The influence of lower-extremity function in elderly individuals’ quality of life (QOL): An analysis of the correlation between SPPB and EQ-5D

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Abstract

Background

If an association between a decline in physical performance and subjective QOL is confirmed, the SPPB could be used as a predictor for declining QOL in older people.

Objective

This study aimed to elucidate the association between the short physical performance battery (SPPB) and QOL (EQ-5D) to determine the utility of the SPPB as a predictor of declining QOL.

Methods

The SPPB and the EQ-5D test were performed with a random sample of participants nested in the Korean Longitudinal Study of Aging (KLoSA) panel. Comparisons of the adjusted mean scores on the EQ-5D index between normal and abnormal SPPB groups were performed. We selected the quartiles of the EQ-5D index variables for the analysis. The association between the EQ-5D index and SPPB abnormality was examined using multinomial logistic regression analysis. Additionally, the associations between gait speed and chair stand time and the EQ-5D index were examined using the same analysis.

Results

Four hundred and twenty-two subjects were included in the analysis. The adjusted means for the EQ-5D index were significantly lower when the SPPB score was abnormal (p = 0.022 for men, p = 0.047 for women). An abnormal SPPB score was significantly associated with the lowest quartile of EQ-5D index score (adjusted OR 3.54 in the lowest quartile for men; adjusted OR 2.50 and 3.37 in the lowest and second quartiles for women). Gait speed was significantly associated with the EQ-5D index for participants of both sexes, but standup time was associated with the EQ-5D index only for men.

Conclusions

An abnormal SPPB score was associated with lower QOL. Thus, the SPPB has the potential to be used as an early predictor of declining QOL in clinical settings and epidemiological studies.

Introduction

Korea has had a large proportion of elderly individuals since 2000. With ongoing physiologic aging and a higher prevalence of chronic degenerative diseases, the decline of physical and emotional health status is on the rise. Accordingly, the elderly population poses a challenge to minimize disability and improve QOL (WHOQOL, 1995).

The ultimate purpose of assessing physical function in the old age is to detect, correct and reverse the decline of physical function or vulnerability in a timely fashion, allowing elderly people to maintain an independent and physically active lifestyle. Among diverse tests of physical function, the SPPB, also known as SPPB, is known to predict declining functional ability and nursing home admission rates in both high-risk groups whose functionality has deteriorated to a certain level and low-risk groups whose functionality is relatively well-preserved (Guralnik et al., 1995, Studenski et al., 2003). The SPPB tests predict falls, inflammatory reactions, disability and nursing home admission rates, and they assess maximum functional outcome rather than lower extremity disability by including tests of standing balance, normal gait speed and timed sit-to-stand (Guralnik et al., 1989). Some researches have been conducted on the effects that physical activity has on psychological well-being or QOL in older adults (Beswick et al., 2008, Buchner et al., 1992, Chun, 2012, Kerse et al., 2008, Penninx et al., 2000).

The 5-dimensional EuroQol (EQ-5D), which reflects health-related QOL, is also widely used because of its brevity and international comparability (Dolan, 1997, The EuroQol Group, 1990). Physical function and QOL represent two major components of multidimensional evaluation in older people. There are few previous reports, however, of direct studies on the association between the two. This study aimed to identify the association between overall QOL and physical function in an elderly population. Moreover, it could be possible for us to assume the QOL by means of simple physical function test.

Using the KLoSA dataset, those who had participated in the physical function test SPPB and who had also responded to EQ-5D questionnaires were selected. We tested whether a significant relationship existed between the two scores and whether specific physical functions had an influence on QOL.

Section snippets

Study population

The KLoSA is a national project first conducted in 2006 to respond to the need for evidence-based policies to address the aging trend of the population. The project was modeled after panel studies of the middle-aged and elderly populations in the United States and the United Kingdom, and the purpose was to generate data comparable with similar studies in other countries and to provide a foundation for policy-making and academic research (Kim et al., 2011).

The participants were drawn randomly

Anthropometric characteristics

Of the 527 subjects randomly selected from the 2nd wave of KLoSA, 422 who had undergone both the SPPB and the EQ-5D were used in the analysis. The respondents’ ages ranged from 47 to 94, with a mean age of 64.11 ± 8.91 for the men and 64.10 ± 10.11 for the women. The highest proportion of men fell into the 60–69 age groups (33.0%), while the highest proportion of women fell into the 50–59 age groups, but the overall distributions were similar (Table 1).

The most common score on the SPPB measure of

Discussion

The health issues of elderly people have recently been emphasized because of the rapid aging of society. Limited exercise capacity, reduced vital capacity, poor muscular strength, restricted flexibility, decreased bone mass, and glucose intolerance develop during the aging process. These physiologic changes lead to loss of physical function and dependence on assistance for performing activities of daily living. We call this transitional state “frailty,” and it may negatively impact physical,

Financial disclosure

None.

Conflicts of interest

The authors have no conflicts of interest to disclose.

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