scholarly journals Mobility Assessment: Sensitivity and Specificity of Measurement Sets in Older Adults

2011 ◽  
Vol 92 (6) ◽  
pp. 905-912 ◽  
Author(s):  
Victoria P. Panzer ◽  
Dorothy B. Wakefield ◽  
Charles B. Hall ◽  
Leslie I. Wolfson
Keyword(s):  
Older Adults ◽  
Sensitivity And Specificity ◽  
Mobility Assessment ◽  
Assessment Sensitivity

scholarly journals Clinimetric Properties of the Performance-Oriented Mobility Assessment

2006 ◽  
Vol 86 (7) ◽  
pp. 944-954 ◽  
Author(s):  
Marjan J Faber ◽  
Ruud J Bosscher ◽  
Piet CW van Wieringen
Keyword(s):  
Older Adults ◽  
Sensitivity And Specificity ◽  
Discriminant Validity ◽  
Rank Correlation ◽  
Reliability And Validity ◽  
Correlation Coefficients ◽  
Performance Tests ◽  
Group Level ◽  
Individual Level ◽  
Mobility Assessment

Abstract Background and Purpose. The Performance-Oriented Mobility Assessment (POMA) is a widely used instrument that provides an evaluation of balance and gait. It is used clinically to determine the mobility status of older adults or to evaluate changes over time. To support the use of the POMA for these purposes, the clinimetric properties (in particular, responsiveness) were determined. Subjects. Participants (78% female; mean age=84.9 years) were living in either self-care or nursing-care residences. Concurrent and discriminant validity were assessed with the total group (N=245), whereas reliability and responsiveness were determined with a subsample (n=30). Fall-related predictive validity was assessed with a subsample of 72 participants. Methods. In addition to the POMA, several reference performance tests were administered. The POMA was assessed on 2 consecutive days by 2 raters (observers). The analyses included the calculation of Spearman rank correlation coefficients (R), limits of agreement (LOA) with Bland-Altman plots, minimal detectable changes at the 95% confidence level (MDC95), and sensitivity and specificity with regard to predicting falls. When possible, findings for the total scale (POMA-T) were complemented by findings for its balance subscale (POMA-B) and its gait subscale (POMA-G). Results. The interrater and test-retest reliability for the POMA-T and the POMA-B were good (R=.74–.93), whereas for the POMA-G, the reliability values, although high as well, were systematically slightly lower (R=.72–.89). The Spearman correlations with the reference performance tests (R=|.64|–|.68|) indicated satisfactory concurrent validity for the POMA-T and the POMA-B, but the corresponding findings for the POMA-G (R=|.52|–|.56|) were less convincing. The discriminant validity values of the 3 scales were about the same. The LOA for the POMA-T were on the order of –4.0 to 4.0 for test-retest agreement and –3.0 to 3.0 for interrater agreement. On the basis of the MDC95 values, it was concluded that changes in POMA-T scores at the individual level should be at least 5 points and that those at the group level (n=30) should be at least 0.8 point to be considered reliable. Even when optimal cutoff points were used, sensitivity and specificity values (varying between 62.5% and 66.1%) for the POMA-T as well as for its 2 subscales indicated poor accuracy in predicting falls. Discussion and Conclusion. The POMA-T and its subscale POMA-B have adequate reliability and validity for assessing mobility in older adults. The POMA-T is useful for demonstrating intervention effects at the group level. Changes within subjects, however, should be at least 5 points before being interpreted as reliable changes. The accuracy of the POMA-T in predicting falls is poor.

scholarly journals Toe Clearance Rehabilitative Slippers for Older Adults With Fall Risk: A Randomized Controlled Trial

2021 ◽  
Vol 12 ◽  
pp. 215145932110291
Author(s):  
Atsuko Satoh ◽  
Yukoh Kudoh ◽  
Sangun Lee ◽  
Masumi Saitoh ◽  
Miwa Miura ◽  
...  
Keyword(s):  
Older Adults ◽  
Fall Risk ◽  
Controlled Trial ◽  
Intervention Group ◽  
Berg Balance Scale ◽  
Control Group ◽  
Mobility Assessment ◽  
Before And After ◽  
Day Services ◽  
And Control

Introduction: To evaluate fall-prevention rehabilitative slippers for use by self-caring, independent older adults. Materials and Methods: This assessor-blinded, randomized, and controlled 1-year study included 59 self-caring, independent participants (49 women) who attended day services. The mean age of participants was 84.0 ± 5.3 years. Participants were randomly selected from 8 nursing homes. We tested slippers top-weighted with a lead bead (200, 300, or 400 g). Intervention group participants walked while wearing the slippers for 10-20 min, 1-3 days/week at the day service center. Fall risk was measured using the Berg Balance Scale and the Tinetti Performance-Oriented Mobility Assessment (POMA) before and at 3-month intervals after the intervention/control phase. Results: After 12 months, the intervention group demonstrated significant improvement. Berg Balance and POMA compared to the control group ( p < .05 p < .01, respectively). Mobility scores improved significantly for both measurements in the intervention group before and after ( p < .01), but the control group had significantly lower scores. Discussion: Overall, falls decreased in the intervention group from 10 to 7, and control group falls increased from 9 to 16 ( p = .02). No adverse events related to the intervention were reported. Conclusions: Rehabilitation training slippers may reduce falls in older adults.

