human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background : objective measures of physical activity and function with a diverse cohort of UK adults in their 70s and 80s were used to investigate relative risk of all-cause mortality and diagnoses of new diseases over a 4-year period . Participants : two hundred and forty older adults were r and omly recruited from 12 general practice s in urban and suburban areas of a city in the United Kingdom . Follow-up included 213 of the baseline sample . Methods : socio-demographic variables , height and weight , and self-reported diagnosed diseases were recorded at baseline . Seven-day accelerometry was used to assess total physical activity , moderate-to-vigorous activity and sedentary time . A log recorded trips from home .  Lower limb function was assessed using the Short Physical Performance Battery . Medical records were accessed on average 50 months post baseline , when new diseases and deaths were recorded . Analyses : ANOVAs were used to assess socio-demographic , physical activity and lower limb function group differences in diseases at baseline and new diseases during follow-up . Regression models were constructed to assess the prospect i ve associations between physical activity and function with mortality and new disease . Results : for every 1,000 steps walked per day , the risk of mortality was 36 % lower ( hazard ratios 0.64 , 95 % confidence interval ( CI ) 0.44–0.91 , P = 0.013 ) . Low levels of moderate-to-vigorous physical activity ( incident rate ratio ( IRR ) 1.67 , 95 % CI 1.04–2.68 , P = 0.030 ) and low frequency of trips from home ( IRR 1.41 , 95 % CI 0.98–2.05 , P = 0.045 ) were associated with diagnoses of more new diseases . Conclusion : physical activity should be supported for adults in their 70s and 80s , as it is associated with reduced risk of mortality and new disease development BACKGROUND Hospitalization represents a stressful and potentially hazardous event for older persons . We evaluated the value of the Short Physical Performance Battery ( SPPB ) in predicting rates of functional decline , rehospitalization , and death in older acutely ill patients in the year after discharge from the hospital . METHODS Prospect i ve cohort study of 87 patients aged 65 years and older who were able to walk and with a Mini-Mental State Examination score ≥ 18 and admitted to the hospital with a clinical diagnosis of congestive heart failure , pneumonia , chronic obstructive pulmonary disease , or minor stroke . Patients were evaluated with the SPPB at hospital admission , were reevaluated the day of hospital discharge , and 1 month later . Subsequently , they were followed every 3 months by telephone interviews to ascertain functional decline , new hospitalizations , and vital status . RESULTS After adjustment for potential confounders , including self-report activity of daily living and comorbidity , the SPPB score at discharge was inversely correlated with the rate of decline in activity of daily living performance over the follow-up ( p < .05 ) . In a multivariable discrete-time survival analysis , patients with poor SPPB scores at hospital discharge ( 0 - 4 ) had a greater risk of rehospitalization or death ( odds ratio : 5.38 , 95 % confidence interval : 1.82 - 15.9 ) compared with those with better SPPB scores ( 8 - 12 ) . Patients with early decline in SPPB score after discharge also had steeper increase in activity of daily living difficulty and higher risk of rehospitalization or death over the next year . CONCLUSIONS In older acutely ill patients who have been hospitalized , the SPPB provides important prognostic information . Lower extremity performance-based functional assessment might identify older patients at high risk of poor outcomes after hospital discharge BACKGROUND This study examines the effects of mobility and cognition on  mortality risk in women late in life . METHODS A prospect i ve study was conducted among 1,495 women ( mean age 87.6 years ) participating in the Study of Osteoporotic Fractures Year 20 examination ( 2006 - 2008 ) .  