Examination And Normative Standards Of Senior Fitness Test In Community-Dwelling Older Adults

PurposesHealthy aging is a positive strategy to cope with aging of the population.To maximize the functional ability of older adults is the core aim of healthy aging.Functional fitness is defined as having the physical capacity to perform normal everyday activities safely and independently without undue fatigue.The Senior Fitness Test（SFT）is a widely used functional fitness assessment system for older adults.Assessing functional fitness in older adults is conducive to grasping the physical fitness and functional level in older adults,and instructing them to exercise scientifically.This study introduced SFT assessment system and conduct examination and evaluation.The study aimed to:（1）examine the applicability of SFT indicators in older adults aged 60 to 79 years in Shanghai communities;（2）construct and validate the normative standards of indicators based on older adults aged 60 to 79 years in Shanghai communities;（3）develop comprehensive evaluation parameters of functional fitness for older adults aged 60 to 79 years in Shanghai communities.Subjects and MethodsThe whole study design comprised three parts,including five sub-studies.The first part of the study was the research on the applicability of SFT indicators in the population aged 60 to 79 years in Shanghai communities.Three sub-studies were included in the first part:（1）Study 1 was a project analysis study of SFT indicators.173 eligible older adults（average age 68.6±5.0 years）were recruited in the form of community recruitment,and tests of SFT indicators were conducted.The completion rates of each indicator and the critical ratio（CR）that were calculated based on extreme grouping were analyzed by mathematical statistics,in order to examine the completion rate and discrimination of SFT in older adults aged 60 to 79 years in Shanghai communities.（2）Study 2 was a test-retest reliability study of SFT indicators.44 volunteers（average age 68.7±5.1 years）were recruited from the research subjects of Study 1.Test-retest was conducted for each same indicator of SFT.The consistency of each measurement result was analyzed by mathematical statistics method.（3）Study 3was a criterion-related validity study,which examine the validity of 2-minute step test as an optional indicator for measuring aerobic capacity in SFT system.Eligible volunteers were recruited from the research subjects of Study 1（30 eligible subjects were finally included,with an average age of 66.8±4.5 years）,and tests were conducted for measuring the numbers of steps within 2 minutes,the distance of walking within 6minutes and VO_2max based on incremental load exercise test.Mathematical statistics methods were applied to analyze the correlation between 2-minute step and 6-minute walk test scores,as well as the correlation between 2-minute step test and criterion validity oxygen uptake.The second part of this study was the research on the construction and verification of SFT norm based on the population aged 60 to 79 years in Shanghai communities（Study 4）.A multistage stratified cluster sampling design was used for conducting population tests.Finally,4848 valid samples（2264 males and 2584 females）were collected based on the population aged 60 to 79 years in Shanghai communities.In Study 4,80%of the randomly selected sample data was used to establish the normative standards,and the localized normative standards of SFT based on the population aged 60 to 79 years in Shanghai communities was constructed.The remaining 20%of the sample data was used for back-substitution test,in order to verify the rationality of the distribution of the norm of each SFT indicator.The third part of this study was the research on establishment and verification of the fitness age formulae in older adults,in order to comprehensively evaluate the functional fitness level in older adults（Study 5）.Formulae for estimating the fitness age was constructed using principal component analysis based on the assumption that the overall fitness level of older adults without exercise habits changed with time basically consistent with the calendar age.Based on the hypothesis that exercise may delay the decline process of the overall level of physical fitness with the increase of calendar age,fitness age was verified,the correlations between fitness age and SFT indicator of each dimensions were analyzed,and the differences of fitness age of older adults with different exercise habits as well as the differences between fitness age and calendar age were compared.The functional fitness of older adults was verified by the comprehensive evaluation method of fitness age.ResultsThe results of Study 1 showed