The diagnostic value of the Short Physical Performance Battery for sarcopenia

Phu, Steven; Kirk, Ben; Hassan, Ebrahim Bani; Vogrin, Sara; Zanker, Jesse; Bernardo, Solange; Duque, Gustavo

doi:10.1186/s12877-020-01642-4

Cited by 57 publications

(58 citation statements)

References 34 publications

(36 reference statements)

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“…Other studies also reported SPPB cut-points of 7–9 being associated with higher mortality risk [ 28 – 30 ]. The optimal SPPB cut-point of ≤11 for discriminating severe sarcopenia in our study was also higher than an Australian study which showed an optimal SPPB cut-point of 5–8, depending on physical performance definition such as GS and SPPB, for severe sarcopenia [ 26 ]. Differences in study populations likely explain the disparity.…”

Section: Discussioncontrasting

confidence: 64%

“…Although SPPB cut-off of ≤9 in men and ≤ 7 in women gave the best sensitivity and specificity for AWGS19 SPPB definition for severe sarcopenia, these results should be interpreted with caution due to the small sample size of men ( n = 8) and women ( n = 2) with severe sarcopenia based on the AWGS19 SPPB criterion. The cut-off of ≤11 was higher than the recommended SPPB cut-point of ≤8–9 suggested by EWGSOP and AWGS19 SPPB criteria for sarcopenia [ 10 , 11 , 26 , 27 ]. Other studies also reported SPPB cut-points of 7–9 being associated with higher mortality risk [ 28 – 30 ].…”

Section: Discussionmentioning

confidence: 70%

“…In our study, the prevalence of sarcopenia and severe sarcopenia combined ranged from 30–41% in men and 23–40% in women depending on AWGS19 definition, justifying the need for markers such as SPPB, to assess sarcopenia and poor physical function in a quicker and easier manner among the wider population. The prevalence of severe sarcopenia among Caucasian older adults was 7 and 8% according to EWGSOP2 SPPB and GS criteria respectively [ 26 ]. The difference in prevalence between definitions was smaller than our study of 3 and 17% for AWGS19 SPPB and GS criteria respectively.…”

Section: Discussionmentioning

confidence: 99%

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SPPB reference values and performance in assessing sarcopenia in community-dwelling Singaporeans – Yishun study

et al. 2021

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Background The Short Physical Performance Battery (SPPB) is an established test of physical performance. We provide reference values for SPPB and determine SPPB performance and cut-offs in assessing sarcopenia for Asian community-dwelling older adults. Methods Five hundred thirty-eight (57.8% women) community-dwelling adults aged 21–90 years were recruited. SPPB and its subtest scores and timings (8 ft. gait speed (GS), five-times repeated chair sit-to-stand (STS) and balance) were determined. Appendicular lean mass divided by height-squared, muscle strength (handgrip) and physical performance (6 m GS, STS and SPPB) were assessed to define sarcopenia for various Asian criteria. Area under the ROC curve (AUC) was used to assess performance of SPPB and subtests in discriminating sarcopenia in adults aged ≥60 years. Optimal SPPB and GS subtest cut-offs for each sarcopenia criterion were determined by maximizing sensitivity and specificity. Results The mean SPPB score was 11.6(SD 1.1) in men and 11.5(SD1.2) in women. Majority of participants(≥50%) aged 21–80 years achieved the maximum SPPB score. SPPB total and subtest scores generally decreased with age (all p < 0.001), but did not differ between sex. Among older adults (≥60 years), SPPB and GS subtest had varied performance in assessing sarcopenia (AUC 0.54–0.64 and 0.51–0.72, respectively), and moderate-to-excellent performance in assessing severe sarcopenia (AUC 0.69–0.98 and 0.75–0.95, respectively), depending on sarcopenia definitions. The optimal cut-offs for discriminating sarcopenia in both sexes were SPPB ≤11points and GS subtest ≤1.0 m/s. The most common optimal cut-offs for discriminating severe sarcopenia according to various definitions were SPPB ≤11points in both sexes, and GS ≤0.9 m/s in men and ≤ 1.0 m/s in women. Conclusions Population-specific normative SPPB values are important for use in diagnostic criteria and to interpret results of studies evaluating and establishing appropriate treatment goals. Performance on the SPPB should be reported in terms of the total sum score and registered time to complete the repeated-chair STS and 8-ft walk tests. The performance of GS subtest was comparable to SPPB and could be a useful, simple and accessible screening tool for discriminating severe sarcopenia in community-dwelling older adults.

