scholarly journals In-Home Mobility Frequency and Stability in Older Adults Living Alone With or Without MCI: Introduction of New Metrics

2021 ◽  
Vol 3 ◽  
Author(s):  
Chao-Yi Wu ◽  
Hiroko H. Dodge ◽  
Christina Reynolds ◽  
Lisa L. Barnes ◽  
Lisa C. Silbert ◽  
...  

Background: Older adults spend a considerable amount of time inside their residences; however, most research investigates out-of-home mobility and its health correlates. We measured indoor mobility using room-to-room transitions, tested their psychometric properties, and correlated indoor mobility with cognitive and functional status.Materials and Methods: Community-dwelling older adults living alone (n = 139; age = 78.1 ± 8.6 years) from the Oregon Center for Aging & Technology (ORCATECH) and Minority Aging Research Study (MARS) were included in the study. Two indoor mobility features were developed using non-parametric parameters (frequency; stability): Indoor mobility frequency (room-to-room transitions/day) was detected using passive infrared (PIR) motion sensors fixed on the walls in four geographic locations (bathroom; bedroom; kitchen; living room) and using door contact sensors attached to the egress door in the entrance. Indoor mobility stability was estimated by variances of number of room-to-room transitions over a week. Test-retest reliability (Intra-class coefficient, ICC) and the minimal clinically important difference (MCID) defined as the standard error of measurement (SEM) were generated. Generalized estimating equations models related mobility features with mild cognitive impairment (MCI) and functional status (gait speed).Results: An average of 206 days (±127) of sensor data were analyzed per individual. Indoor mobility frequency and stability showed good to excellent test-retest reliability (ICCs = 0.91[0.88–0.94]; 0.59[0.48–0.70]). The MCIDs of mobility frequency and mobility stability were 18 and 0.09, respectively. On average, a higher indoor mobility frequency was associated with faster gait speed (β = 0.53, p = 0.04), suggesting an increase of 5.3 room-to-room transitions per day was associated with an increase of 10 cm/s gait speed. A decrease in mobility stability was associated with MCI (β = −0.04, p = 0.03).Discussion: Mobility frequency and stability in the home are clinically meaningful and reliable features. Pervasive-sensing systems deployed in homes can objectively reveal cognitive and functional status in older adults who live alone.

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.


2007 ◽  
Vol 15 (2) ◽  
pp. 184-194 ◽  
Author(s):  
Marissa E. Mendelsohn ◽  
Denise M. Connelly ◽  
Tom J. Overend ◽  
Robert J. Petrella

Although popular in clinical settings, little is known about the utility of all-extremity semirecumbent exercise machines for research. Twenty-one community-dwelling older adults performed two exercise trials (three 4-min stages at increasing workloads) to evaluate the reliability and validity of exercise responses to submaximal all-extremity semirecumbent exercise (BioStep). Exercise responses were measured directly (Cosmed K4b2) and indirectly through software on the BioStep. Test–retest reliability (ICC2,1) was moderate to high across all three stages for directly measured METs (.92, .87, and .88) and HR (.91, .83, and .86). Concurrent criterion validity between the K4b2and BioStep MET values was moderate to very good across the three stages on both Day 1 (r= .86, .71, and .83) and Day 2 (r= .73, .87, and .72). All-extremity semirecumbent submaximal exercise elicited reliable and valid responses in our sample of older adults and thus can be considered a viable exercise mode.


2014 ◽  
Vol 27 (7) ◽  
pp. 1121-1133 ◽  
Author(s):  
Emily S. Bower ◽  
Julie Loebach Wetherell ◽  
C. Caroline Merz ◽  
Andrew J. Petkus ◽  
Vanessa L. Malcarne ◽  
...  

