Short Physical Performance Battery, usual gait speed, grip strength and Vulnerable Elders Survey each predict functional decline among older women with breast cancer

摘要

? 2017 Elsevier Inc. ? 2017 Elsevier Inc. Objective To determine the ability of three performance-based measures [Short Physical Performance Battery (SPPB), gait speed, and Grip Strength] and a self-report measure [Vulnerable Elders Survey (VES-13)] to predict functional decline among older women with breast cancer. Patients and Methods Longitudinal data from a study of women ≥ 65 years, with newly diagnosed stages I–III breast cancer, recruited from ambulatory oncology clinics between July 2010 and April 2014, was used. The primary outcome was functional decline, Yes or No, defined as a decrease in ≥ 1-point from baseline to 12 months, on Activities of Daily Living Scales. Multivariable logistic regression and receiver operator curve analyses were conducted. Results Among 123 participants 18 (15%) developed functional decline. The predictive abilities for measures were: SPPB [Adjusted odds ratio (AOR) = 1.65 per unit decrease in scores, 95% confidence interval (CI) = 1.33–2.05; area under the receiver operator curve (AUC) = 0.93; sensitivity = 94%, specificity = 80%]; gait speed (AOR = 1.76 per unit increase in usual walking time, CI = 1.29–2.41; AUC = 0.93; sensitivity = 87%, specificity = 79%); VES-13 (AOR = 1.64 per unit increase in scores, CI = 1.31–2.05; AUC = 0.87; sensitivity = 83%, specificity = 84%); and grip strength: (AOR = 1.18 per unit decrease in grip strength, CI = 1.06–1.30; AUC = 0.80; sensitivity = 67%, specificity = 77%). Conclusion SPPB, gait speed, grip strength and VES-13 all demonstrated excellent predictive abilities for functional decline. Larger studies are warranted to confirm the utility of these measures for identifying older adults with cancer at increased risk for functional decline, who may then be targeted for studies to explore the effects of interventions to improve function. Objective To determine the ability of three performance-based measures [Short Physical Performance Battery (SPPB), gait speed, and Grip Strength] and a self-report measure [Vulnerable Elders Survey (VES-13)] to predict functional decline among older women with breast cancer. Patients and Methods Longitudinal data from a study of women ≥ 65 years, with newly diagnosed stages I–III breast cancer, recruited from ambulatory oncology clinics between July 2010 and April 2014, was used. The primary outcome was functional decline, Yes or No, defined as a decrease in ≥ 1-point from baseline to 12 months, on Activities of Daily Living Scales. Multivariable logistic regression and receiver operator curve analyses were conducted. Results Among 123 participants 18 (15%) developed functional decline. The predictive abilities for measures were: SPPB [Adjusted odds ratio (AOR) = 1.65 per unit decrease in scores, 95% confidence interval (CI) = 1.33–2.05; area under the receiver operator curve (AUC) = 0.93; sensitivity = 94%, specificity = 80%]; gait speed (AOR = 1.76 per unit increase in usual walking time, CI = 1.29–2.41; AUC = 0.93; sensitivity = 87%, specificity = 79%); VES-13 (AOR = 1.64 per unit increase in scores, CI = 1.31–2.05; AUC = 0.87; sensitivity = 83%, specificity = 84%); and grip strength: (AOR = 1.18 per unit decrease in grip strength, CI = 1.06–1.30; AUC = 0.80; sensitivity = 67%, specificity = 77%). Conclusion SPPB, gait speed, grip strength and VES-13 all demonstrated excellent predictive abilities for functional decline. Larger studies are warranted to confirm the utility of these measures for identifying older adults with cancer at increased risk for functional decline, who may then be targeted for studies to explore the effects of interventions to improve function.