Table 1.
Summary of the PANINI Toolkit tools and measures by domain.
| Domain | Tool | Measure(s) | Examples of Validation in Older Adults | ||
|---|---|---|---|---|---|
| Subdomain | Article | Population(s) | Comparator | ||
| (1) Socio-demographics | |||||
| Socio-demographic | PANINI Questionnaire | Age, nationality, language, education and occupation | n/a | n/a | n/a |
| Social | PANINI Questionnaire | Marital status, living situation and social circumstances | n/a | n/a | n/a |
| (2) General Health | |||||
| Intoxicants | PANINI Questionnaire | Alcohol, smoking and drug use | n/a | n/a | n/a |
| Medical history | PANINI Questionnaire | Past and current medical conditions | n/a | n/a | n/a |
| Medication use | PANINI Questionnaire | Current medication use | n/a | n/a | n/a |
| Anthropometrics | Calibrated height and weight measure | Height (cm) and weight (kg) | n/a | n/a | n/a |
| Tape measure | Waist, hip, calf and mid-arm circumferences (cm) | n/a | n/a | n/a | |
| Body composition | Dual-energy X-ray absorptiometry (DXA) | Fat mass, lean soft-tissue mass (comprising muscle, inner organs and body water) and bone mineral content (kg) (Same measures as DXA) | [13,16,57] | CD, H | 4-C-model, CT, MRI |
| Bioelectrical Impedance Analysis (BIA) | [17,58,59] | CD, H | TBW, 4-C model, CT, DXA | ||
| (3) Nutrition | |||||
| Malnutrition | Mini Nutritional Assessment (MNA) | Nutritional status (points) (normal nutritional status, at risk of malnutrition, malnourished) | [18,60,61] | CD, H, I, Frail, Healthy | Nutritional assessment by physician, comprehensive nutritional assessment (anthropometry, biochemistry and dietary intake) other malnutrition screening tools |
| Dietary intake | Food frequency questionnaire | Macronutrient and micronutrient intake (incl. fluid intake) | [19] | CD | 24 h recalls |
| (4) Physical Activity and Physical Performance | |||||
| Physical activity | Modified Minnesota Leisure Time Activities (MLTPA) Questionnaire | Self-reported physical activity (kcal/week) | [20,21] | CD | Accelerometer |
| International Physical Activity Questionnaire Short Form (IPAQ-s) | Self-reported physical activity (vigorous, moderate, walking, sitting) (hours/day) | [22,23] | CD | Accelerometer | |
| Accelerometer | Physical activity, energy expenditure and sedentary behavior | n/a | n/a | n/a | |
| Mobility | PANINI Questionnaire | Self-reported mobility | n/a | n/a | n/a |
| Physical Performance | Short Physical Performance Battery (SPPB) | Composite physical performance score (points) | [24,62,63,64,65] | CD, H | Self-reported mobility limitations/disability |
| 4 m walk test | Gait speed (m/s) | ||||
| Chair stand test | Time to complete 5 stands from a chair (s) | ||||
| Balance tests | Ability to maintain balance for 10 s in side-by-side, tandem and semi-tandem positions (yes/no, points) | ||||
| Balance tests with eyes closed | (Same as SPPB balance tests with eyes closed) | ||||
| Handheld dynamometer | Hand grip strength (kg) | [25,26,28,65] | CD | Isometric muscle strength (knee extension, hip flexor, elbow flexion, trunk extension, pinch) | |
| Frailty | Fried Frailty Phenotype Criteria | Frailty status (robust, pre-frail or frail) a | [29,66,67] | CD | Other frailty indices (e.g., Frailty Index) |
| Shrinking: weight loss questions b | Shrinking: unintentional weight loss in past year b (yes/no) | ||||
| Weakness: handheld dynamometer | Weakness: hand grip strength (kg) | ||||
| Poor endurance: Depression Center for Epidemiologic Studies Depression Scale (CES-D) c | Poor endurance: depression score (points) | ||||
| Slowness: 4 m walk test | Slowness: gait speed (m/s) | ||||
| Low activity: MLTPA Questionnaire | Low Activity: physical activity (kcal/week) | ||||
| Falls | Short Fall Efficacy Scale International (FES-I) | Fear of falling (points) | [30] | CD | FES-I (original) |
| PANINI Questionnaire | Fall history information in past year | ||||
| Activities of daily living (ADLs) | Katz Index of Independence in Activities of daily living (ADL) | Ability to independently complete ADLs (yes/no, points) | [31,32,33] | CD | Self-reported mobility impairment/disability |
| (5) Psychological and Cognitive Health | |||||
| Cognition | Standardized Mini Mental State Examination (SMMSE) | Cognitive status (points) | [34,35,44] | I, H | MMSE |
| Psychological | Geriatric Depression Scale-15 (GDS-15) | Depression (normal, mild/moderate/severe depression) | [36,37,38] | CD, H | Structured clinical interviews for DSM-IV and ICD-10 criteria |
Bulleted items represent individual measures within a composite measure. Measures from the PANINI Questionnaire are assessed through customized questionnaire. m = meter, 4-c = 4-component, CT = computed tomography, MRI = magnetic resonance imaging, TBW = total body water, CD = community dwelling, H = hospitalized, I = institutionalized, incl. = including, n/a = not applicable. a All criteria of the Fried Frailty Phenotype are assessed as above or below a specified threshold cutoff (adjusted for BMI, age, height and/or sex as appropriate). b Unintentional weight loss is assessed by self-reported weight loss of ≥4.5kg in the year before the current evaluation, or unintentional weight loss of ≥5% of the previous year’s body weight is used to assess the “shrinking” criteria of the Fried Frailty Phenotype. c The evaluation of two statements from the CES-D scale: (a) “I felt that everything I did was an effort” and (b) “I could not get going”, is used to assess the “poor endurance” criteria of the Fried Frailty Phenotype.