Mobility  ( ascertained by Short Physical Performance Battery [ SPPB ] ) was categorized as poor ( SPPB 0 - 3 , n = 312 ) , intermediate ( SPPB 4 - 9 , n = 799 ) , or good ( SPPB 10 - 12 , n = 384 ) . Cognitive status ( adjudicated based on neuropsychological tests ) was classified as normal ( n = 873 ) , mild cognitive impairment ( n = 354 ) , or dementia ( n = 268 ) . Deaths ( n = 749 ) were identified from Year 20 through July 31 , 2014 ( average follow-up 4.9 years ) . RESULTS There was not strong evidence of an interaction between mobility and cognition for prediction of mortality risk ( p interaction term .16 ) . Compared to women with good mobility , mortality risks were increased among women with intermediate mobility ( hazard ratio [ HR ] 1.26 , 95 % confidence interval [ CI ] 1.02 - 1.57 ) and those with poor mobility ( HR 1.64 , 95 % CI 1.24 - 2.16 ) after consideration of cognition and other mortality risk factors . Similarly , mortality risks were higher among women with mild cognitive impairment ( HR 1.46 , 95 % CI 1.21 - 1.76 ) and those with dementia ( HR 1.88 , 95 % CI 1.54 - 2.31 ) compared to women with normal cognition after consideration of mobility and other mortality risk factors . CONCLUSIONS Among women late in life , 5-year mortality risk was substantially increased among women with deficits in mobility even after accounting for cognition and traditional prognostic indicators . Similarly , deficits in cognition were associated with increased 5-year mortality despite consideration of mobility and conventional risk factors OBJECTIVES To evaluate the predictive value of muscle strength and physical performance in the oldest old for all-cause mortality ; hospitalization ; and the onset of disability , defined as a decline in activities of daily living ( ADLs ) , independent of muscle mass , inflammatory markers , and comorbidities . DESIGN A prospect i ve , observational , population -based follow-up study . SETTING Three well-circumscribed areas of Belgium . PARTICIPANTS Five hundred sixty participants aged 80 and older were followed for 33.5 months ( interquartile range 31.1 - 35.6 months ) . MEASUREMENTS  Grip strength , Short Physical Performance Battery ( SPPB ) score , and muscle mass  were measured at baseline ; ADLs at baseline and after 20 months ; and all-cause mortality and time to first hospitalization from inclusion onward . Kaplan-Meier curves and Cox proportional hazards models were calculated for all-cause mortality and hospitalization . Logistic regression analysis was used to determine predictors of decline in ADLs . RESULTS Kaplan-Meier curves showed significantly higher all-cause mortality and hospitalization in subjects in the lowest tertile of grip strength and SPPB score . The adjusted Cox proportional hazards model showed that participants with high grip strength or a high SPPB score had a lower risk of mortality and hospitalization , independent of muscle mass , inflammatory markers , and comorbidity . A relationship was found between SPPB score and decline in ADLs , independent of muscle mass , inflammation , and comorbidity . CONCLUSION In people aged 80 and older , physical performance is a strong predictor of mortality , hospitalization , and disability , and muscle strength is a strong predictor of mortality and hospitalization . All of these relationships were independent of muscle mass , inflammatory markers , and comorbidity This study aims to determine the cardiac dysfunction prevalence , to investigate the relationship between the Short Physical Performance Battery ( SPPB ) test and structural and functional echocardiographic parameters and to determine whether SPPB scores and cardiac dysfunction are independent mortality predictors in an elderly Russian population . A r and om sample of 284 community-dwelling adults aged 65 and older were selected from a population -based register and divided into two age groups ( 65 - 74 and ≥75 ) .  The SPPB test , echocardiography and all-cause mortality were measured . The prevalence of cardiac dysfunction was 12 % in the 65 - 74 group and 23 % in the ≥75 group . The multivariate models could explain 15 % and 23 % of the SPPB score total variance for the 65 - 74 and ≥75 age groups , respectively . In the younger age group , the mean follow-up time was 2.6±0.46 years , and the adjusted hazard ratio ( HR ) for risk of mortality from cardiac dysfunction was 4.9 . In the older age group , the mean follow-up time was 2.4±0.61 years , and both cardiac dysfunction and poor physical performance were found to be independent predictors of mortality ( adjusted HR=3.4 and adjusted HR=4.2 , respectively ) . The cardiac dysfunction prevalence in this elderly Russian population was found to be comparable to , or even lower than , reported prevalences for Western countries . Furthermore , the observed correlations between echocardiographic abnormalities and