ABSTRACTBackground:Although fear of falling is prevalent among older adults recovering from hip fracture, current instruments are inadequate due to focus on specific situations and measurement of self-efficacy rather than fear.Methods:The authors revised and tested a form of the Fear of Falling Questionnaire with three groups of older adults: 405 recovering from hip fracture, 89 healthy community dwelling, and 42 with severe fear of falling. Test-retest reliability was evaluated in a subsample of 16 hip fracture patients. Internal consistency was compared across all groups. Construct validity was established through factor analysis, convergent validity with a measure of fall-related self-efficacy, and discriminant validity with measures of depression and affect.Results:A revised two-factor, six-item scale appears to have adequate psychometric properties. Scores were lower in the healthy comparison group relative to the hip fracture and fear of falling groups. Cronbach's α ranged from 0.72–0.83, with test-retest reliability of 0.82. Correlations with a measure of fall-related self-efficacy were moderate for the hip fracture group (0.42) and high with the healthy comparison (0.68) and fear of falling (0.70) groups. Correlations with depression and negative and positive affect were low to moderate.Conclusions:The Fear of Falling Questionnaire – Revised shows promise as a self-report measure of fear of falling, and is one of the first to be tested in older adults recovering from hip fracture. Advantages are that it is global rather than situation-specific and measures fear rather than self-efficacy. Future research on this scale is recommended in other older adult samples for whom fear of falling is relevant.


2021 ◽  
pp. 105477382110368
Author(s):  
Kuei-Min Chen ◽  
Meng-Chin Chen ◽  
Hui-Fen Hsu ◽  
Frank Belcastro ◽  
Wei-Yun Chang

This study aimed to verify the factorial structure, internal consistency, test-retest reliability, and discriminant validity of the High-need Community-dwelling Older Adults Screening Scale (HCOASS). A 20-item HCOASS covering five domains was used with a systematic random sample of 818 community-dwelling older adults. After the analyses, the Exploratory Factor Analysis suggested a removal of two items, resulting in 5 domains with 18 items, and the Confirmatory Factor Analysis yielded satisfactory results with Goodness of Fit Index of .98. The HCOASS demonstrated acceptable internal consistency (Kuder-Richardson Formula 20 α = .75) and excellent test-retest reliability (0.94; 95% CI [0.91, 0.97]). The area under the Receiver Operating Characteristic (ROC) curve was 0.90 (95% CI [0.84, 0.95]) and the optimal cut-off score was 4/5. The HCOASS is a valid and reliable screening tool. It has the potential for consistent and efficient administration to be used by non-healthcare professionals in the community.


2020 ◽  
Vol 35 ◽  
pp. 153331752090716
Author(s):  
O. Vicente de Sousa ◽  
J. Mendes ◽  
T. F. Amaral

This study investigated how different nutritional and functional status indicators are associated with mortality in patients with Alzheimer’s disease (AD). A prospective cohort study was conducted among 79 community-dwelling older adults with AD. Follow-up was 60 months. Undernutrition status was evaluated by Mini Nutritional Assessment (MNA), body mass index, mid-arm muscle circumference (MAMC), calf circumference, and phase angle. Functional status was assessed by handgrip strength, and usual gait speed. Twenty-two participants died (27.8%). Results show that undernutrition (hazard ratio [HR] 5.69, 95% confidence interval [CI] 2.21-14.61), weight loss (HR 3.82, 95% CI 1.37-10.63), underweight (HR 3.24, 95% CI 1.18-8.82), low MAMC (HR 4.54, 95% CI 1.65-12.48), calf circumference ≤ 31 (HR 4.27, 95% CI 1.63-11.16), low HGS (HR 3.11, 95% CI 1.18-8.17), and low gait speed (HR 4.73, 95% CI 1.68-13.27) were all associated with mortality. In conclusion, a poor nutritional and functional status was associated with a higher risk of mortality, regardless of sex, age, marital status, education, and cognitive function.


