Development and validation of a prediction model for self-reported mobility decline in community-dwelling older adults
Sanchez-Santos MT., Williamson E., Nicolson PJA., Bruce J., Collins GS., Mallen CD., Griffiths F., Garret A., Morris A., Slark M., Lamb SE., Conway O., Darton F., Dutton S., Garrett A., Hagan D., Haywood D., Hewitt A., Lamb S., Marian I., Nevay L., Nicolson P., Vadher K., Ward L., Watson M., Arden N., Barker K., Collins G., Fairbank J., Fitch J., French D., Hanson Z., Hutchinson C., Mallen C., Petrou S.
Objectives: The aim of this study is to develop and validate two models to predict 2-year risk of self-reported mobility decline among community-dwelling older adults. Study Design and Setting: We used data from a prospective cohort study of people aged 65 years and over in England. Mobility status was assessed using the EQ-5D-5L mobility question. The models were based on the outcome: Model 1, any mobility decline at 2 years; Model 2, new onset of persistent mobility problems over 2 years. Least absolute shrinkage and selection operator logistic regression was used to select predictors. Model performance was assessed using C-statistics, calibration plot, Brier scores, and decision curve analyses. Models were internally validated using bootstrapping. Results: Over 18% of participants who could walk reported mobility decline at year 2 (Model 1), and 7.1% with no mobility problems at baseline, reported new onset of mobility problems after 2 years (Model 2). Thirteen and 6 out of 31 variables were selected as predictors in Models 1 and 2, respectively. Models 1 and 2 had a C-statistic of 0.740 and 0.765 (optimism < 0.013), and Brier score = 0.136 and 0.069, respectively. Conclusion: Two prediction models for mobility decline were developed and internally validated. They are based on self-reported variables and could serve as simple assessments in primary care after external validation.