Research Square · Feb 22, 2021
SPPB reference values and performance in assessing sarcopenia in community-dwelling Singaporeans – Yishun Study
By Lee SY, Choo PL, Pang BWJ et al.
Abstract Background: The Short Physical Performance Battery (SPPB) is an established test of physical performance. We provide reference values for SPPB and determine SPPB performance and cut-offs in assessing sarcopenia for Asian community-dwelling older adults.Methods: 538 (57.8% women) community-dwelling adults aged 21–90 years were recruited. SPPB and its subtest scores and timings (8ft gait speed (GS), five-times repeated chair sit-to-stand (STS) and balance) were determined. Appendicular lean mass divided by height-squared, muscle strength (handgrip) and physical performance (6m GS, STS and SPPB) were assessed to define sarcopenia for various Asian criteria. Area under the ROC curve (AUC) was used to assess performance of SPPB and subtests in discriminating sarcopenia. Optimal SPPB and GS subtest cut-offs for each sarcopenia criterion were determined by maximizing sensitivity and specificity.Results: The mean SPPB score was 11.6(SD 1.1) in men and 11.5(SD1.2) in women. Majority of participants(≥50%) aged 21–80 years achieved the maximum SPPB score. SPPB total and subtest scores generally decreased with age (all p<0.001), but did not differ between sex. SPPB was limited in assessing sarcopenia (AUC 0.56–0.64) but had moderate-to-excellent performance in assessing severe sarcopenia (AUC 0.69–0.98), with optimal cut-off of ≤11points. SPPB GS subtest had moderate-to-excellent performance in assessing sarcopenia (AUC 0.62–0.72) and severe sarcopenia (AUC 0.81–0.95). The optimal GS cut-off for sarcopenia was 1.0m/s.Conclusions: Population-specific normative SPPB values are important for use in diagnostic criteria and to interpret results of studies evaluating and establishing appropriate treatment goals. Performance on the SPPB should be reported in terms of the total sum score and registered time to complete the repeated-chair STS and 8-ft walk tests. An SPPB cut-off of ≤11points was optimal in assessing sarcopenia. GS subtest could be an independent criterion for discriminating sarcopenia in community-dwelling older adults.