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Can measures of physical performance in mid-life improve the clinical prediction of disability in early old age? Findings from a British birth cohort study

Dodds, RM; Kuh, D; Sayer, AA; Cooper, R; (2018) Can measures of physical performance in mid-life improve the clinical prediction of disability in early old age? Findings from a British birth cohort study. Experimental Gerontology , 110 pp. 118-124. 10.1016/j.exger.2018.06.001. Green open access

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Abstract

BACKGROUND: Poor performance in physical tests such as grip strength and walking speed is a risk factor for disability in old age, although whether such measures improve the discrimination of clinical prediction models when traditional clinical risk factors are already known is not clear. The prevalence of disability in mid-life is relatively low and hence screening in this age group may present an opportunity for early identification of those at increased future risk who may benefit most from preventative interventions. METHODS: Data were drawn from two waves of the Medical Research Council National Survey of Health and Development. We examined whether several chronic conditions, poor health behaviours and lower scores on three measures of physical performance (grip strength, chair rise speed and standing balance time) at age 53 were associated with self-reported mobility and/or personal care disability at age 69. We used the area under the curve statistic (AUC) to assess model discrimination. RESULTS: At age 69, 44% (826/1855) of participants reported mobility and/or personal care disability. Our final clinical prediction model included sex, knee osteoarthritis, taking 2+ medications, smoking, increased BMI and poor performance in all three physical tests, with an AUC of 0.740 compared with 0.708 for a model which did not include the performance measures. CONCLUSION: Measures of physical performance in midlife improve discrimination in clinical prediction models for disability over 16 years. Importantly, these and similar measures are also potential targets of future diet, exercise and pharmacological intervention in mid-life.

Type: Article
Title: Can measures of physical performance in mid-life improve the clinical prediction of disability in early old age? Findings from a British birth cohort study
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.exger.2018.06.001
Publisher version: http://doi.org/10.1016/j.exger.2018.06.001
Language: English
Additional information: Copyright © 2018 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/BY/4.0/).
Keywords: Birth cohort study, Clinical prediction, Disability, Physical performance
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
URI: https://discovery.ucl.ac.uk/id/eprint/10051356
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