC of 0.80.
Conclusion(s): This study suggested that the SPPB-com is better tool for discriminating among the non-frailty, pre-frailty and frailty compared with the SPPB. A previous study reported that a one point increase in the SPPB-com score reduced the risk of needing long-term care by a remarkable 23% (Makizako et al., 2017). Therefore, the SPPB-com may be able to discover an elderly people had the risk of pre-frailty not only for Japanese community-dwelling elderly people but also for high-functioning older adults throughout the world.
Implications: The SPPB-com score can identify pre-frailty before frailty even in high-functioning elderly people, and would therefore assist in the early detection of frailty.
Funding, acknowledgements: We have no funding acknowledgement in this study.
Keywords: Frail Elderly, Outpatients, Physical Functional Performance
Topic: Older people
Did this work require ethics approval? Yes
Institution: Niitani Clinic
Committee: Nitani Clinic Ethics Review Committee
Ethics number: NCL-18001
All authors, affiliations and abstracts have been published as submitted.