that the completion rate of each test indicator of the research subjects ranged from 97.6%to 100%,indicating that the completion rate was high.The range of CR value of each indicator was 7.79 to 11.70,indicating that the discrimination of each test indicator was good.The results of Study 2 showed that the intraclass correlation coefficient of two tests for each indicators ranged from 0.815 to 0.958,indicating that test-retest reliability was good.The results of Study 3 showed that the correlation between scores of 2-minute step test and VO_2max was 0.48,and the correlation between relative oxygen uptake was 0.58（p<0.05）,which indicated that the 2-minute step test was an effective simple test indicator for measuring aerobic capacity in older adults.Combined with the results from Study 1 and Study 2,the 2-minute step test showed a high completion rate,discrimination,reliability and validity in older adults aged 60 to 79 years in Shanghai Communities,implying that it could be included in the SFT assessment system to evaluate the aerobic capacity in older adults.In Study 4,3878 individuals（1811 males and 2067 females）were eventually included in the modeling group.All indicators of SFT in the modeling group showed an age-related decline,and the downward trend was statistically significant（p<0.05）.The median level of each indicator of SFT in this study was not as the same as the norm in other countries and regions,which possessed the characteristics of local population.Therefore,the percentile cut point was used to construct an evaluation norm based on older adults aged 60～79 years in Shanghai communities.The SFT norm constructed in this study based on 970 individuals（453 males and 517 females）was verified.The absolute difference between the actual distribution value and the theoretical distribution value of each single indicator ranged form-3.0%to+3.8%,implying that the evaluation criteria had good consistency.Based on the population data（659 males and 794 females）from questionnaires that chose"never exercise",Study 5 completed the establishment of two formulae for estimating physical fitness age for males and females.For males,five indicator were finally extracted for establishing fitness age,and they were 30-second chair stand test,2-minute step test,30-second arm curl test,8-foot up and go test and chair sit and reach test.For females,four indicator were finally extracted for establishment,and they were30-second chair stand test,2-minute step test,30-second arm curl test,and 8-foot up and go test.The results showed that fitness age was significantly correlated with SFT（p<0.05）.With the improvement of active level of exercise,fitness age of males and females showed a younger trend（p<0.05）,and the difference between calendar age and fitness age also gradually increased.Conclusions（1）Each indicator of SFT assessment system in older adults,including 30-second chair stand test,30-second arm curl test,2-minute step test,chair sit and reach test,back scratch test and 8-foot up and go test,had good completion rate,discrimination and test-retest reliability in older adults aged 60 to 79 years in Shanghai communities.As an alternative indicator of aerobic capacity in the SFT system,2-minute step test was moderately related to the level of VO_2max,and it could be used as an effective assessment indicator for the evaluation of aerobic capacity dimensions in older adults aged 60 to 79 years in Shanghai communities.（2）The levels of SFT indicators in older adults aged 60 to 79 years in Shanghai communities showed different age-related trends in males and females of all age groups;Based on the population aged 60 to 79 years in Shanghai communities,the normative standards for 30-second chair stand test,30-second arm curl test,2-minute step test,chair sit and reach test,back scratch test and 8-foot up and go test were established.Retrogression test showed that the distribution of the norm was reasonable and could be applied to evaluate the functional fitness of older adults aged 60 to 79 years in Shanghai communities.（3）Based on the SFT indicators,the formulae for estimating fitness age of older adults was established and verified,and functional fitness level of older adults aged 60 to 79 years in Shanghai community could be comprehensively evaluated.The formulae for estimating the fitness age in older adults were:Male:FA=34.917-0.408X_CS-0.088X_ST-0.502X_AC+1.703X_UG-0.091X_SR+0.698×age Female:FA=35.496-0.467X_CS-0.09X_ST-0.513X_AC+1.938X_UG+0.681×ageIn the formulae,FA refers to fitness age,and X_CS,X_ST,X_AC,X_UG,X_SR stand for testscores of 30-second chair stand test,2-minute step test,30-second arm curl test,8-foot up and go test and chair sit and reach test,respectively.