Slowness as a Predictor of Functional Decline in Older Adults: Comparison of Moberg Picking-Up Test and Walking Speed

Objectives: Slowness, generally assessed by walking speed (WS), is an estimator of frailty and its outcomes. Because of potential difficulties in assessing WS, the Moberg picking-up test (MPUT) might be an alternative. This study investigated the capacity of slowness measurements (WS and MPUT) to predict nonfatal adverse consequences of frailty: primarily, decline in basic activities of daily living (BADL); and secondarily, decline in instrumental activities of daily living (IADL), fall, hospitalization, and incident disease. Design: Observational (prospective longitudinal study). Setting and Participants: This study used data from the population-based Lausanne cohort 65+. At baseline, 1887 individuals (aged 72-77 years) completed both WS (time to walk 20 m at usual pace) and MPUT (time to pick up 12 objects) assessments. Methods: All outcomes, assessed at 1- and 4-year follow-ups, were entered in separate logistic regression models with adjustment for age, sex, and respective values at baseline. The prediction of all outcomes by either WS or MPUT was assessed using area under the receiver operating characteristic curve and compared by c2 tests. Results: There were positive associations between slowness either assessed by WS [relative risk (RR) = 2.48; P <.001] or MPUT (RR = 1.91; P <.001) and decline in BADL at 1-year follow-up. These associations remained significant at 4-year follow-up for both WS (RR = 2.28; P <.001) and MPUT (RR = 1.95; P <.001). There was no significant difference between predictive values of slow WS and MPUT for decline in BADL at 1-year (P=.328) and 4-year follow-ups (P=.413). The prediction was not significantly different for secondary outcomes, except for decline in IADL for which the prediction was slightly better for WS. Conclusions and Implications: MPUT may be an alternative measurement of slowness with predictive value of functional decline. No significant difference in predictive capabilities of MPUT and WS for specific adverse consequences of frailty is promising in favor of using MPUT for measuring slowness. (C) 2022 AMDA - The Society for Post-Acute and Long-Term Care Medicine.