Alternative items for identifying hierarchical levels of physical disability by using physical performance tests in women aged 75 years and older

Aim: To identify individuals at hierarchical levels of physical disability by using physical performance tests and to determine threshold values for the discriminating of levels of physical disability in women aged 75 years or older. Methods: A cross-sectional observational study was conducted on 306 community-dwelling women aged 75 years or order (range, 75-99 years). Physical disability was categorized into no disability, mobility disability and activities of daily living (ADL) disability, by evaluating selected ADL and mobility-related functional tasks. Physical function tests comprised nine items (such as strength, balance, mobility and walking ability). To assess the observed threshold values, receiver-operator curves were prepared for all the scales. Results: The results revealed significant differences among all the pairwise group comparisons in all the performance tests, except in the one-legged stance, tandem stance and tandem walk tests. The individuals with ADL disability were unable to perform the one-legged stance (28.9%), tandem stance (32.5%), functional reach (19.3%), tandem walk (61.4%), alternate step (53.0%) and 5-chair sit-to-stand (31.3%) tests. The observed thresholds for discriminating between the no disability and mobility disability groups and between the mobility disability and ADL disability groups were as follows: timed Up & Go test, 8.5 s and 12.7 s; usual gait speed, 1.05 m/s and 0.79 m/s; and grip strength, 19.5 kg and 16.3 kg, respectively. Conclusion: Tests for balance and lower extremity strength can be used together to identify or monitor the characteristics of the hierarchical levels of physical disability in women aged 75 years or older. Geriatr Gerontol Int 2010; 10: 302-310.