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Identifying Early Decline of Physical Function in Community-Dwelling Older Women: Performance-Based and Self-Report Measures

JS Brach, PT, PhD, GCS, is Assistant Professor, Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, 6035 Forbes Tower, Pittsburgh, PA 15260 (USA) (jbrach{at}pitt.edu).
JM VanSwearingen, PT, PhD, is Associate Professor, Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh
AB Newman, MD, MPH, is Associate Professor, Department of Geriatric Medicine, School of Medicine, and Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh
AM Kriska, PhD, FACSM, is Associate Professor, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh

Address all correspondence to Dr Brach

Background and Purpose. The ability to identify early decline in physical function is important, but older people experiencing decline may fail to report the early changes in physical function. The purpose of this study was to compare the descriptions of physical function in community-dwelling older women obtained using performance-based and self-report measures. Subjects and Methods. One hundred seventy community-dwelling women with a mean age of 74.3 years (SD=4.3, range=56.6–83.6) completed the activities of daily living (ADL), instrumental activities of daily living (IADL), and social activity (SA) sections of the Functional Status Questionnaire (FSQ). They also completed performance-based measures of gait speed and the 7-item Physical Performance Test (PPT). Results. The majority of the women scored at the ceiling for the self-report measures of function (ADL=77%, IADL=61%, SA=94%), whereas only 7% scored at the ceiling for the PPT and 30% scored at the ceiling for gait speed (defined as >1.2 m/s). For 2 items of the FSQ, sensitivity was low (8% and 9%) and specificity was high (97% and 98%) compared with performance on the PPT. Discussion and Conclusion. In this sample of community-dwelling older women, performance-based measures identified more limitations in physical function than did self-report measures.

Key Words: Community dwelling • Measurement • Older adults • Physical function

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