Instruments to Assess Mobility Limitation in Community-Dwelling Older Adults: A Systematic Review

2015 ◽  
Vol 23 (2) ◽  
pp. 298-313 ◽  
Author(s):  
Jane Chung ◽  
George Demiris ◽  
Hilaire J. Thompson

Mobility is critical in maintaining independence in older adults. This study aims to systematically review the scientific literature to identify measures of mobility limitation for community-dwelling older adults. A systematic search of PubMed, CINAHL, and psycINFO, using the search terms “mobility limitation”, “mobility disability”, and “mobility difficulty” yielded 1,847 articles from 1990 to 2012; a final selection of 103 articles was used for the present manuscript. Tools to measure mobility were found to be either self-report or performance-based instruments. Commonly measured constructs of mobility included walking, climbing stairs, and lower extremity function. There was heterogeneity in ways of defining and measuring mobility limitation in older adults living in the community. Given the lack of consistency in assessment tools for mobility, a clear understanding and standardization of instruments are required for comparison across studies and for better understanding indicators and outcomes of mobility limitation in community-dwelling older adults.

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 546-546
Author(s):  
Christine Brewer

Abstract Few nursing students show preference in working with older adults. The purpose of this study was to review the U.S. nursing education evidence-based literature to determine curricula innovation to positively influence preference for working with older adults. CINAHL, Medline, Ovid Emcare, PsychInfo, and PubMed databases were searched for relevant U.S studies published between 2009 and 2020 using the search terms “nursing students”, “geriatrics OR gerontology OR older adults OR elderly OR aging”, “career OR work”, and “choice OR preference OR attitude”. Nine studies were eligible for inclusion. Nursing education may play a role in influencing how students perceive and prefer to work with older adults. Promising interventions include stand-alone gerontology courses, intergenerational service-learning experiences, and clinical experiences with community dwelling older adults. More evidence-based research with larger sample sizes are needed to determine effective nursing education interventions to improve nursing students’ attitude and preference for working with older adults.


2019 ◽  
Vol 31 (12) ◽  
pp. 1699-1707 ◽  
Author(s):  
Toshinori Nishizawa ◽  
Ayako Morita ◽  
Takeo Fujiwara ◽  
Katsunori Kondo

ABSTRACTBackground:Subjective memory complaints (SMC) have been suggested as an early marker of mild cognitive impairment and dementia. However, there is a paucity of evidence on the effects of early life conditions on the development of SMC in old age. This study is aimed at investigating the association between childhood socioeconomic status (SES) and SMC in community-dwelling older adults.Methods:We used the data of the Japan Gerontological Evaluation Study, a population-based cohort study of people aged 65 years or older enrolled from 28 municipalities across Japan. Childhood SES and SMC in everyday life were assessed from the self-report questionnaire administered in 2010 (n = 16,184). Poisson regression was performed to determine their association, adjusted for potential confounders and life-course mediators and examined cohort effects.Results:We identified SMC in 47.4% of the participants. After adjusting for sex, age, and number of siblings, low and middle childhood SES were associated with 29% (prevalence ratio [PR]: 1.29, 95% confidence interval [CI]: 1.22, 1.36) and 10% higher prevalence of SMC (PR: 1.10, 95%CI: 1.04, 1.17), respectively, compared with high childhood SES (p for trend <.001). The interaction terms between childhood SES and age groups were not statistically significant.Conclusion:Childhood SES is significantly associated with SMC among community-dwelling older adults. Efforts to minimize childhood poverty may diminish or delay the onset of SMC and dementia in later life.


2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv18-iv27 ◽  
Author(s):  
Shawn Leng-Hsien Soh ◽  
Chee-Wee Tan ◽  
Lane Judith ◽  
Nigel Gleeson ◽  
Tim Xu