SPPB scores were limited . Cardiac dysfunction was shown to be a strong mortality predictor in both age groups , and poor physical performance was identified as an independent mortality predictor in the oldest subjects We investigated the predictive value of geriatric assessment ( GA ) on overall survival ( OS ) for older adults with acute myelogenous leukemia ( AML ) . Consecutive patients ≥ 60 years with newly diagnosed AML and planned intensive chemotherapy were enrolled at a single institution . Pretreatment GA included evaluation of cognition , depression , distress , physical function ( PF ) ( self-reported and objective ly measured ) , and comorbidity . Objective PF was assessed using the Short Physical Performance Battery ( SPPB , timed 4-m walk , chair st and s , st and ing balance ) and grip strength . Cox proportional hazards models were fit for each GA measure as a predictor of OS . Among 74 patients , the mean age was 70 years , and 78.4 % had an Eastern Cooperative Oncology Group ( ECOG ) score ≤ 1 . OS was significantly shorter for participants who screened positive for impairment in cognition and objective ly measured PF . Adjusting for age , gender , ECOG score , cytogenetic risk group , myelodysplastic syndrome , and hemoglobin , impaired cognition ( Modified Mini-Mental State Exam < 77 ) and impaired objective PF ( SPPB < 9 ) were associated with worse OS . GA methods , with a focus on cognitive and PF , improve risk stratification and may inform interventions to improve outcomes for older AML patients Objective : To evaluate whether HIV infection was associated with reduced physical performance , and to examine if reduced physical performance predicted mortality in our aging cohort of HIV-infected and HIV-uninfected persons . Design : Prospect i ve , observational cohort of current and former injection drug users in the AIDS Linked to the IntraVenous Experience study in Baltimore , Maryl and , USA . Methods : The  Short Physical Performance Battery ( SPPB )  was used as an objective measure of physical performance and measured semiannually along with behavioral and demographic data . Correlates of reduced physical performance ( SPPB score ⩽10 ) were identified and the relationship between reduced physical performance , HIV infection and mortality was analyzed by Cox regression . Results : Among 12 270 person-visits contributed by 1627 participants , the median age was 51 , 30.3 % were HIV-infected and 32.6 % had an SPPB score 10 or less . In multivariable models , HIV infection was independently associated with 30 % increased odds of reduced physical performance [ odds ratio 1.30 ; 95 % confidence interval (CI):1.12–1.52 ] . Reduced physical performance predicted mortality in a dose-response manner and within all HIV disease strata . Whereas reduced physical performance alone ( hazard ratio 2.52 , 95 % CI : 1.59–4.00 ) and HIV infection alone ( hazard ratio 2.78 , 95 % CI : 1.70–4.54 ) increased mortality , HIV-infected participants with reduced physical performance had a six-fold increased mortality risk ( hazard ratio 6.03 , 95 % CI : 3.80–10.0 ) compared with HIV-uninfected participants with higher physical performance . Conclusion : HIV infection was independently associated with reduced physical performance . HIV and reduced physical performance have independent and joint effects on mortality . Physical performance measurement may be an important research and clinical tool to predict adverse outcomes among aging HIV-infected persons BACKGROUND The Short Physical Performance Battery ( SPPB ) , which includes walking , balance , and chair st and s tests , independently predicts mobility disability and activities of daily living disability . To date , however , there is no definitive evidence from r and omized controlled trials that SPPB scores can be improved . Our objective was to assess the effect of a comprehensive physical activity ( PA ) intervention on the SPPB and other physical performance measures . METHODS A total of 424 sedentary persons at risk for disability ( ages 70 - 89 years ) were r and omized to a moderate-intensity PA intervention or a successful aging ( SA ) health education intervention and were followed for an average of 1.2 years . RESULTS The mean baseline SP 
    Output:
    
agent
The association between poor performance on SPPB and all-cause mortality remained highly consistent independent of follow-up length , subsets of participants , geographic area , and age of the population .
