scholarly journals Cognitive Correlates of Functional Performance in Older Adults: Comparison of Self-Report, Direct Observation, and Performance-Based Measures

2011 ◽  
Vol 17 (05) ◽  
pp. 853-864 ◽  
Author(s):  
Maureen Schmitter-Edgecombe ◽  
Carolyn Parsey ◽  
Diane J. Cook
2016 ◽  
Vol 37 (1) ◽  
pp. 79-98 ◽  
Author(s):  
Tiffany E. Shubert ◽  
Matthew Lee Smith ◽  
Luohua Jiang ◽  
Marcia G. Ory

The Otago Exercise Program (OEP) is an evidence-based fall prevention program disseminated internationally. Little is known about the implementation or effectiveness of the OEP in the United States. The purposes were to (a) identify characteristics of older adults enrolled in OEP, and (b) examine perceived and actual functional performance changes after participation in 8 weeks of the program. Baseline and 8-week functional and self-report data were collected on 210 older adults from 2013 to 2015. Linear mixed models and general estimating equations logistic regression models adjusted for socio-demographic factors were performed to assess changes. At 8 weeks, scores dramatically improved on self-report and physical performance tests: Timed Up-and-Go ( p < .001), 30-Second Chair Rise ( p < .001), and Four-Stage Balance ( p < .001). Findings support that participation in the U.S. OEP as part of a plan of care can result in significant improvements in objective functional mobility, balance measures, and self-reported ability.


2012 ◽  
Vol 92 (2) ◽  
pp. 318-328 ◽  
Author(s):  
Alaina M. Newell ◽  
Jessie M. VanSwearingen ◽  
Elizabeth Hile ◽  
Jennifer S. Brach

BackgroundPerceived ability or confidence plays an important role in determining function and behavior. The modified Gait Efficacy Scale (mGES) is a 10-item self-report measure used to assess walking confidence under challenging everyday circumstances.ObjectiveThe purpose of this study was to determine the reliability, internal consistency, and validity of the mGES as a measure of gait in older adults.DesignThis was a cross-sectional study.MethodsParticipants were 102 community-dwelling older adults (mean [±SD] age=78.6±6.1 years) who were independent in ambulation with or without an assistive device. Participants were assessed using the mGES and measures of confidence and fear, measures of function and disability, and performance-based measures of mobility. In a subsample (n=26), the mGES was administered twice within a 1-month period to establish test-retest reliability through the intraclass correlation coefficient (ICC [2,1]). The standard error of measure (SEM) was determined from the ICC and standard deviation. The Cronbach α value was calculated to determine internal consistency. To establish the validity of the mGES, the Spearman rank order correlation coefficient was used to examine the association with measures of confidence, fear, gait, and physical function and disability.ResultsThe mGES demonstrated test-retest reliability within the 1-month period (ICC=.93, 95% confidence interval=.85, .97). The SEM of the mGES was 5.23. The mGES was internally consistent across the 10 items (Cronbach α=.94). The mGES was related to measures of confidence and fear (r=.54–.88), function and disability (Late-Life Function and Disability Instrument, r=.32–.88), and performance-based mobility (r=.38–.64).LimitationsThis study examined only community-dwelling older adults. The results, therefore, should not be generalized to other patient populations.ConclusionThe mGES is a reliable and valid measure of confidence in walking among community-dwelling older adults.


1997 ◽  
Vol 5 (4) ◽  
pp. 298-310 ◽  
Author(s):  
Marieke J.G. van Heuvelen ◽  
Gertrudis I.J.M. Kempen ◽  
Johan Ormel ◽  
Mathieu H.G. de Greef

To evaluate the validity of self-report measures of physical fitness as substitutes for performance-based tests, self-reports and performance-based tests of physical fitness were compared. Subjects were a community-based sample of older adults (N = 624) aged 57 and over. The performance-based tests included endurance, flexibility, strength, balance, manual dexterity, and reaction time. The self-report evaluation assessed selected individual subcomponents of fitness and used both peers and absolute standards as reference. The results showed that compared to performance-based tests, the self-report items were more strongly interrelated and they less effectively evaluated the different subdomains of physical fitness. Corresponding performance-based tests and self-report items were weakly to moderately associated. All self-report items were related most strongly with the performance-based endurance test. Apparently. older people tend to estimate overall fitness, in which endurance plays an important part, rather than individual subcomponents of Illness. Therefore, the self-report measures have limited validity as predictors of performance-based physical fitness.


