The Predictive Validity of Physical Performance Measures in Determining Markers of Preclinical Disability in Community-Dwelling Middle-Aged and Older Adults: A Systematic Review

Background. Identification of preclinical disability in middle-aged and older adults might allow early identification of and treatment for functional mobility deficits. Purpose. This study aimed to determine which physical performance measures (PPMs) were effective in identifying preclinical disability in individuals at risk for future disability. Data Sources. CINHAL, PubMed, Scopus, and Web of Science databases were searched until September 2017 using key words. Study Selection. Two individuals screened peer-reviewed prospective longitudinal studies that assessed healthy individuals >45 years old using PPMs at baseline. Eight studies met inclusion criteria. Data Extraction. Two individuals extracted data on participant demographics, PPMs, predictive validity effect size, and disability outcomes. Risk of bias was assessed using the Quality Assessment Tool for Cohort Studies II (Q-Coh II). Data Synthesis. Four constructs were used to guide data synthesis: functional mobility, activities of daily living disability, fall(s), and hospitalization. Multiple sit-to-stands from a chair, standing balance, and gait speed were found to have some merit in identifying preclinical disability across all 4 disability constructs. All studies were scored as good-quality studies using the Q-Coh II. Limitations. The heterogeneity in follow-up times and reporting of risk prediction statistics made it difficult to compare results across studies, PPMs, and constructs. The 4 constructs used as markers of preclinical disability potentially do not fully capture the progression of disability. Conclusions. Physical therapists should consider using PPMs on healthy adult populations to gather baseline data during annual health screens for use in identifying preclinical disability.