Novel physical performance-based models for activities of daily living disability prediction among Chinese older community population: a nationally representative survey in China
Abstract Background Physical performances including upper and lower limb functions have predictive roles in activities of daily living (ADL) disability, but they have rarely been incorporated into prediction models. This study primarily aimed to develop and validate novel physical performance-based...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-03-01
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| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12877-022-02905-y |
| _version_ | 1819025859421405184 |
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| author | Li Zhang Yueqiao Chen Jing Liu Yifan Yu Huijie Cui Qiuzhi Chen Kejin Chen Chunxia Yang Yanfang Yang |
| author_facet | Li Zhang Yueqiao Chen Jing Liu Yifan Yu Huijie Cui Qiuzhi Chen Kejin Chen Chunxia Yang Yanfang Yang |
| author_sort | Li Zhang |
| collection | DOAJ |
| description | Abstract Background Physical performances including upper and lower limb functions have predictive roles in activities of daily living (ADL) disability, but they have rarely been incorporated into prediction models. This study primarily aimed to develop and validate novel physical performance-based models for ADL disability among Chinese older adults. Comparisons of predictive performance across multiple models were performed, and model simplification was further explored. Methods Data were obtained from the China Health and Retirement Longitudinal Study in the 2011 and 2015 waves, containing 2192 older adults over 60 years old. Our models were constructed by logistic regression analysis, using a backward stepwise selection. Model performance was internally validated by discrimination, calibration, and clinical utility. Integrated Discrimination Improvement (IDI) and Net Reclassification Improvement (NRI) were used to assess the incremental benefit of the extended models. Moreover, nomograms were built for visualization. Results We selected gender, age, smoking, self-report health condition, BMI, depressive symptoms, and cognitive function into the fundamental model (Model 1). Based on Model 1, five novel prediction models were constructed by adding handgrip strength (Model 2), Short Physical Performance Battery (SPPB) (Model 3), gait speed (Model 4), handgrip strength plus SPPB (Model 5), and handgrip strength plus gait speed (Model 6), respectively. Significant improvement in predictive values were observed for all five novel models compared with Model 1 (C-index = 0.693). The lower limb model (Model 3 SPPB model: C-index = 0.731) may play a key role in the prediction of ADL disability, reflecting a comparable predictive value to the comprehensive models combining both upper and lower limbs (Model 5 handgrip strength + SPPB model: C-index = 0.732). When we simplified the lower limb models by replacing SPPB with gait speed, the predictive values attenuated slightly (C-index: Model 3 vs Model 4: 0.731 vs 0.714; Model 5 vs Model 6: 0.732 vs 0.718), but still better than the upper limb model (Model 2 handgrip strength model: C-index = 0.701). Conclusions Physical performance-based models, especially lower limb model, provided improved prediction for ADL disability among Chinese older adults, which may help guide the targeted intervention. |
| first_indexed | 2024-12-21T05:17:22Z |
| format | Article |
| id | doaj.art-98246cd216dd43aea1287225feb44385 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-12-21T05:17:22Z |
| publishDate | 2022-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-98246cd216dd43aea1287225feb443852022-12-21T19:14:54ZengBMCBMC Geriatrics1471-23182022-03-0122111310.1186/s12877-022-02905-yNovel physical performance-based models for activities of daily living disability prediction among Chinese older community population: a nationally representative survey in ChinaLi Zhang0Yueqiao Chen1Jing Liu2Yifan Yu3Huijie Cui4Qiuzhi Chen5Kejin Chen6Chunxia Yang7Yanfang Yang8Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan UniversityDepartment of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan UniversityDepartment of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan UniversityDepartment of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan UniversityDepartment of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan UniversityDepartment of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan UniversityDepartment of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan UniversityDepartment of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan UniversityDepartment of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan UniversityAbstract Background Physical performances including upper and lower limb functions have predictive roles in activities of daily living (ADL) disability, but they have rarely been incorporated into prediction models. This study primarily aimed to develop and validate novel physical performance-based models for ADL disability among Chinese older adults. Comparisons of predictive performance across multiple models were performed, and model simplification was further explored. Methods Data were obtained from the China Health and Retirement Longitudinal Study in the 2011 and 2015 waves, containing 2192 older adults over 60 years old. Our models were constructed by logistic regression analysis, using a backward stepwise selection. Model performance was internally validated by discrimination, calibration, and clinical utility. Integrated Discrimination Improvement (IDI) and Net Reclassification Improvement (NRI) were used to assess the incremental benefit of the extended models. Moreover, nomograms were built for visualization. Results We selected gender, age, smoking, self-report health condition, BMI, depressive symptoms, and cognitive function into the fundamental model (Model 1). Based on Model 1, five novel prediction models were constructed by adding handgrip strength (Model 2), Short Physical Performance Battery (SPPB) (Model 3), gait speed (Model 4), handgrip strength plus SPPB (Model 5), and handgrip strength plus gait speed (Model 6), respectively. Significant improvement in predictive values were observed for all five novel models compared with Model 1 (C-index = 0.693). The lower limb model (Model 3 SPPB model: C-index = 0.731) may play a key role in the prediction of ADL disability, reflecting a comparable predictive value to the comprehensive models combining both upper and lower limbs (Model 5 handgrip strength + SPPB model: C-index = 0.732). When we simplified the lower limb models by replacing SPPB with gait speed, the predictive values attenuated slightly (C-index: Model 3 vs Model 4: 0.731 vs 0.714; Model 5 vs Model 6: 0.732 vs 0.718), but still better than the upper limb model (Model 2 handgrip strength model: C-index = 0.701). Conclusions Physical performance-based models, especially lower limb model, provided improved prediction for ADL disability among Chinese older adults, which may help guide the targeted intervention.https://doi.org/10.1186/s12877-022-02905-yPrediction modelPhysical performanceActivities of daily living disabilityShort physical performance batteryGait speed |
| spellingShingle | Li Zhang Yueqiao Chen Jing Liu Yifan Yu Huijie Cui Qiuzhi Chen Kejin Chen Chunxia Yang Yanfang Yang Novel physical performance-based models for activities of daily living disability prediction among Chinese older community population: a nationally representative survey in China BMC Geriatrics Prediction model Physical performance Activities of daily living disability Short physical performance battery Gait speed |
| title | Novel physical performance-based models for activities of daily living disability prediction among Chinese older community population: a nationally representative survey in China |
| title_full | Novel physical performance-based models for activities of daily living disability prediction among Chinese older community population: a nationally representative survey in China |
| title_fullStr | Novel physical performance-based models for activities of daily living disability prediction among Chinese older community population: a nationally representative survey in China |
| title_full_unstemmed | Novel physical performance-based models for activities of daily living disability prediction among Chinese older community population: a nationally representative survey in China |
| title_short | Novel physical performance-based models for activities of daily living disability prediction among Chinese older community population: a nationally representative survey in China |
| title_sort | novel physical performance based models for activities of daily living disability prediction among chinese older community population a nationally representative survey in china |
| topic | Prediction model Physical performance Activities of daily living disability Short physical performance battery Gait speed |
| url | https://doi.org/10.1186/s12877-022-02905-y |
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