Epidemiology of Perceived Physical Fatigability in Older Adults: The Long Life Family Study

LaSorda, Kelsea R.; Gmelin, Theresa; Kuipers, Allison L.; Boudreau, Robert M.; Santanasto, Adam J; Christensen, Kaare; Renner, Sharon W; Wojczynski, Mary K.; Andersen, Stacy L.; Cosentino, Stephanie; Glynn, Nancy W.

doi:10.1093/gerona/glz288

Cited by 35 publications

(52 citation statements)

References 51 publications

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“…[22,23] In the present study, we found that the PFS not only had good concurrent and convergent validity against ADL and IADL, but also was positively associated with total SPPB score and gait speed. Our findings concur with findings from the Long Life Family Study [10] showing that having difficulty with ADLs (physical disability) was a risk factor associated with greater perceived physical fatigability. The current study also indicated that perceived physical fatigability was a risk factors associated with physical limitation in this very old Chinese group.…”

Section: Discussionsupporting

confidence: 90%

“…[10] In the LLFS [10] , mean PFS Physical scores of those 80-89 year and ≥90 years old were 19.1 and 28.6 points, respectively, indicating that our sample had greater fatigability, with a mean of 25.5 points. Similar to LaSorda et al, [10] we found that women had significantly higher PFS Physical scores than men.…”

Section: Discussionmentioning

confidence: 84%

“…The PFS Physical subscale has good convergent validity against performance measures of mobility, physical function and fitness, as well as good concurrent validity against performance-based measures of fatigability [6] . Greater perceived physical fatigability using the PFS has been shown to be higher in women than men, associated with poorer mobility, meaningful decline in physical function, and other important health indicators [3,4,7,9,10] .…”

Section: Introductionmentioning

confidence: 99%

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Validation of Perceived Physical Fatigability Using the Simplified-Chinese Version of the Pittsburgh Fatigability Scale

Zhang

et al. 2020

Preprint

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Background: The Pittsburgh Fatigability Scale (PFS) was developed to capture fatigue and demand in a single tool, filling a gap that no validated questionnaire existed to measure perceived fatigability. Since fatigability is a more sensitive measure of a person’s susceptibility to fatigue, we validated the simplified-Chinese version of the PFS among Chinese community-dwelling older adults.Methods: The PFS was translated into the simplified-Chinese by the translation, retro-translation method. Internal consistency of the Physical subscale of the PFS was evaluated by Cronbach’s alpha. Convergent validity and discriminant validity were evaluated against physical performance measures (i.e., Short Physical Performance Battery & Timed Up and Go Test) and daily living performance (i.e., Barthel Index & Instrumental activity of daily living).Results: The simplified-Chinese version of PFS Physical scores showed strong internal consistency (Cronbach’s alpha=0.81). Higher PFS Physical scores were associated with worse physical performance, and daily living performance (|correlation coefficient| range: 0.36-0.56, p<.001). Age- and sex-adjusted PFS Physical scores had moderate to good overall discrimination for correctly classifying people by their physical performance and daily living performance (AUCs range 0.70-0.87, p<.001)Conclusions: The PFS simplified-Chinese version is a valid instrument to assess perceived physical fatigability in Chinese-speaking older adults with good convergent validity. Thus, the PFS, with low cost and greater feasibility, is a desired tool to measure fatigability in large population studies.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

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Validation of Perceived Physical Fatigability Using the Simplified-Chinese Version of the Pittsburgh Fatigability Scale

Zhang

et al. 2020

Preprint

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“…We found that fatigue was significantly associated with increased fall risk by 25%, after adjustment for several covariates, including previous fall history. Future studies should include a more sensitive measure of fatigue, namely perceived fatigability ( 15 , 62 , 65 ), as well as include women, as they have a greater prevalence of fatigability ( 65 ). Measuring fatigability enables us to describe an older adults’ susceptibility to experiencing fatigue in the context of a quantifiable demand at a fixed intensity and duration ( 61 , 62 ).…”

