TY - JOUR
T1 - Pittsburgh Fatigability Scale
T2 - One-Page Predictor of Mobility Decline in Mobility-Intact Older Adults
AU - Simonsick, Eleanor M.
AU - Schrack, Jennifer A.
AU - Santanasto, Adam J.
AU - Studenski, Stephanie A.
AU - Ferrucci, Luigi
AU - Glynn, Nancy W.
N1 - Publisher Copyright:
Published 2018. This article is a U.S. Government work and is in the public domain in the USA.
PY - 2018/11
Y1 - 2018/11
N2 - OBJECTIVES: To evaluate the Pittsburgh Fatigability Scale (PFS) as a predictor of performance and functional decline in mobility-intact older adults. DESIGN: Longitudinal analysis of Baltimore Longitudinal Study of Aging data. SETTING: National Institute on Aging, Clinical Research Unit, Baltimore, Maryland. PARTICIPANTS: Mobility-intact men (46.8%) and women aged 60 to 89 with concurrent PFS administration and performance and functional assessment and follow-up assessment within 1 to 4 years (N=579). MEASUREMENTS: The PFS is a self-administered, 1-page assessment of expected physical and mental fatigue with a score ranging from 0 (no) to 5 (extreme) associated with performing 10 activities. Analyses examined associations between each dimension scored continuously (0–50), categorically (0–5), and dichotomously and change in and likelihood of clinically meaningful decline in usual and fast gait speed, chair stand pace, and reported walking ability. Covariates included age, age2, sex, race, visit status, baseline function, and follow-up time. We defined meaningful decline as 0.05 m/s per year for usual gait speed, 0.07 m/s per year for fast gait speed, 0.02 chair stands/s per year and 1 point or more for walking ability index. RESULTS: Over a mean 2.2 years, 20.5% to 37.7% of participants experienced meaningful decline across assessments. Independent of covariates, higher PFS physical and mental scores were most consistently associated with greater decline in usual gait speed, chair stand pace, and reported walking ability regardless of scoring approach. For example, higher physical fatigability was associated with twice the likelihood of meaningful decline in gait speed as lower physical fatigability (p=.001). PFS scores were superior to fatigue symptoms such as tiredness and energy level in predicting performance decline, which showed no association. CONCLUSION: Routine self-administered perceived fatigability assessment may help identify older persons vulnerable to accelerated mobility decline. J Am Geriatr Soc 66:2092–2096, 2018.
AB - OBJECTIVES: To evaluate the Pittsburgh Fatigability Scale (PFS) as a predictor of performance and functional decline in mobility-intact older adults. DESIGN: Longitudinal analysis of Baltimore Longitudinal Study of Aging data. SETTING: National Institute on Aging, Clinical Research Unit, Baltimore, Maryland. PARTICIPANTS: Mobility-intact men (46.8%) and women aged 60 to 89 with concurrent PFS administration and performance and functional assessment and follow-up assessment within 1 to 4 years (N=579). MEASUREMENTS: The PFS is a self-administered, 1-page assessment of expected physical and mental fatigue with a score ranging from 0 (no) to 5 (extreme) associated with performing 10 activities. Analyses examined associations between each dimension scored continuously (0–50), categorically (0–5), and dichotomously and change in and likelihood of clinically meaningful decline in usual and fast gait speed, chair stand pace, and reported walking ability. Covariates included age, age2, sex, race, visit status, baseline function, and follow-up time. We defined meaningful decline as 0.05 m/s per year for usual gait speed, 0.07 m/s per year for fast gait speed, 0.02 chair stands/s per year and 1 point or more for walking ability index. RESULTS: Over a mean 2.2 years, 20.5% to 37.7% of participants experienced meaningful decline across assessments. Independent of covariates, higher PFS physical and mental scores were most consistently associated with greater decline in usual gait speed, chair stand pace, and reported walking ability regardless of scoring approach. For example, higher physical fatigability was associated with twice the likelihood of meaningful decline in gait speed as lower physical fatigability (p=.001). PFS scores were superior to fatigue symptoms such as tiredness and energy level in predicting performance decline, which showed no association. CONCLUSION: Routine self-administered perceived fatigability assessment may help identify older persons vulnerable to accelerated mobility decline. J Am Geriatr Soc 66:2092–2096, 2018.
KW - aging
KW - fatigability
KW - mobility decline
KW - self-report
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U2 - 10.1111/jgs.15531
DO - 10.1111/jgs.15531
M3 - Article
C2 - 30315707
AN - SCOPUS:85054909410
SN - 0002-8614
VL - 66
SP - 2092
EP - 2096
JO - Journal of the American Geriatrics Society
JF - Journal of the American Geriatrics Society
IS - 11
ER -