Evaluation of Two Fatigability Severity Measures in Elderly Adults

Abstract

Objectives To document the stability, concurrent validity and clinical correlates of two fatigability severity measures as recommended by the American Geriatrics Society. Design Descriptive, cross-sectional. Setting Two independent-living and one community senior centers. Participants 43 volunteers, average age 85 ± 6 years. Measurements Perceived fatigability severity was quantified by directly asking subjects to report change in energy following a standardized 10-minute walk at self-selected pace. Performance fatigability severity was defined as a ratio of change in walking speed and total distance walked. The walk test was repeated within two weeks to assess stability. Total daily physical activity (PA) was measured over seven consecutive days using waist-worn accelerometer. Frailty was measured with the VES13 interview scale and gait speed was measured using standardized 25-feet walk test. Results The perceived and performance fatigability severity measures were significantly correlated (r=.94, p<01) and stable over two assessments (r= .82 and .85, respectively p<.01). Both fatigability severity measures were significantly correlated with PA level (r=−.42 and −.44, respectively p<.05), frailty (r=.47 and .53, respectively p<.01) and gait speed (r= −.45 and −.54 respectively, p<.01.). Conclusion The methodology described in this study permits the calculation of two highly correlated fatigability severity scores, which summarize the relationship of a person’s change in self-reported tiredness or change in physical performance to concurrently measured PA. The fatigability severity scores are reproducible and correlated with clinical measures predictive of decline. The methods used to quantify fatigability severity can be implemented during a brief assessment (< 15 minutes) and should be useful in the design and evaluation of interventions to increase PA in older adults at risk for functional decline.

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