SPPB or chair stand test: Which is associated with mortality risk in high-functioning older adults?

OBJECTIVE: To investigate the associations of the Short Physical Performance Battery (SPPB) and the Chair Stand Test (CST) with all-cause mortality risk among high-functioning older adults over a 15-year follow-up. STUDY DESIGN: Longitudinal cohort study using data from the English Longitudinal Study of Ageing (ELSA) with a 15-year follow-up. SETTING: General community in England. PARTICIPANTS: A population-based sample of 2747 individuals with baseline high physical function (gait speed > 0.8 m/s or > 1.0 m/s). Poor lower extremity function was defined as SPPB ≤ 10 points and CST > 15 s. MAIN OUTCOME MEASURE(S): All-cause mortality during the follow-up. Cox proportional hazards models, adjusted for sociodemographic, behavioural, and clinical factors were used to estimate hazard ratios (HRs). RESULTS: Mortality rates were 19.6 and 39.7 per 1000 person-years for SPPB > 10 and ≤ 10 points, and 21.9 and 41.4 per 1000 person-years for CST ≤ 15 and > 15 s, respectively. The risk of mortality was 31% higher for SPPB ≤ 10 points (HR 1.31; 95% CI 1.12-1.54) and 36% higher for CST > 15 s (HR 1.36; 95% CI 1.13-1.62). In a sensitivity analysis (gait speed > 1.0 m/s), the risk of mortality was 43% higher for SPPB ≤ 10 (HR 1.43; 95% CI 1.11-1.83) and 75% higher for CST > 15 s (HR 1.75; 95% CI 1.30-2.36). CONCLUSION: Both the SPPB and the CST were associated with mortality risk among high-functioning older adults. However, given its quick, easy application, CST may be preferable in clinical settings.