2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Janelle Gravesande ◽  
Julie Richardson ◽  
Lauren Griffith ◽  
Fran Scott

Abstract Background Older adults with type 2 diabetes (DM2) are at increased risk of falling due to complications including: diabetic peripheral neuropathy, diabetic retinopathy, autonomic neuropathy and diabetic foot ulcers. The purpose of this study was to determine the test-retest reliability, internal consistency, construct validity and to perform factor analysis of a new falls Risk Perception Questionnaire (RPQ) in older community-dwelling adults with DM2. Methods A prospective cohort of 30 community-dwelling older adults, ≥ 55 years, with DM2 was assembled. At baseline, perceived risk of falling, fear of falling and physical activity were measured. At time 2 (T2), at least 2 days later, perceived risk of falling was assessed again to determine the test-retest reliability of the RPQ. At time 3 (T3), approximately six weeks later, and time 4 (T4), at least 2 days after T3, perceived risk of falling was assessed by phone to determine the test-retest reliability of the RPQ when administered by phone. Results The RPQ demonstrated excellent test-retest reliability when delivered in person (ICC = 0.78, 95% Confidence Interval, CI: 0.59–0.89) and by phone (ICC = 0.82, 95% CI: 0.65–0.91), good internal consistency (α = 0.78) and adequate construct validity (r = 0.52, 95% CI: 0.20–0.74, p = 0.003) in older adults with DM2. Conclusion Given the good psychometric properties in this sample of persons with Diabetes, the RPQ has the potential to be used in clinical practice as a risk assessment and fall prevention tool. However, further testing needs to be done using a larger sample.


2021 ◽  
Vol 28 (11) ◽  
pp. 1-15
Author(s):  
Hanna Brodowski ◽  
Natascha Andres ◽  
Margareta Gumny ◽  
Cornelia Eicher ◽  
Elisabeth Steinhagen-Thiessen ◽  
...  

Background/Aims The ability to climb stairs is an important prerequisite for activities of daily living and social participation in older adults, and is therefore an important part of rehabilitation. However, there is no consensus on how to measure stair-climbing ability. The aim of this study was to investigate the test–retest reliability of the measurement of stair-climbing speed (steps per second) as a parameter for functional ability in older adults. Methods A total of 57 participants who were in hospital and 56 participants who were community-dwelling and did not have any limitations in activities in daily living, all aged 60 years and over, ascended and descended a set of 13 stairs twice. The halfway point of the staircase was marked in order to split the time required for both the ascending and the descending actions. Additional measurements consisted of the Functional Reach Test, the Timed Up and Go Test, walking ability using the GAITRite walkway system and the isometric strength of four muscle groups of the lower extremities using a handheld dynamometer. Results Test–retest reliability of the first and second half of the stair-climbing for both ascending and descending showed excellent results for the group of hospitalised participants (intraclass correlation coefficient, [ICC] 0.87, 95% confidence interval [CI] 0.79–0.93 to 0.94, 95% CI 0.9 – 0.97 for comparison of first vs second half of stair climbing; ICC 0.9, 95% CI 0.83-0.94 to ICC 0.95, 95% CI 0.92–0.97 for comparing first vs second measurement)) and moderate to excellent results for the group of community-dwelling participants with no limitations (ICC 0.58, 95% CI 0.37–0.73 to ICC 0.76, 95% 95% CI 0.63-0.85 for comparison of first vs second half of stair climbing; ICC 0.82, 95% CI 0.71-0.89 to 0.92, 95% CI 0.87–0.95 for comparing first vs second measurement). As expected, hospitalised participants took significantly longer descending than ascending stairs (t(56)=6.98, P<0.001, d=0.93). A general and significant trend of increasing speed while descending could be observed in both groups (performing paired sample t-tests). Conclusions The results indicate that stair-climbing speed is not constant and that different patterns exist in older adults who have no limitations and in those who are hospitalised. The use of stair-climbing speed as an assessment tool should include both stair ascent and descent, because differences in these speeds seem to be indicators of stair-climbing ability.


Sign in / Sign up

Export Citation Format

Share Document