Conclusions An SPPB score lower than 10 is predictive of all-cause mortality .
The systematic implementation of the SPPB in clinical practice setting s may provide useful prognostic information about the risk of all-cause mortality .
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background : objective measures of physical activity and function with a diverse cohort of UK adults in their 70s and 80s were used to investigate relative risk of all-cause mortality and diagnoses of new diseases over a 4-year period . Participants : two hundred and forty older adults were r and omly recruited from 12 general practice s in urban and suburban areas of a city in the United Kingdom . Follow-up included 213 of the baseline sample . Methods : socio-demographic variables , height and weight , and self-reported diagnosed diseases were recorded at baseline . Seven-day accelerometry was used to assess total physical activity , moderate-to-vigorous activity and sedentary time . A log recorded trips from home .  Lower limb function was assessed using the Short Physical Performance Battery . Medical records were accessed on average 50 months post baseline , when new diseases and deaths were recorded . Analyses : ANOVAs were used to assess socio-demographic , physical activity and lower limb function group differences in diseases at baseline and new diseases during follow-up . Regression models were constructed to assess the prospect i ve associations between physical activity and function with mortality and new disease . Results : for every 1,000 steps walked per day , the risk of mortality was 36 % lower ( hazard ratios 0.64 , 95 % confidence interval ( CI ) 0.44–0.91 , P = 0.013 ) . Low levels of moderate-to-vigorous physical activity ( incident rate ratio ( IRR ) 1.67 , 95 % CI 1.04–2.68 , P = 0.030 ) and low frequency of trips from home ( IRR 1.41 , 95 % CI 0.98–2.05 , P = 0.045 ) were associated with diagnoses of more new diseases . Conclusion : physical activity should be supported for adults in their 70s and 80s , as it is associated with reduced risk of mortality and new disease development BACKGROUND Hospitalization represents a stressful and potentially hazardous event for older persons . We evaluated the value of the Short Physical Performance Battery ( SPPB ) in predicting rates of functional decline , rehospitalization , and death in older acutely ill patients in the year after discharge from the hospital . METHODS Prospect i ve cohort study of 87 patients aged 65 years and older who were able to walk and with a Mini-Mental State Examination score ≥ 18 and admitted to the hospital with a clinical diagnosis of congestive heart failure , pneumonia , chronic obstructive pulmonary disease , or minor stroke . Patients were evaluated with the SPPB at hospital admission , were reevaluated the day of hospital discharge , and 1 month later . Subsequently , they were followed every 3 months by telephone interviews to ascertain functional decline , new hospitalizations , and vital status . RESULTS After adjustment for potential confounders , including self-report activity of daily living and comorbidity , the SPPB score at discharge was inversely correlated with the rate of decline in activity of daily living performance over the follow-up ( p < .05 ) . In a multivariable discrete-time survival analysis , patients with poor SPPB scores at hospital discharge ( 0 - 4 ) had a greater risk of rehospitalization or death ( odds ratio : 5.38 , 95 % confidence interval : 1.82 - 15.9 ) compared with those with better SPPB scores ( 8 - 12 ) . Patients with early decline in SPPB score after discharge also had steeper increase in activity of daily living difficulty and higher risk of rehospitalization or death over the next year . CONCLUSIONS In older acutely ill patients who have been hospitalized , the SPPB provides important prognostic information . Lower extremity performance-based functional assessment might identify older patients at high risk of poor outcomes after hospital discharge BACKGROUND This study examines the effects of mobility and cognition on  mortality risk in women late in life . METHODS A prospect i ve study was conducted among 1,495 women ( mean age 87.6 years ) participating in the Study of Osteoporotic Fractures Year 20 examination ( 2006 - 2008 ) .  