COMPARATIVE ACCURACY OF SHORT PHYSICAL PERFORMANCE BATTERY VS. TIME UP AND GO: FALL SCREENING IMPLICATIONS

摘要

Performance-based screening tests for risk stratification are key in clinical decision-making aimed at prevention of major geriatric syndromes. Busy healthcare settings have constraints (e.g., time, space) that challenge the administration of multiple tests for distinct syndromes. Enhanced understanding about opportunities to bundle screening approaches for inter-related conditions vis-à-vis increasing screening efficiency is warranted. We compared the accuracy of the Short Physical Performance Battery (SPPB) and the Time Up and Go (TUG), well-established mobility disability and falls screening tests, respectively, in discriminating fall history. Cross-sectional study of community-dwelling adults 65 years and older of Hispanic origin selected from four senior centers in Miami, Florida. Outcome was self-reported fall in the previous 12 months. Standardized SPPB (scores) and TUG (seconds) were obtained. Receiver operating characteristic (ROC) curves were statistically compared. Analytic sample had 102 participants (mean age: 76.4 ± 6.4 years, 56.7% female). Fall had occurred in 31.4% of sample. Median SPPB score was 8 (25th-75th percentiles: 7–10), and TUG was 14.1 seconds (25th-75th percentiles: 11.5–17.4). ROCs for SPPB and TUG overlapped substantially; areas under ROCS estimating the overall accuracy of each test in discriminating those who had fallen from those who hadn’t yielded similar areas under ROCs; i.e., 70.3% and 69.4% (p-value=0.839), respectively. Results provide preliminary evidence that SPPB might have screening accuracy comparable to that provided by the widely used TUG for fall risk assessment. Prospective studies comparing predictive accuracy regarding subsequent falls, while taking account competing risks, will help determining opportunities on whether/how to integrate mobility disability and falls screening recommendations.