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Can measures of physical performance in mid-life improve the clinical prediction of disability in early old age? Findings from a British birth cohort study

Lookup NU author(s): Dr Richard Dodds, Professor Avan Sayer

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

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.


Publication metadata

Author(s): Dodds RM, Kuh D, Sayer AA, Cooper R

Publication type: Article

Publication status: Published

Journal: Experimental Gerontology

Year: 2018

Volume: 110

Pages: 118-124

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.

URL: https://doi.org/10.1016/j.exger.2018.06.001

DOI: 10.1016/j.exger.2018.06.001


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