Short Physical Performance Battery or Chair Stand: Which Better Predicts Disability Among High-Functioning Older Adults?

Objective: To compare the Short Physical Performance Battery (SPPB) and Chair Stand Test (CST) in terms of their ability to identify the risk of incident disability in instrumental activities of daily living (IADL) and basic activities of daily living (BADL) over an 8-year follow-up among high-functioning older adults.

Design: Longitudinal study.

Setting and participants: A sample of 2386 participants from the English Longitudinal Study of Ageing (ELSA) who were free of IADL/BADL disability and had a gait speed greater than 0.8 m/s at baseline.

Methods: Receiver operating characteristic curves were used to evaluate the accuracy of the SPPB and CST to identify the risk of incident IADL/BADL disability. Subsequently, the trajectories of incident IADL/BADL disability were analyzed according to the SPPB and CST cutoff points using generalized linear mixed models adjusted for sociodemographic, behavioral, and clinical characteristics.

Results: Performance in the SPPB ≤11 points and CST ≥11.5 seconds more accurately identified the risk of incident IADL/BADL disability than SPPB ≤10 points and CST >15 seconds, which are the cutoff points most commonly recommended in the literature to date. Finally, the trajectories of incident IADL/BADL disability were similar for SPPB ≤11 points and CST ≥11.5 seconds.

Conclusions and implications: SPPB ≤11 points and CST ≥11.5 seconds more accurately identified the risk of incident IADL/BADL disability than previously recommended cutoff points. As both instruments were similar in predicting trajectories of incident disability, the CST may represent a more practical choice for clinical screening, given its simplicity and shorter administration time.