Section: Discussionmentioning

confidence: 99%

Higher Fatigue Prospectively Increases the Risk of Falls in Older Men

Renner

Cauley

Brown

et al. 2020

Innovation in Aging

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Background and Objectives Fatigue is a common complaint and shares many risk factors with falls, yet the independent contribution of fatigue on fall risk is unclear. This study’s primary aim was to assess the association between fatigue and prospective fall risk in 5,642 men aged 64-100 enrolled in the Osteoporotic Fractures in Men Study (MrOS). The secondary aim was to examine the association between fatigue and recurrent fall risk. Research Design and Methods Fatigue was measured at baseline using the Medical Outcomes Study (short form) single-item question “during the past four weeks, how much of the time did you feel energetic?” Responses were then classified: higher fatigue=“none”, “little”, or “some” of the time and lower fatigue=“a good bit”, “most”, or “all” of the time. We assessed falls using triannual questionnaires. Fall risk was examined prospectively over three years; recurrent falling was defined as ≥2 falls within the first year. Generalized estimating equations and multinomial logistic regression modeled prospective and recurrent fall risk as a function of baseline fatigue status, adjusted for demographics, medications, physical activity, and gait speed. Results Men with higher (26%) vs. lower baseline fatigue were older (75.1±6.2 vs.73.2±5.7 years), 24% less active, and had worse function (gait speed=1.09±0.24 vs. 1.24±0.21 m/s), all p<0.0001. Within one year, 25.4% (N=1,409) had fallen at least once, of which 47.4% (N=668) were recurrent fallers. Men with higher vs. lower fatigue had 25% increased fall risk (RR=1.25, 95% CI:1.14, 1.36) over 3 years follow-up, but had 50% increased odds of recurrent falling (OR 1.50, 95% CI: 1.22, 1.85) within the first year. Discussion and Implications Fatigue is an important risk factor of falling independent of established risk factors. Reductions in fatigue (i.e., increased energy) may lessen the burden of falls in older men and provide a novel avenue for fall risk intervention.

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“…Fatigability, defined as the measurement of fatigue in relation to an activity of fixed intensity and duration, accounts for this so called self-pacing bias [7,10]. Thus, fatigability is a more sensitive measure of someone's susceptibility to fatigue, making this construct more suitable as a research outcome [7,11,12].…”

Section: Introductionmentioning

confidence: 99%

Translation and validation of the Dutch Pittsburgh Fatigability Scale for older adults

et al. 2020

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Background: The original Pittsburgh Fatigability Scale (PFS) was developed to assess perceived fatigability in older adults. The objective of this study was to translate the PFS into Dutch and investigate its validity and reliability among hospitalized older adults aged ≥70 years. Methods: The PFS was translated into Dutch and pretested for comprehensibility by the Three-Step Test Interview method. The factor structure underlying the final version was evaluated by confirmatory factor analysis (CFA) and exploratory factor analyses (EFA). Internal consistency of the identified subscales was evaluated by Cronbach's alpha. Construct validity was evaluated by hypothesis testing. Test-retest reliability was evaluated using intraclass correlation coefficients (ICC) and Bland Altman plots. Results: The validation sample included 233 patients. CFA of the original factor structure resulted in poor model fit in our Dutch sample. EFA of PFS physical and mental subscales resulted in a two-factor solution underlying the data with good internal consistency of the identified subscales (Cronbach's alpha: 0.80-0.92). Five out of six hypotheses were confirmed, indicating good construct validity. Retest assessments were performed among 50 patients and showed good reliability for both the physical (ICC: 0.80, 95%CI: 0.68; 0.88) and mental subscale (ICC: 0.81, 95%CI: 0.68; 0.89). Conclusion: The Dutch PFS is a valid and reliable instrument to assess fatigability in older hospitalized patients.

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Epidemiology of Perceived Physical Fatigability in Older Adults: The Long Life Family Study

Cited by 35 publications

References 51 publications

Validation of Perceived Physical Fatigability Using the Simplified-Chinese Version of the Pittsburgh Fatigability Scale

Validation of Perceived Physical Fatigability Using the Simplified-Chinese Version of the Pittsburgh Fatigability Scale

Higher Fatigue Prospectively Increases the Risk of Falls in Older Men

Translation and validation of the Dutch Pittsburgh Fatigability Scale for older adults

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