Abstract Background Falls efficacy is a widely-studied latent construct in community-dwelling older adults. Various self-reported instruments have been used to measure falls efficacy. Empirical evidence is needed to justify the selection of a specific instrument to measure the intended construct. Objectives To summarize evidence on the development, content validity and structural validity of instruments measuring falls efficacy in community-dwelling older adults using Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist. Study Design and Setting MEDLINE, Web of Science, PsychINFO, SCOPUS, CINAHL were searched (May 2019). Records on development of instruments and studies assessing content validity or structural validity of falls efficacy related scales were included. COSMIN methodology guided the review of eligible studies and methodological quality. Evidence of content validity: relevance, comprehensiveness and comprehensibility and unidimensionality for structural validity were synthesized. A modified GRADE approach was applied to evidence synthesis. Results 35 studies on 18 instruments were included in the review. High quality evidence showed that modified Falls-Efficacy Scale (FES)–13 items (mFES-13) is relevant but not comprehensive for measuring falls efficacy. Moderate quality evidence supported the FES-10 had sufficient relevance and the mFES-14 had sufficient comprehensibility. Only the Activities-specific Balance Confidence (ABC) Scale–Simplified (ABC-15) had sufficient relevance of moderate quality evidence to measure balance confidence. Low to very low quality evidence underpinned content validity of other instruments. High quality evidence supported sufficient unidimensionality for eight instruments (FES-10, mFES-14, ABC-6, ABC-15, ABC-16, Iconographical FES (Icon-FES), FES–International (FES-I) and Perceived Ability to Prevent and Manage Fall Risks (PAPMFR)). Conclusion Content validity of the instruments to measure falls efficacy is understudied. Structural validity is sufficient for a number of widely-used instruments. Measuring balance confidence is a subset of falls efficacy. Further work is needed to investigate the broader continuum of falls efficacy.


2005 ◽  
Vol 60 (8) ◽  
pp. 1007-1012 ◽  
Author(s):  
J. S. Lee ◽  
S. B. Kritchevsky ◽  
F. Tylavsky ◽  
T. Harris ◽  
E. M. Simonsick ◽  
...  

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.


2010 ◽  
Vol 90 (5) ◽  
pp. 748-760 ◽  
Author(s):  
Ankur Desai ◽  
Valerie Goodman ◽  
Naaz Kapadia ◽  
Barbara L. Shay ◽  
Tony Szturm

BackgroundPoor balance control, mobility restrictions, and fall injuries are serious problems for many older adults.ObjectiveThe purpose of this study was to evaluate a new dynamic standing balance assessment test for identifying individuals at risk for falling in a group of community-dwelling older adults.DesignThis was a cross-sectional observational study of 72 community-dwelling older adults who were receiving rehabilitation in a geriatric day hospital.MethodA Dynamic Balance Assessment (DBA) test protocol was developed based on the concept of the Sensory Organization Test and the Clinical Test of Sensory Interaction and Balance. The DBA consists of 6 tasks performed on a normal floor surface and repeated on a sponge surface. A flexible pressure mat was used to record the foot's center of pressure (COP) on both surfaces, and loss of balance was recorded. Balance performance also was evaluated using the Berg Balance Scale, the Timed “Up & Go” Test, gait speed, and the Six-Minute Walk Test. Participants were classified as “fallers” or “nonfallers” based on a self-report.ResultsNo significant differences were noted between the faller group (n=47) and the nonfaller group (n=25) for demographic variables or medications. The DBA composite scores, which were derived from analysis of COP excursions of the 6 tasks performed on the sponge surface, were able to distinguish between fallers and nonfallers. Of the clinical tests, only the Timed “Up & Go” Test was able to differentiate between the faller and nonfaller groups.LimitationsA prospective study is needed to confirm the current findings and to expand testing to a larger and more diverse sample.ConclusionsThe findings indicate that analysis of the extent and amount of COP displacements during selected tasks and under different surface conditions is an appropriate method to assess dynamic standing balance controls and can discriminate between fallers and nonfallers among community-dwelling elderly people.


Healthcare ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1193
Author(s):  
Chia-Hui Lin ◽  
Chieh-Yu Liu ◽  
Jiin-Ru Rong

Screening the frailty level of older adults is essential to avoid morbidity, prevent falls and disability, and maintain quality of life. The Tilburg Frailty Indicator (TFI) is a self-report instrument developed to assess frailty for community-dwelling older adults. The aim of this study was to explore the psychometric properties of the Taiwanese version of TFI (TFI-T). The sample consisted of 210 elderly participants living in the community. The scale was implemented to conduct a confirmatory factor analysis (CFA) test for validity. The models were evaluated through sensitivity, specificity, area under the curve, and receiving operating characteristic (ROC) curve. CFA was performed to evaluate construct validity, and the TFI-T has a goodness of fit with the three-factor structure of the TFI. Totally, the 15 items of TFI-T have acceptable internal consistency (Cronbach’s alpha = 0.78), and test–retest reliability (r = 0.88, p < 0.001). The criterion-related validity was examined, the TFI-T correlation with the Kihon Checklist (KCL) score (r = 0.74; p < 0.001). The cutoff of 5.5 based on the Youden index was considered optimal. The area under the ROC curve analysis indicated that the TFI-T has good accuracy in frailty screening. The TFI-T exhibits good reliability and validity and can be used as a sensitive and accurate instrument, which is highly applicable to screen frailty in Taiwan among older adults.


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