The Predictive Validity of Physical Performance Measures in Determining Markers of Preclinical Disability in Community-Dwelling Middle-Aged and Older Adults: A Systematic Review

Abstract

Background: Identification of preclinical disability in middle-aged and older adults might allow early identification of and treatment for functional mobility deficits.

Purpose: This study aimed to determine which physical performance measures (PPMs) were effective in identifying preclinical disability in individuals at risk for future disability.

Data sources: CINHAL, PubMed, Scopus, and Web of Science databases were searched until September 2017 using key words.

Study selection: Two individuals screened peer-reviewed prospective longitudinal studies that assessed healthy individuals > 45 years old using PPMs at baseline. Eight studies met inclusion criteria.

Data extraction: Two individuals extracted data on participant demographics, PPMs, predictive validity effect size, and disability outcomes. Risk of bias was assessed using the Quality Assessment Tool for Cohort Studies II (Q-Coh II).

Data synthesis: Four constructs were used to guide data synthesis: functional mobility, activities of daily living disability, fall(s), and hospitalization. Multiple sit-to-stands from a chair, standing balance, and gait speed were found to have some merit in identifying preclinical disability across all 4 disability constructs. All studies were scored as good-quality studies using the Q-Coh II.

Limitations: The heterogeneity in follow-up times and reporting of risk prediction statistics made it difficult to compare results across studies, PPMs, and constructs. The 4 constructs used as markers of preclinical disability potentially do not fully capture the progression of disability.

Conclusions: Physical therapists should consider using PPMs on healthy adult populations to gather baseline data during annual health screens for use in identifying preclinical disability.