Development and Validation of a Cutoff for the Chair Stand Test as a Screening for Mobility Impairment in the Context of the Integrated Care for Older People Program
Emmanuel González-Bautista, Philipe de Souto Barreto, Aarón Salinas‐Rodríguez, Betty Manrique Espinoza, Sandrine Sourdet, Yves Rolland, Leocadio Rodríguez‐Mañas, Sandrine Andrieu, Bruno Vellas, MAPT/DSA Group, Jean-François Dartigues, Isabelle Marcet, Fleur Delva, Alexandra Foubert, Sandrine Cerda (Bordeaux), Marie-Noëlle-Cuffi contrib-type="author">, Corinne Costes (Castres), Olivier Rouaud, Patrick Manckoundia, Valérie Quipourt, Sophie Marilier, Evelyne Franon (Dijon), Lawrence Bories, Marie-Laure Pader, Marie-France Basset, Bruno Lapoujade, Valérie Faure, Michael Li Yung Tong, Christine Malick-Loiseau, Evelyne Cazaban-Campistron (Foix), Françoise Desclaux, Colette Blatge (Lavaur), Thierry Dantoine, Cécile Laubarie-Mouret, Isabelle Saulnier, Jean-Pierre Clément, Marie-Agnès Picat, Laurence Bernard-Bourzeix, Stéphanie Willebois, Iléana Désormais, Noëlle Cardinaud (Limoges), Marc Bonnefoy, Pierre Livet, Pascale Rebaudet, Claire Gédéon, Catherine Burdet, Flavien Terracol (Lyon), Alain Pesce, Stéphanie Roth, Sylvie Chaillou, Sandrine Louchart (Monaco), Kristel Sudres, Nicolas Lebrun, Nadège Barro-Belaygues (Montauban), Jacques Touchon, Karim Bennys, Audrey Gabelle, Aurélia Romano, Lynda Touati, Cécilia Marelli, Cécile Pays (Montpellier), Philippe Robert, Franck Le Duff, Claire Gervais, Sébastien Gonfrier (Nice), Yannick Gasnier and Serge Bordes, Danièle Begorre, Christian Carpuat, Khaled Khales, Jean-François Lefebvre, Samira Misbah El Idrissi, Pierre Skolil, Jean-Pierre Salles (Tarbes), Stéphane Lehéricy, Marie Chupin, Jean-François Mangin, Ali Bouhayia (Paris), Michèle Allard (Bordeaux), Frédéric Ricolfi (Dijon), Dominique Dubois (Foix), Marie Paule Bonceour Martel (Limoges), François Cotton (Lyon), Alain Bonafé, Stéphane Chanalet (Nice), Françoise Hugon (Tarbes), Fabrice Bonneville, Christophe Cognard, François Chollet (Toulouse)., Thierry Voisin, Julien Delrieu, Sophie Peiffer, Anne Hitzel, (Toulouse) contrib-type="author">, Michèle Allard (Bordeaux), Michel Zanca (Montpellier), Jacques Monteil (Limoges), Jacques Darcourt (Nice)., Hélène Derumeaux, Nadège Costa (Toulouse)., Claire Vinel
Abstract
BACKGROUND: The 5-repetition chair stand test (CST) is increasingly being used to assess locomotion capacity in older adults. However, there is a lack of age-stratified cutoffs for adults aged ≥70 validated against a higher risk of functional loss. METHODS: We used 2 population-based studies (Study on global AGEing and adult health in Mexico [SAGE Mexico] and Toledo Study for Healthy Aging [TSHA]) and receiver operating characteristic (ROC) analyses to develop and cross-validate age-stratified chair stand cutoffs with activities of daily living (ADL) disability as the outcome. Then, we used data from an randomized controlled trial (RCT) (Multidomain Alzheimer Preventive Trial [MAPT]) and a frailty day-hospital for external validation with cross-sectional and longitudinal measures of ADL disability. The merged sample of SAGE Mexico and TSHA was n = 1 595; sample sizes for external validation were: MAPT n = 1 573 and Frailty day-hospital n = 2 434. The Cox models for incident disability in MAPT had a mean follow-up of 58.6 months. RESULTS: Cutoffs obtained were 14 second (ages 70-79) and 16 second (ages 80+). Those cutoffs identified older adults at higher odds of incident ADL disability odds ratio (OR) = 1.72 (95% confidence interval [CI] 1.06; 2.78) for ages 70-79 and odds ratio (OR) = 2.27 (95% CI 1.07; 4.80) in those aged 80+. Being a slow chair stander according to the cut points was associated with ADL disability in cross-sectional and longitudinal measures. CONCLUSIONS: Fourteen- and 16-second cut points for the CST are suitable to identify people at higher risk of functional decline among older adults in Mexico and Toledo, Spain. Adjusting the cut point from 14 to 16 second generally improved the psychometric properties of the test. The validation of these cutoffs can facilitate the screening for limited mobility and the implementation of the Integrated Care for Older People program.