Predicting Ability of Modified Short Physical Performance Battery

Background: The aim of this study was to investigate the capacity of the Short Physical Performance Battery (SPPB) and SPPB based on a community-based (SPPB-com) score, as developed earlier to discriminate among the non-frailty, pre-frailty and frailty respondents, classified according to the Kihon Checklist score, in communities of Japanese elderly people. Methods: A total of 132 elderly outpatients aged ≥ 65 years were participated in this study. Frailty was measured using the Kihon Checklist score (points) and divided into three groups. Participants were assessed using the SPPB (0-12 points) and SPPB-com (0-10 points) instruments. Handgrip strength (kg), maximum isometric knee extensor strength (N/kg) and maximum walking speed (m/s) were measured as physical functions. Discriminant analysis using the forward stepwise procedure was performed to estimate frailty groups. Receiver operating characteristics analysis was employed to calculate the area under the curve (AUC) and to determine the optimal cut-off point, which would best discriminate non-frailty from frailty respondents. Results: The SPPB-com score could classify the participants into non-frailty, pre-frailty or frailty groups with an accuracy of 62.5% following validation. The SPPB score, with a cut-off point of 11, gave the best trade-off between sensitivity and specificity, with AUC = 0.77. Conversely, the SPPB-com score, with a cut-off point of only 5, gave the best trade-off between sensitivity and specificity, with an AUC of 0.80. Conclusion: The SPPB-com score can identify pre-frailty before frailty even in high-functioning elderly people, and would therefore assist in the early detection of frailty.