Mobility  ( ascertained by Short Physical Performance Battery [ SPPB ] ) was categorized as poor ( SPPB 0 - 3 , n = 312 ) , intermediate ( SPPB 4 - 9 , n = 799 ) , or good ( SPPB 10 - 12 , n = 384 ) . Cognitive status ( adjudicated based on neuropsychological tests ) was classified as normal ( n = 873 ) , mild cognitive impairment ( n = 354 ) , or dementia ( n = 268 ) . Deaths ( n = 749 ) were identified from Year 20 through July 31 , 2014 ( average follow-up 4.9 years ) . RESULTS There was not strong evidence of an interaction between mobility and cognition for prediction of mortality risk ( p interaction term .16 ) . Compared to women with good mobility , mortality risks were increased among women with intermediate mobility ( hazard ratio [ HR ] 1.26 , 95 % confidence interval [ CI ] 1.02 - 1.57 ) and those with poor mobility ( HR 1.64 , 95 % CI 1.24 - 2.16 ) after consideration of cognition and other mortality risk factors . Similarly , mortality risks were higher among women with mild cognitive impairment ( HR 1.46 , 95 % CI 1.21 - 1.76 ) and those with dementia ( HR 1.88 , 95 % CI 1.54 - 2.31 ) compared to women with normal cognition after consideration of mobility and other mortality risk factors . CONCLUSIONS Among women late in life , 5-year mortality risk was substantially increased among women with deficits in mobility even after accounting for cognition and traditional prognostic indicators . Similarly , deficits in cognition were associated with increased 5-year mortality despite consideration of mobility and conventional risk factors OBJECTIVES To evaluate the predictive value of muscle strength and physical performance in the oldest old for all-cause mortality ; hospitalization ; and the onset of disability , defined as a decline in activities of daily living ( ADLs ) , independent of muscle mass , inflammatory markers , and comorbidities . DESIGN A prospect i ve , observational , population -based follow-up study . SETTING Three well-circumscribed areas of Belgium . PARTICIPANTS Five hundred sixty participants aged 80 and older were followed for 33.5 months ( interquartile range 31.1 - 35.6 months ) . MEASUREMENTS  Grip strength , Short Physical Performance Battery ( SPPB ) score , and muscle mass  were measured at baseline ; ADLs at baseline and after 20 months ; and all-cause mortality and time to first hospitalization from inclusion onward . Kaplan-Meier curves and Cox proportional hazards models were calculated for all-cause mortality and hospitalization . Logistic regression analysis was used to determine predictors of decline in ADLs . RESULTS Kaplan-Meier curves showed significantly higher all-cause mortality and hospitalization in subjects in the lowest tertile of grip strength and SPPB score . The adjusted Cox proportional hazards model showed that participants with high grip strength or a high SPPB score had a lower risk of mortality and hospitalization , independent of muscle mass , inflammatory markers , and comorbidity . A relationship was found between SPPB score and decline in ADLs , independent of muscle mass , inflammation , and comorbidity . CONCLUSION In people aged 80 and older , physical performance is a strong predictor of mortality , hospitalization , and disability , and muscle strength is a strong predictor of mortality and hospitalization . All of these relationships were independent of muscle mass , inflammatory markers , and comorbidity This study aims to determine the cardiac dysfunction prevalence , to investigate the relationship between the Short Physical Performance Battery ( SPPB ) test and structural and functional echocardiographic parameters and to determine whether SPPB scores and cardiac dysfunction are independent mortality predictors in an elderly Russian population . A r and om sample of 284 community-dwelling adults aged 65 and older were selected from a population -based register and divided into two age groups ( 65 - 74 and ≥75 ) .  The SPPB test , echocardiography and all-cause mortality were measured . The prevalence of cardiac dysfunction was 12 % in the 65 - 74 group and 23 % in the ≥75 group . The multivariate models could explain 15 % and 23 % of the SPPB score total variance for the 65 - 74 and ≥75 age groups , respectively . In the younger age group , the mean follow-up time was 2.6±0.46 years , and the adjusted hazard ratio ( HR ) for risk of mortality from cardiac dysfunction was 4.9 . In the older age group , the mean follow-up time was 2.4±0.61 years , and both cardiac dysfunction and poor physical performance were found to be independent predictors of mortality ( adjusted HR=3.4 and adjusted HR=4.2 , respectively ) . The cardiac dysfunction prevalence