{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T22:38:13Z","timestamp":1776465493210,"version":"3.51.2"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,12,28]],"date-time":"2017-12-28T00:00:00Z","timestamp":1514419200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Geriatrics Gerontology Int"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>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\u2010dwelling 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data are from 709 non\u2010disabled older persons participating in the \u201cInvecchiare in Chianti\u201d 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\u2010year disability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The analysis showed a \u201cphysical\u201d cluster (including weight loss, reduced grip strength\/gait speed\/physical activity, impaired balance, environmental barriers) and a \u201cpsychosocial\u201d 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 \u201cfit\u201d group, the relative risks of becoming disabled in the \u201cphysical,\u201d \u201cpsychosocial\u201d and \u201cmixed\u201d deficit groups were 2.23 (95% CI 0.71\u20137.00), 1.52 (95% CI 0.62\u20133.75) and 6.37 (95% CI 2.83\u201314.33), respectively. The positive and negative predictive values for the \u201cphysical,\u201d \u201cpsychosocial\u201d and \u201cmixed\u201d deficit groups were, respectively, 9% and 87%, 6% and 83%, and 27% and 94%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>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. <jats:bold>Geriatr Gerontol Int 2018; 18: 685\u2013691<\/jats:bold><\/jats:p><\/jats:sec>","DOI":"10.1111\/ggi.13226","type":"journal-article","created":{"date-parts":[[2017,12,28]],"date-time":"2017-12-28T07:16:44Z","timestamp":1514445404000},"page":"685-691","source":"Crossref","is-referenced-by-count":9,"title":["Clusters of functional domains to identify older persons at risk of disability"],"prefix":"10.1111","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0711-2131","authenticated-orcid":false,"given":"Luisa","family":"Costanzo","sequence":"first","affiliation":[{"name":"Geriatric Unit Campus Bio\u2010Medico University of Rome  Rome"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudio","family":"Pedone","sequence":"additional","affiliation":[{"name":"Geriatric Unit Campus Bio\u2010Medico University of Rome  Rome"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matteo","family":"Cesari","sequence":"additional","affiliation":[{"name":"Geriatric Unit, Department of Medical Sciences and Community Health University of Milan  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luigi","family":"Ferrucci","sequence":"additional","affiliation":[{"name":"National Institute on Aging National Institutes of Health  Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefania","family":"Bandinelli","sequence":"additional","affiliation":[{"name":"Healthcare Agency of Florence  Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raffaele","family":"Antonelli Incalzi","sequence":"additional","affiliation":[{"name":"Geriatric Unit Campus Bio\u2010Medico University of Rome  Rome"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,12,28]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2013.03.022"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1209034"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2011.03597.x"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/gls119"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/56.3.M146"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2009.02137.x"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2009.09.015"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2009.11.003"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glv096"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2011.09.003"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afv144"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-016-0225-2"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2000.tb03873.x"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/26.4.315"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/55.6.M350"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/geronj\/49.2.M85"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/geronb\/53B.1.S9"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)04402-X"},{"key":"e_1_2_7_20_1","first-page":"224","article-title":"Frailty: a public health perspective","volume":"86","author":"Raphael D","year":"1995","journal-title":"Can J Public Health"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3956(75)90026-6"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/014662167700100306"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1159\/000088705"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2648.2006.04021.x"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1983.tb03391.x"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2648.2003.02767.x"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2006.00745.x"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2009.11.008"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.1923"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2005.53501.x"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-015-0078-0"}],"container-title":["Geriatrics &amp; 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