Volume 30 - Article 7 | Pages 227–252  

Self-Reported Versus Performance-Based Measures of Physical Function: Prognostic Value for Survival

By Noreen Goldman, Dana Glei, Luis Rosero-Bixby, Shu-Ti Chiou, Maxine Weinstein

Abstract

Background: Although previous studies have indicated that performance assessments strongly predict future survival, few have evaluated the incremental value in the presence of controls for self-reported activity and mobility limitations.

Objective: We assess and compare the added value of four tests -- walking speed, chair stands, grip strength, and peak expiratory flow (PEF) -- for predicting all-cause mortality.

Methods: Using population-based samples of older adults in Costa Rica (n = 2290, aged 60+) and Taiwan (n = 1219, aged 53+), we estimate proportional hazards models of mortality for an approximate five-year period. Receiver Operator Characteristic (ROC) curves are used to assess the prognostic value of each performance assessment.

Results: Self-reported measures of physical limitations contribute substantial gains in mortality prediction, whereas performance-based assessments yield modest incremental gains. PEF provides the greatest added value, followed by grip strength. Our results suggest that including more than two performance assessments may provide little improvement in mortality prediction.

Conclusions: PEF and grip strength are often simpler to administer in home interview settings, impose less of a burden on some respondents, and, in the presence of self-reported limitations, appear to be better predictors of mortality than do walking speed or chair stands.

Comments: Being unable to perform the test is often a strong predictor of mortality, but these indicators are not well-defined. Exclusion rates vary by the specific task and are likely to depend on the underlying demographic, health, social and cultural characteristics of the sample.

Author's Affiliation

Other articles by the same author/authors in Demographic Research

The vanishing advantage of longevity in Nicoya, Costa Rica: A cohort shift
Volume 49 - Article 27

Life expectancy loss among Native Americans during the COVID-19 pandemic
Volume 47 - Article 9

COVID-19 risk factors and mortality among Native Americans
Volume 45 - Article 39

Mexican mortality 1990‒2016: Comparison of unadjusted and adjusted estimates
Volume 44 - Article 30

Calloused hands, shorter life? Occupation and older-age survival in Mexico
Volume 42 - Article 32

Costa Rican mortality 1950‒2013: An evaluation of data quality and trends compared with other countries
Volume 40 - Article 29

High life expectancy and reversed socioeconomic gradients of elderly people in Mexico and Costa Rica
Volume 38 - Article 3

The declining effect of sibling size on children's education in Costa Rica
Volume 31 - Article 48

Is Latin America starting to retreat from early and universal childbearing?
Volume 20 - Article 9

The effects of war losses on mortality estimates for Italy: A first attempt
Volume 13 - Article 15

Introduction to the Special Collection “Human Mortality over Age, Time, Sex, and Place: The 1st HMD Symposium”
Volume 13 - Article 10

Most recent similar articles in Demographic Research

Measuring short-term mobility patterns in North America using Facebook advertising data, with an application to adjusting COVID-19 mortality rates
Volume 50 - Article 10    | Keywords: COVID-19, data collection, Facebook, mortality, North America, short-term mobility

Immigrant mortality advantage in the United States during the first year of the COVID-19 pandemic
Volume 50 - Article 7    | Keywords: COVID-19, immigrants, mortality

Frailty at death: An examination of multiple causes of death in four low mortality countries in 2017
Volume 49 - Article 2    | Keywords: aging, causes of mortality, mortality, multiple causes of death

Ethnic and regional inequalities in Russian military fatalities in Ukraine: Preliminary findings from crowdsourced data
Volume 48 - Article 31    | Keywords: armed conflict, fatality, military, mortality, Russia, Ukraine, war

The question of the human mortality plateau: Contrasting insights by longevity pioneers
Volume 48 - Article 11    | Keywords: age, France, Gompertz mortality, mortality, mortality plateau, older population, parametric models, supercentenarians, survival analysis, trajectories