Inability to Perform the Repeated Chair Stand Task Predicts Fall-related Injury in Older Primary Care Patients

AbstractObjectiveTo examine whether the chair stand component of the Short Physical Performance Battery (SPPB) predicts fall-related injury among older adult primary care patients.Design2-year longitudinal cohort study of 430 Boston-area primary care patients aged ≥65 years screened to be at risk for mobility decline. The three components of the SPPB (balance time, gait speed, and chair stand time) were measured at baseline. Participants reported incidence of fall-related injuries quarterly for two years. Complementary log-log discrete time hazard models were constructed to examine the hazard of fall-related injury across SPPB scores, adjusting for age, gender, race, Digit Symbol Substitution Test score, and fall history.ResultsParticipants were 68% female and 83% white, with a mean age of 76.6 (SD=7.0). A total of 137 (32%) reported a fall-related injury during the follow-up period. Overall, inability to perform the chair stand task was a significant predictor of fall-related injury (HR [hazard ratio]=2.11, 95% CI=1.23-3.62, p=0.01). Total SPPB score, gait component score, and balance component score were not predictive of fall-related injury.ConclusionInability to perform the repeated chair stand task was associated with increased hazard of an injurious fall over 2 years among a cohort of older adult primary care patients. Objective To examine whether the chair stand component of the Short Physical Performance Battery (SPPB) predicts fall-related injury among older adult primary care patients. Design 2-year longitudinal cohort study of 430 Boston-area primary care patients aged ≥65 years screened to be at risk for mobility decline. The three components of the SPPB (balance time, gait speed, and chair stand time) were measured at baseline. Participants reported incidence of fall-related injuries quarterly for two years. Complementary log-log discrete time hazard models were constructed to examine the hazard of fall-related injury across SPPB scores, adjusting for age, gender, race, Digit Symbol Substitution Test score, and fall history. Results Participants were 68% female and 83% white, with a mean age of 76.6 (SD=7.0). A total of 137 (32%) reported a fall-related injury during the follow-up period. Overall, inability to perform the chair stand task was a significant predictor of fall-related injury (HR [hazard ratio]=2.11, 95% CI=1.23-3.62, p=0.01). Total SPPB score, gait component score, and balance component score were not predictive of fall-related injury. Conclusion Inability to perform the repeated chair stand task was associated with increased hazard of an injurious fall over 2 years among a cohort of older adult primary care patients. Corresponding Author: Cristina Shea, Spaulding Hospital Cambridge, 1575 Cambridge St., Cambridge, MA 02138, Phone: 617-952-6956, Fax: 617-952-6965, sheacristina@gmail.com. Author Disclosures: There are no competing interests or financial benefits to the authors to disclose. This work was supported by the National Institute on Aging (R01 AG032052-03), Eunice Kennedy Shriver National Institute of Child Health and Human Development (1K24HD070966-01), and the National Center for Research Resources in a grant to the Harvard Clinical and Translational Science Center (1 UL1 RR025758-01). The main results of this study have been presented as a poster presentation at the 2017 American Congress of Rehabilitation Medicine conference. This study has not been previously submitted to any journal. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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