@article{ref1,
title="Clusters of functional domains to identify older persons at risk of disability",
journal="Geriatrics and gerontology international",
year="2018",
author="Costanzo, Luisa and Pedone, Claudio and Cesari, Matteo and Ferrucci, Luigi and Bandinelli, Stefania and Antonelli Incalzi, Raffaele",
volume="18",
number="5",
pages="685-691",
abstract="AIM: To date, there is no consensus on which set of variables should be used to identify older persons at risk of disability in activities of daily living. The present study aimed to: (i) evaluate how different deficits cluster in a population of community-dwelling older persons; and (ii) investigate whether the discriminative capacity of physical performance measures towards the development of disability might be improved by adding psychological, social and environmental indicators. <br><br>METHODS: Data are from 709 non-disabled older persons participating in the &quot;Invecchiare in Chianti&quot; study. We carried out a cluster analysis of 12 deficits in multiple functional domains, selected from the available frailty assessment instruments. Then, participants were assigned to a group, based on the obtained clusters of variables. For each group, we measured the prognostic capacity and the predictive ability for 6-year disability. <br><br>RESULTS: The analysis showed a &quot;physical&quot; cluster (including weight loss, reduced grip strength/gait speed/physical activity, impaired balance, environmental barriers) and a &quot;psychosocial&quot; cluster (e.g. living alone, depression, low income). Thus, participants were classified into four groups according to the presence of a physical and/or psychosocial cluster. Compared with the &quot;fit&quot; group, the relative risks of becoming disabled in the &quot;physical,&quot; &quot;psychosocial&quot; and &quot;mixed&quot; deficit groups were 2.23 (95% CI 0.71-7.00), 1.52 (95% CI 0.62-3.75) and 6.37 (95% CI 2.83-14.33), respectively. The positive and negative predictive values for the &quot;physical,&quot; &quot;psychosocial&quot; and &quot;mixed&quot; deficit groups were, respectively, 9% and 87%, 6% and 83%, and 27% and 94%. <br><br>CONCLUSIONS: As expected, physical and psychosocial deficits cluster predominantly into different groups. Even when both are considered simultaneously, the ability to predict incident disability is still insufficient. Geriatr Gerontol Int 2017; ••: ••-••.<br><br>© 2017 Japan Geriatrics Society.<p /> <p>Language: en</p>",
language="en",
issn="1444-1586",
doi="10.1111/ggi.13226",
url="http://dx.doi.org/10.1111/ggi.13226"
}