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BMC Med. 2016 Dec 22;14(1):215. doi: 10.1186/s12916-016-0763-7.

Short Physical Performance Battery and all-cause mortality: systematic review and meta-analysis.

Author information

1
Cardiology Unit, Azienda Ospedaliero-Universitaria S.Anna, Via Aldo Moro, 8, 44124, Ferrara, Italy. pvsrti@unife.it.
2
University of Maryland School of Medicine, Baltimore, MD, USA.
3
Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
4
Department of Critical Care Medicine and Surgery, Unit of Gerontology and Geriatric Medicine, University of Florence and Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
5
Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.
6
INSERM UMR1027, Université de Toulouse III Paul Sabatier, Toulouse, France.
7
Department of Geriatrics, Neurosciences and Orthopaedics, Catholic University of the Sacred Heart, Rome, Italy.
8
Institute of Health and Society, Université catholique de Louvain (UCL), Brussels, Belgium.
9
Department of Public Health and Primary Care, KU Leuven (KUL), Leuven, Belgium.
10
Institut de Recherche Sante et Societe, Universite Catholique de Louvain, Brussels, Belgium.
11
Department of Neurology & Medicine, Albert Einstein College of Medicine, Bronx, New York, USA.
12
Department of Epidemiology, Albert Einstein College of Medicine, Bronx, New York, USA.
13
Department of Public Health, University of Turku, Turku, Finland.
14
National Institute on Aging, Longitudinal Studies Section, Clinical Research Branch, NIA-ASTRA Unit, Harbor Hospital, Baltimore, MD, USA.
15
Department of Medicine, Division of Gastroenterology and Hepatology, University of California San Francisco, San Francisco, CA, USA.
16
Clinical Research Unit, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Barcelona, Spain.
17
Servei de Geriatria i Cures Palliatives, Hospital Universitari de la Santa Creu, Vic, Barcelona, Spain.
18
Health Services Research Group, IMIM, Hospital del Mar Medical Research Institute, Barcelona, Spain.
19
CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
20
Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Gyeonggi, Republic of Korea.
21
Medicine and Epidemiology & Community Health, University of Minnesota, Minneapolis, Minnesota, USA.
22
General Internal Medicine, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA.
23
California Pacific Medical Center Research Institute, San Francisco, CA, USA.
24
Department of Family Medicine, The North-Western State Medical University named after I.I. Mechnikov, St. Petersburg, Russia.
25
Faculte' de Me' decine, Laboratoire d'Epidemiologie et Sante' Communautaire (Unite' Inserm 558), Alle'es Jules Guesde, Toulouse, France.
26
Unit of Geriatric Pharmacoepidemiology, Research Hospital of Cosenza, Italian National Research Centre on Aging (INRCA), Cosenza, Italy.
27
Departments of Epidemiology and Medicine, Johns Hopkins University, Baltimore, MD, USA.
28
Cardiology Unit, Azienda Ospedaliero-Universitaria S.Anna, Via Aldo Moro, 8, 44124, Ferrara, Italy.
29
Maria Cecilia Hospital, GVM Care & Research, E.S.: Health Science Foundation, Cotignola, Italy.
30
Department of Medical Science, Section of Internal and Cardiorespiratory Medicine, University of Ferrara, Ferrara, Italy.

Abstract

BACKGROUND:

The Short Physical Performance Battery (SPPB) is a well-established tool to assess lower extremity physical performance status. Its predictive ability for all-cause mortality has been sparsely reported, but with conflicting results in different subsets of participants. The aim of this study was to perform a meta-analysis investigating the relationship between SPPB score and all-cause mortality.

METHODS:

Articles were searched in MEDLINE, the Cochrane Library, Google Scholar, and BioMed Central between July and September 2015 and updated in January 2016. Inclusion criteria were observational studies; >50 participants; stratification of population according to SPPB value; data on all-cause mortality; English language publications. Twenty-four articles were selected from available evidence. Data of interest (i.e., clinical characteristics, information after stratification of the sample into four SPPB groups [0-3, 4-6, 7-9, 10-12]) were retrieved from the articles and/or obtained by the study authors. The odds ratio (OR) and/or hazard ratio (HR) was obtained for all-cause mortality according to SPPB category (with SPPB scores 10-12 considered as reference) with adjustment for age, sex, and body mass index.

RESULTS:

Standardized data were obtained for 17 studies (n = 16,534, mean age 76 ± 3 years). As compared to SPPB scores 10-12, values of 0-3 (OR 3.25, 95%CI 2.86-3.79), 4-6 (OR 2.14, 95%CI 1.92-2.39), and 7-9 (OR 1.50, 95%CI 1.32-1.71) were each associated with an increased risk of all-cause mortality. The association between poor performance on SPPB and all-cause mortality remained highly consistent independent of follow-up length, subsets of participants, geographic area, and age of the population. Random effects meta-regression showed that OR for all-cause mortality with SPPB values 7-9 was higher in the younger population, diabetics, and men.

CONCLUSIONS:

An SPPB score lower than 10 is predictive of all-cause mortality. The systematic implementation of the SPPB in clinical practice settings may provide useful prognostic information about the risk of all-cause mortality. Moreover, the SPPB could be used as a surrogate endpoint of all-cause mortality in trials needing to quantify benefit and health improvements of specific treatments or rehabilitation programs. The study protocol was published on PROSPERO (CRD42015024916).

KEYWORDS:

All-cause mortality; Meta-analysis; Physical function; Short Physical Performance Battery

PMID:
28003033
PMCID:
PMC5178082
DOI:
10.1186/s12916-016-0763-7
[Indexed for MEDLINE]
Free PMC Article

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