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Lookup NU author(s): Dr Richard Dodds,
Professor Avan Sayer
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
Background Poor performance in physical tests such as grip strength and walking speed is a risk factor for disability in old age, although whether such measures improve the discrimination of clinical prediction models when traditional clinical risk factors are already known is not clear. The prevalence of disability in mid-life is relatively low and hence screening in this age group may present an opportunity for early identification of those at increased future risk who may benefit most from preventative interventions. Methods Data were drawn from two waves of the Medical Research Council National Survey of Health and Development. We examined whether several chronic conditions, poor health behaviours and lower scores on three measures of physical performance (grip strength, chair rise speed and standing balance time) at age 53 were associated with self-reported mobility and/or personal care disability at age 69. We used the area under the curve statistic (AUC) to assess model discrimination. Results At age 69, 44% (826 / 1855) of participants reported mobility and/or personal care disability. Our final clinical prediction model included sex, knee osteoarthritis, taking 2+ medications, smoking, increased BMI and poor performance in all three physical tests, with an AUC of 0.740 compared with 0.708 for a model which did not include the performance measures. Conclusion Measures of physical performance in midlife improve discrimination in clinical prediction models for disability over 16 years. Importantly, these and similar measures are also potential targets of future diet, exercise and pharmacological intervention in mid-life.
Author(s): Dodds RM, Kuh D, Sayer AA, Cooper R
Publication type: Article
Publication status: Published
Journal: Experimental Gerontology
Print publication date: 01/09/2018
Online publication date: 07/06/2018
Acceptance date: 01/06/2018
Date deposited: 04/06/2018
ISSN (print): 0531-5565
ISSN (electronic): 1873-6815
Publisher: Elsevier Inc.
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