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BMC Medicine
Published in: BMC Medicine 1/2016

Open Access 01-12-2016 | Research article

Short Physical Performance Battery and all-cause mortality: systematic review and meta-analysis

Authors: Rita Pavasini, Jack Guralnik, Justin C. Brown, Mauro di Bari, Matteo Cesari, Francesco Landi, Bert Vaes, Delphine Legrand, Joe Verghese, Cuiling Wang, Sari Stenholm, Luigi Ferrucci, Jennifer C. Lai, Anna Arnau Bartes, Joan Espaulella, Montserrat Ferrer, Jae-Young Lim, Kristine E. Ensrud, Peggy Cawthon, Anna Turusheva, Elena Frolova, Yves Rolland, Valerie Lauwers, Andrea Corsonello, Gregory D. Kirk, Roberto Ferrari, Stefano Volpato, Gianluca Campo

Published in: BMC Medicine | Issue 1/2016

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Abstract

Background

The Short Physical Performance Battery (SPPB) is a well-established tool to assess lower extremity physical performance status. Its predictive ability for all-cause mortality has been sparsely reported, but with conflicting results in different subsets of participants. The aim of this study was to perform a meta-analysis investigating the relationship between SPPB score and all-cause mortality.

Methods

Articles were searched in MEDLINE, the Cochrane Library, Google Scholar, and BioMed Central between July and September 2015 and updated in January 2016. Inclusion criteria were observational studies; >50 participants; stratification of population according to SPPB value; data on all-cause mortality; English language publications. Twenty-four articles were selected from available evidence. Data of interest (i.e., clinical characteristics, information after stratification of the sample into four SPPB groups [0–3, 4–6, 7–9, 10–12]) were retrieved from the articles and/or obtained by the study authors. The odds ratio (OR) and/or hazard ratio (HR) was obtained for all-cause mortality according to SPPB category (with SPPB scores 10–12 considered as reference) with adjustment for age, sex, and body mass index.

Results

Standardized data were obtained for 17 studies (n = 16,534, mean age 76 ± 3 years). As compared to SPPB scores 10–12, values of 0–3 (OR 3.25, 95%CI 2.86–3.79), 4–6 (OR 2.14, 95%CI 1.92–2.39), and 7–9 (OR 1.50, 95%CI 1.32–1.71) were each associated with an increased risk of all-cause mortality. The association between poor performance on SPPB and all-cause mortality remained highly consistent independent of follow-up length, subsets of participants, geographic area, and age of the population. Random effects meta-regression showed that OR for all-cause mortality with SPPB values 7–9 was higher in the younger population, diabetics, and men.

Conclusions

An SPPB score lower than 10 is predictive of all-cause mortality. The systematic implementation of the SPPB in clinical practice settings may provide useful prognostic information about the risk of all-cause mortality. Moreover, the SPPB could be used as a surrogate endpoint of all-cause mortality in trials needing to quantify benefit and health improvements of specific treatments or rehabilitation programs.
The study protocol was published on PROSPERO (CRD42015024916).
Appendix
Available only for authorised users
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Metadata
Title
Short Physical Performance Battery and all-cause mortality: systematic review and meta-analysis
Authors
Rita Pavasini
Jack Guralnik
Justin C. Brown
Mauro di Bari
Matteo Cesari
Francesco Landi
Bert Vaes
Delphine Legrand
Joe Verghese
Cuiling Wang
Sari Stenholm
Luigi Ferrucci
Jennifer C. Lai
Anna Arnau Bartes
Joan Espaulella
Montserrat Ferrer
Jae-Young Lim
Kristine E. Ensrud
Peggy Cawthon
Anna Turusheva
Elena Frolova
Yves Rolland
Valerie Lauwers
Andrea Corsonello
Gregory D. Kirk
Roberto Ferrari
Stefano Volpato
Gianluca Campo
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2016
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/s12916-016-0763-7

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