in this elderly Russian population was found to be comparable to , or even lower than , reported prevalences for Western countries . Furthermore , the observed correlations between echocardiographic abnormalities and SPPB scores were limited . Cardiac dysfunction was shown to be a strong mortality predictor in both age groups , and poor physical performance was identified as an independent mortality predictor in the oldest subjects We investigated the predictive value of geriatric assessment ( GA ) on overall survival ( OS ) for older adults with acute myelogenous leukemia ( AML ) . Consecutive patients ≥ 60 years with newly diagnosed AML and planned intensive chemotherapy were enrolled at a single institution . Pretreatment GA included evaluation of cognition , depression , distress , physical function ( PF ) ( self-reported and objective ly measured ) , and comorbidity . Objective PF was assessed using the Short Physical Performance Battery ( SPPB , timed 4-m walk , chair st and s , st and ing balance ) and grip strength . Cox proportional hazards models were fit for each GA measure as a predictor of OS . Among 74 patients , the mean age was 70 years , and 78.4 % had an Eastern Cooperative Oncology Group ( ECOG ) score ≤ 1 . OS was significantly shorter for participants who screened positive for impairment in cognition and objective ly measured PF . Adjusting for age , gender , ECOG score , cytogenetic risk group , myelodysplastic syndrome , and hemoglobin , impaired cognition ( Modified Mini-Mental State Exam < 77 ) and impaired objective PF ( SPPB < 9 ) were associated with worse OS . GA methods , with a focus on cognitive and PF , improve risk stratification and may inform interventions to improve outcomes for older AML patients Objective : To evaluate whether HIV infection was associated with reduced physical performance , and to examine if reduced physical performance predicted mortality in our aging cohort of HIV-infected and HIV-uninfected persons . Design : Prospect i ve , observational cohort of current and former injection drug users in the AIDS Linked to the IntraVenous Experience study in Baltimore , Maryl and , USA . Methods : The  Short Physical Performance Battery ( SPPB )  was used as an objective measure of physical performance and measured semiannually along with behavioral and demographic data . Correlates of reduced physical performance ( SPPB score ⩽10 ) were identified and the relationship between reduced physical performance , HIV infection and mortality was analyzed by Cox regression . Results : Among 12 270 person-visits contributed by 1627 participants , the median age was 51 , 30.3 % were HIV-infected and 32.6 % had an SPPB score 10 or less . In multivariable models , HIV infection was independently associated with 30 % increased odds of reduced physical performance [ odds ratio 1.30 ; 95 % confidence interval (CI):1.12–1.52 ] . Reduced physical performance predicted mortality in a dose-response manner and within all HIV disease strata . Whereas reduced physical performance alone ( hazard ratio 2.52 , 95 % CI : 1.59–4.00 ) and HIV infection alone ( hazard ratio 2.78 , 95 % CI : 1.70–4.54 ) increased mortality , HIV-infected participants with reduced physical performance had a six-fold increased mortality risk ( hazard ratio 6.03 , 95 % CI : 3.80–10.0 ) compared with HIV-uninfected participants with higher physical performance . Conclusion : HIV infection was independently associated with reduced physical performance . HIV and reduced physical performance have independent and joint effects on mortality . Physical performance measurement may be an important research and clinical tool to predict adverse outcomes among aging HIV-infected persons BACKGROUND The Short Physical Performance Battery ( SPPB ) , which includes walking , balance , and chair st and s tests , independently predicts mobility disability and activities of daily living disability . To date , however , there is no definitive evidence from r and omized controlled trials that SPPB scores can be improved . Our objective was to assess the effect of a comprehensive physical activity ( PA ) intervention on the SPPB and other physical performance measures . METHODS A total of 424 sedentary persons at risk for disability ( ages 70 - 89 years ) were r and omized to a moderate-intensity PA intervention or a successful aging ( SA ) health education intervention and were followed for an average of 1.2 years . RESULTS The mean baseline SP 
    Output:
    