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Section: Discussioncontrasting

confidence: 64%

Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 99%

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SPPB reference values and performance in assessing sarcopenia in community-dwelling Singaporeans – Yishun study

et al. 2021

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“…Composite measures should be used as different tests are complimentary in their ability to detect different components of physical performance, strength and muscle mass. For example, the use of the SPPB to screen for sarcopenia had lower sensitivity if it was used alone without measures of muscle mass [ 57 ].…”

Section: Discussionmentioning

confidence: 99%

Performance on sit-to-stand tests in relation to measures of functional fitness and sarcopenia diagnosis in community-dwelling older adults

Yee

Allen

et al. 2021

Eur Rev Aging Phys Act

107

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Background The sit-to-stand (STS) test has been deployed as surrogate measures of strength or physical performance in sarcopenia diagnosis. This study examines the relationship of two common STS variants – Five Times Sit-to-Stand Test (5TSTS) and 30 s Chair Stand Test (30CST) – with grip strength, muscle mass and functional measures, and their impact on sarcopenia prevalence in community-dwelling older adults. Methods This is a cross-sectional analysis of 887 community-dwelling adults aged ≥50 years. Participants completed a battery of physical fitness tests - 5TSTS, 30CST, grip strength, gait speed, Timed-Up-and-Go (TUG) for dynamic balance and six-minute walk test (6MWT) for cardiorespiratory endurance. Muscle mass was measured using multi-frequency segmental bioelectrical impedance analysis (BIA). We performed correlation analysis between STS performance and other fitness measures and muscle mass, followed by multiple linear regression for the independent determinants of STS performance. Results Mean participant age was 67.3±7 years, with female predominance (72.9%). STS tests exhibited weak correlations with grip strength (30CST, r = 0.290; 5TSTS, r = − 0.242; both p< 0.01), and stronger correlations with gait speed (30CST, r = 0.517; 5TSTS, r = − 0.533; both p< 0.01), endurance (30CST, r = 0.558; 5TSTS, r = − 0.531; both p < 0.01) and dynamic balance (30CST, r = − 0.501; 5TSTS, r = 0.646; both p< 0.01). Muscle mass correlated with grip strength but not STS. In multiple regression analysis, all fitness measures were independently associated with 30CST performance. Performance in both STS tests remained independent of muscle mass. There was no significant difference in prevalence of possible sarcopenia diagnosis using grip strength or STS (30CST, 25.0%; 5TSTS, 22.1%; grip strength, 22.3%; p = 0.276). When both measures are used, prevalence is significantly higher (42.0%; p = 0.276). Prevalence of confirmed sarcopenia with inclusion of muscle mass was significantly lower using STS compared with grip strength (30CST, 4.6%; 5TSTS, 4.1% vs. grip strength, 7.1%; p< 0.05). Conclusion In the sarcopenia construct, STS tests better represents muscle physical performance rather than muscle strength. Different subsets of population with possible sarcopenia are identified depending on the test used. The lack of association of STS performance with muscle mass results in a lower prevalence of confirmed sarcopenia compared with grip strength, but may better reflect changes in muscle quality.

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“…Both devices, the DXA machine and the dynamometer, were calibrated following the manufacturer’s instructions. Physical performance was evaluated by short physical performance battery (SPPB) composed of three tests: balance, 4 m gait speed and chair stand [ 22 , 23 ]. The balance test included tandem, semi-tandem and side-by-side standing.…”

Section: Methodsmentioning

confidence: 99%

Associations between Physical Function, Bone Density, Muscle Mass and Muscle Morphology in Older Men with Sarcopenia: A Pilot Study

et al. 2021

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Background and Objectives: It is thought that muscle and bone interact only on a biomechanical level, however, some research is now emerging that links bone and muscle on a cellular level. The aim of this study was to explore associations between physical function, muscle mass and bone density in community-dwelling elderly men with sarcopenia. A secondary goal was to analyze if muscle morphology was associated with bone density and physical functioning. Materials and Methods: Body composition was measured by dual-energy X-ray absorptiometry (DXA). Bone density was evaluated according to WHO criteria. Sarcopenia was diagnosed according to European Working Group on Sarcopenia in Older People (EWGSOP) criteria: low muscle mass and low muscle strength or low physical performance. Microbiopsy of musculus vastus lateralis was performed with a disposable muscle microbiopsy system. The perimeter and cross-sectional area of muscle fibers were calculated using image analysis software in whole slide images; type of fibers and their distribution were evaluated as well. Results: A total of 151 men, 60 years or older were included in this study. Mean age of the subjects was 72.9 ± 8.02 years. Sarcopenia was diagnosed in 45 (29.8%) men. Multiple significant correlations were found between bone mineral density, lean mass, appendicular lean mass, arm and leg lean mass, gait speed, balance test and handgrip strength in sarcopenic men. Lean mass was associated with femoral neck BMD (bone mineral density; r = 0.418, p = 0.006) and handgrip strength (r = 0.553, p < 0.001). In the sarcopenia group, 25 muscle biopsies were examined. In 9 sarcopenic men with T-scores equal or below −2.5, the muscle fiber area had a significant correlation with the balance test (r = 0.73, p = 0.025). Conclusions: In men with sarcopenia, low lean muscle mass was associated with low femoral neck BMD and low muscle strength. In sarcopenic men with osteoporosis, low muscle fiber area was associated with low scores in a balance test.

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The diagnostic value of the Short Physical Performance Battery for sarcopenia

Cited by 57 publications

References 34 publications

SPPB reference values and performance in assessing sarcopenia in community-dwelling Singaporeans – Yishun study

SPPB reference values and performance in assessing sarcopenia in community-dwelling Singaporeans – Yishun study

Performance on sit-to-stand tests in relation to measures of functional fitness and sarcopenia diagnosis in community-dwelling older adults

Associations between Physical Function, Bone Density, Muscle Mass and Muscle Morphology in Older Men with Sarcopenia: A Pilot Study

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