2011 ◽  
Vol 8 (5) ◽  
pp. 716-723 ◽  
Author(s):  
Katherine S. Hall ◽  
Edward McAuley

Background:Few studies have examined physical activity behavior and its associated outcomes in older adults living in retirement communities. Guided by the disablement model and social cognitive theory, we tested a cross-sectional model in which physical activity was hypothesized to influence disability indirectly through self-efficacy, functional performance, and functional limitations.Methods:One hundred six older men and women residing in independent-living (ILF) assisted-living (ALF) facilities completed self-report measures of self-efficacy, function, and disability. Objective assessments of physical activity and functional performance were conducted using waist-mounted accelerometers and the short physical performance battery (SPPB), respectively. Path analysis was used to examine the proposed associations among constructs.Results:Older adults who were more active were also more efficacious and had better physical function and fewer functional limitations. Only higher levels of self-efficacy were associated with less disability. The effects of individual-level covariates were also examined.Conclusions:This cross-sectional study is among the first to examine the associations between physical activity, function, and disability among older adults residing in ILFs and ALFs. Future research addressing the physical and psychological needs of this growing population is warranted.


Author(s):  
Maureen Schmitter-Edgecombe ◽  
Courtney McAlister ◽  
David Greeley

Abstract Objective: This study used multiple assessment methods to examine instrumental activities of daily living (IADLs) performance in individuals with Parkinson’s disease with mild cognitive impairment (PD-MCI) compared to individuals with mild cognitive impairment (MCI) and cognitively healthy older adults (HOA). Associations between functional performance and cognition were also examined. Methods: Eighteen individuals with PD-MCI, 48 individuals with MCI, and 66 HOAs were assessed with multiple IADL measures, including direct observation, a performance-based measure, and self- and informant-report questionnaires. Performance on the direct-observation measure was further characterized by coding for four error types: omissions, substitutions, and inefficient and irrelevant/off-task actions. Results: Both the PD-MCI and MCI groups performed more poorly on the overall score for all IADL measures relative to HOAs. Although the PD-MCI and MCI groups did not differ in overall performance, on the direct-observation measure, the PD-MCI group took longer and made more inefficient and irrelevant/off-task errors relative to the HOA and MCI groups, whereas the MCI group made more omission and substitution errors relative to HOAs. Further, the pattern of cognitive correlates that associated most strongly with the functional measures varied across groups and functional assessment methods. Conclusion: Compared to HOAs, PD-MCI and MCI groups demonstrated increased difficulties performing everyday activities, and cognitive and motor abilities differentially contributed to the everyday task difficulties of these two groups.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 890-891
Author(s):  
Staja Booker ◽  
Roger Fillingim

Abstract Osteoarthritis (OA) contributes to movement-evoked pain, impaired function and mobility, and reduced quality of life among older adults. Assessment of pain has not traditionally considered the dynamic changes that occur with gross motor movement, and thus self-reports of pain often reflect static or resting pain. This case-control pilot study examined inter- and intra-racial differences in movement-evoked pain and performance-based function in older adults (N= 28) with knee OA. Cases consisted of Blacks and Whites with OA; controls included Blacks without OA. The Biodex Pro System 4, an isokinetic and isometric dynamometer commonly used in rehabilitative medicine, measured knee muscle function. Pain intensity was assessed pre-, ante-, and post- completion of 2 repetition sets of five alternating knee flexion and extension maximum voluntary contractions at angular velocities of 90° (greater resistance) and 180° (lower resistance). Repeated Measures Analysis of Variance with Bonferroni correction identified statistically significant differences in pain for within- and between-subjects at 90° and 180°. Pain increased during the repetitions and decreased after completion of both repetition sets; this non-linear relationship was significant (p= .004). One-way ANOVA demonstrated peak torque (extension), a muscle’s maximum strength capability, was significantly higher in White cases and Blacks controls compared to Blacks cases. Novel findings revealed that baseline pain is much higher and functional performance is significantly lower in Blacks with OA compared to White cases and Black controls. This research advances precision pain measurement and our understanding of the biological mechanisms uniquely involved in the experience of knee OA and mobility.


GeroPsych ◽  
2019 ◽  
Vol 32 (1) ◽  
pp. 41-52
Author(s):  
Matthew C. Costello ◽  
Shane J. Sizemore ◽  
Kimberly E. O’Brien ◽  
Lydia K. Manning

Abstract. This study explores the relative value of both subjectively reported cognitive speed and gait speed in association with objectively derived cognitive speed. It also explores how these factors are affected by psychological and physical well-being. A group of 90 cognitively healthy older adults ( M = 73.38, SD = 8.06 years, range = 60–89 years) were tested in a three-task cognitive battery to determine objective cognitive speed as well as measures of gait speed, well-being, and subjective cognitive speed. Analyses indicated that gait speed was associated with objective cognitive speed to a greater degree than was subjective report, the latter being more closely related to well-being than to objective cognitive speed. These results were largely invariant across the 30-year age range of our older adult sample.


Sign in / Sign up

Export Citation Format

Share Document