The participants were tested with the SPPB by the same rater at two different time points. Mean time between test and retest was 2.5 days with a time span of 1–7 days. All tests were conducted between 9 am and 4 pm. The same test room was used for each test and adequate spacing and lighting was assured to ensure optimal test performance. Standardized equipment was used for all the participants. Two experienced physiotherapists who had carefully familiarized themselves with the SPPB test were involved in the study. They used the Norwegian test manual as well as video material from the original test-development as means of preparation. The testers were instructed not to familiarize themselves with the scores on the first test before performing the retest.
A convenience sample of 62 older people were eligible and participated in the study. The participants were recruited from a community center for seniors in Oslo, Norway. Among the participants, 39 were inpatients/living in a nursing home adjacent to the senior center, and 22 participants lived at home and attended the senior center on a weekly basis. Twenty-four of the nursing- home residents had been diagnosed with dementia, based on a comprehensive geriatric assessment as confirmed by the nursing home’s physician. The recruitment was a targeted recruitment at the senior center in the form of a short talk on the study aims. The inclusion criteria were: being aged 67 years or older and being able to stand up alone or with the help of one person and being able to walk six meters with or without a walking aid. The exclusion criteria were: patients who were medically unstable or had severe communication problems. Further details about the participants can be found in Table 1.

Baseline characteristics and SPPB summary score at test 1 and 2 for all participants and for group comparison dementia/no dementia

VariableaAll participants N = 61Participants with dementia n = 24Participants without dementia n = 37P-value
Age88.4 (8.1), (67–102)88.3 (6.2), (69–97)88.4 (9.2) (67–102).958e
Sex
 Women50 (82)21 (87.5)29 (78.4).572f
 Men11 (18)3 (12 .5)8 (21.6)
Use of walking aids

Frame/rollator
36 (59.0)13 (54.2)23(62.2).307f

Cane
3 (4.9)03 (8.1)

Other
6 (9.9)3 (12.5)3 (8.1)

None
16 (26.2)8 (33.3)8 (21.6)
Type of dwelling

Nursing Home
39 (63.9)24 (100)15 (40.5).001f

Home
22 (36.1)022 (59.5)
 Number of days between tests2.5(1.5), (1–7)2.5 (1.3), (1–6)2.5 (1.6), (1–7).972f
 SPPBb summary score test 13.7 (2.4), (0–10)2.2 (1.4), (0–4)4.7 (2.4), (1–10).001e
 SPPBb summary score test 24.1 (2.5), (0–9)2.4 (2.0), (0–7)5.2 (2.1), (1–9).001e
 Gait speed m/s0.47 (0.17) (0.13–0.97)0.40 (0.16) (0.13–0.79)0.51 (0.17) (0.22–0.97).02e

aContinuous variables are expressed in mean (SD), (min-max), categorical variables are expressed in number (%).

bShort Physical Performance Battery (SPPB), min-max = 0–12, higher score indicates better function

eIndependent sample t-test fChi-Square test

Participants were asked between tests if they had experienced illness or other events that could affect the results on the second test. None of the participants reported such an event.
The Norwegian version of SPPB which was translated into Norwegian by Bergh et al. [14 ] was used in the study. This test consists of two scoring sheets in which the first sheet is used for absolute values measured in seconds and the other sheet is used for comments and scoring according to the test’s 0–4-point scale.
Five performance scores (from 0 to 4) were given for each test, with a score of 0 representing inability to complete the test and 4 the highest level of performance. For tests of standing balance, the subjects were asked to attempt to maintain their feet in the side-by-side, semi-tandem (heel of one foot beside the big toe of the other foot), and tandem (heel of one foot directly in front of the other foot) positions for 10 s each. The subjects were given a score of 1 if they could hold a side-by-side standing position for 10 s but were unable to hold a semi-tandem position for 10 s, a score of 2 if they could hold a semi-tandem position for 10 s but were unable to hold a full tandem position for more than 2 s, a score of 3 if they could stand in the full tandem position for 3 to 9 s, and a score of 4 if they could stand in the full tandem position for 10 s.
A 4 m (13 ft) walk at the subjects’ habitual pace was timed, and the participants were scored according to quartiles for the length of time required. The time of the faster of two walks was used for scoring.
Subjects were asked to fold their arms across their chests and to stand up from a sitting position once; if they successfully rose from the chair, they were asked to stand up and sit down five times as quickly as possible. Quartiles for the length of time required for this measure were used for scoring. The summary performance score was created by adding the scores for the tests of standing balance, walking, and repeatedly rising from a chair giving a maximum score of 12.
The scoring protocol for the SPPB includes comments regarding performance and the reasons for not completing an item. In the Norwegian version, a meters/s calculation for walking, as well as an alternative test for sit-to- stand (STS) where the person is allowed to rise and sit with the use of chair handles, has been added as an appendix. This is not a modification of the SPPB as such, since none of these additions are scored on a scale of 0–4 or added to the summary score of the SPPB [14 ].
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