PROJECT SUMMARY/ABSTRACTThis patient-oriented research R21 application will provide funding support for validating a novel approach forassessing functional capacity among hospitalized older adults with chronic obstructive pulmonary disease(COPD) an area of substantial and increasing significance. Our proposed innovative screening method isobjective quick and based on muscle performance assessment of underlying systemic dynapenia. Within thisproject we will perform a 90-day longitudinal study to validate prediction of COPD exacerbations hospitalizationsand mortality using the proposed method.The proposed functional capacity assessment method incorporates an upper-extremity function (UEF) test toobviate the need for walking tasks in bed-bound hospitalized elders. The UEF test involves repetitive elbowflexion measured using low-cost sensors which is easily performed (standing sitting or in bed) in less than oneminute. Post-processing and scoring will be performed in less than one minutes using an app on laptop orcellphone. We have patented and validated the UEF test for assessing frailty based on motion (kinematics) dataand its feasibility has previously been demonstrated in pilot outpatient and inpatient participants. Within thisproject implementing the same hardware and measurement protocol we will improve the algorithm to assessmuscle deconditioning (dynapenia) using a new muscle model that will be added to our original UEF algorithm.The proposed approach builds upon pilot research among COPD patients performed by an excellent group ofinterdisciplinary investigators at the University of Arizona Center on Aging and the Arizona Respiratory ScienceCenter demonstrating significant associations between UEF speed (and embedded strength parameters) withthe 6-minute walk distance (6MWD) test the most commonly used measure of functional capacity in COPD.The goal of this R21 project is to: 1) Develop and evaluate an upper-extremity muscle model; and 2: (ClinicalStudy): Longitudinally assess UEF validity for predicting 90-day adverse health events among 120 COPD-relatedhospitalized older adults ( 65 years) Predictive Index development and assessment of UEF accuracyfeasibility and reliability.We expect to extend scientific knowledge regarding the nature of muscle deconditioning (dynapenia) associatedwith COPD focusing on an upper-extremity function measure (rather than gait assessment). From a clinicalviewpoint we expect to validate a quick and accurate objective tool for assessing functional capacity amongCOPD patients as an alternative to the 6MWD test with the ultimate goal of providing a quick and cost-effectivescreening tool to support acute and outpatient elders risk stratification. If demonstrated effective we expect thatthis tool could be used to predict those at highest risk to enable personalized COPD care and support the qualityof life and independence of older adults with COPD or multiple chronic conditions.