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

​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-timesrepeated chair sit-to-stand (STS) and balance) were determined. Appendicular lean mass divided by height-squared, muslce 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 mean and 11.5 (SD 1.2) 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 abd 0.75-0.95, respectively), depending on sarcopenia definitions. The optimal cut-offs for discriminating sarcopenia in both sexed were SPPB ≤11 points and GS subtest ≤1.0m/s. The most common optimal cut-offs for discriminating severe sarcopenia according to various definitions were SPPB ≤11points in both sexes, and GS ≤0.9m/s in men and ≤1.0m/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 substest was comparable to SPPB and could be a useful, simple and accessible screening tool for discriminating severe sarcopenia in community-dwelling older adults.

SOURCE:
BMC Geriatrics

DOI:
https://doi.org/10.1186/s12877-021-02147-4

AUTHOR(S):
Lee SY, Choo PL, Pang BWJ,Lau LK, Jabbar KA, Seah JWT, Chen KK, Ng TP, Wee SL