scholarly journals The Role of Cognitive Factors in Old Age Balance Impairments

2017 ◽  
Vol 4 (2) ◽  
Author(s):  
Priyanka Yadav
Keyword(s):  
Older Adults ◽  
Dual Task ◽  
Sensory System ◽  
T Test ◽  
Cognitive Factors ◽  
Attention And Memory ◽  
Mobility Assessment ◽  
Task Training ◽  
Dual Task Training

The ability of human beings to perform more than one task at a time has long been focus of study in the literature on human attention and memory. Older adults are more penalized when they must divide their attention between two input resources i.e input and holding or holding and responding. Falls have potentially devastating physical, social and psychological consequences. Falling is one of the most serious problems associated with ageing. Sensory system deteriorates with age, increased attention is allocated to “HIGHTEN” the signal coming from this system in order to gain necessary information for postural control. Older adults show marked reduction in the ability to perform the postural and cognitive task simultaneously. A study was conducted by physiotherapy and psychology students in a small town of Haryana on institutionalized older adults in which Dual task training under various sets of instruction that is Fixed priority and Variable priority instruction sets effects the balance who are living in residential care facilities. Tinneti Performance Oriented Mobility Assessment (POMA) and Mini mental status examination were used as tools to assess balance and cognitive abilities. Various studies related to the role of cognitive factors in balance impairments were reviewed. Data was analyzed using SPSS 13.0 software packages and paired sample t –test within the group and independent sample t – test between the groups with p – value at a significance level of p < 0.05 was used. The result of the study supported the hypothesis that there is significant improvement in balance of institutionalized elderly people who received dual task training with variable priority instruction set. (p < 0.001). The use of validated measurement tool like Tinnetti performance oriented mobility assessment on balance allowed clearer interpretation of the results. There is improvement in TPOMA Scores after 4 weeks training program in both groups. This shows that cognitive factors do play an important role in maintaining balance and coordination. Any impairment related to sensory system or cognition leads to balance impairments and increased risk for falls.

scholarly journals Reliability and validity of a quick test of cognitive speed (AQT) in screening for mild cognitive impairment and dementia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Pouya Farokhnezhad Afshar ◽  
Elisabeth H. Wiig ◽  
Seyed Kazem Malakouti ◽  
Behnam Shariati ◽  
Sara Nejati
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Sensitivity And Specificity ◽  
Older Patients ◽  
Reliability And Validity ◽  
Quick Test ◽  
Significant Difference ◽  
Cognitive Speed ◽  
Color Form

Abstract Background Cognitive disorders are one of the important issues in old age. There are many cognitive tests, but some variables affect their results (e.g., age and education). This study aimed to evaluate the reliability and validity of A Quick Test of Cognitive Speed (AQT) in screening for mild cognitive impairment (MCI) and dementia. Methods This is a psychometric properties study. 115 older adults participated in the study and were divided into three groups (46 with MCI, 24 with dementia, and 45 control) based on the diagnosis of two geriatric psychiatrists. Participants were assessed by AQT and Mini-Mental State Examination (MMSE). Data were analyzed using Pearson correlation, independent t-test, and ROC curve by SPSS v.23. Results There was no significant correlation between AQT subscales and age and no significant difference between the AQT subscales in sex, educational levels. The test-retest correlations ranges were 0.84 from 097. Concurrent validity was significant between MMSE and AQT. Its correlation was with Color − 0.78, Form − 0.71, and Color-Form − 0.72. The cut-off point for Color was 43.50 s, Form 52 s, and Color-Form 89 s were based on sensitivity and specificity for differentiating older patients with MCI with controls. The cut-off point for Color was 62.50 s, for Form 111 s, and Color-Form 197.50 s based on sensitivity and specificity measures for differentiating older patients with dementia and MCI. Conclusion The findings showed that AQT is a suitable tool for screening cognitive function in older adults.

Reliability and validity of A Quick Test of Cognitive Speed (AQT) in Iranian older adults

2020 ◽  
Author(s):  
Pouya Farokhnezhad Afshar ◽  
Elisabeth H. Wiig ◽  
Seyed Kazem Malakouti ◽  
Behnam Shariati
Keyword(s):  
Older Adults ◽  
Sensitivity And Specificity ◽  
Older Patients ◽  
Convergent Validity ◽  
Pearson Correlation ◽  
Reliability And Validity ◽  
Quick Test ◽  
Significant Difference ◽  
Cognitive Speed ◽  
Color Form

Abstract Background: Cognitive disorders are one of the most important issues in old age. They may remain hidden in the early stages. There are many cognitive tests, but some variables affect their results (e.g., age and education.) This study aimed to evaluate the reliability and validity of A Quick Test of Cognitive Speed (AQT) in Iranian older adults.Methods: This study aimed to test the psychometric properties of AQT. 114 older adults participated in the study and were divided into three groups (46 with mild cognitive impairments (MCI), 24 with dementia, and 45 without MCI and dementia) based on the diagnosis of two geriatric psychiatrists. Participants were assessed by AQT and Mini-Mental State Examination (MMSE). Data were analyzed using Pearson correlation, independent t-test, and ROC curve by SPSS v.23.Results: There was no significant correlation between AQT subscales and age and no significant difference between the AQT subscales in male and female, educational levels, and marital status. The test-retest correlations (r) were significant for Color (C) 0.84, Form (F) 0.91 and Color-Form (CF) 0.94. Convergent validity was significant between MMSE and AQT. Its correlation was with Color -0.78, Form -0.71, and Color-Form -0.72. The cut-off point for Color was 43.50 s, Form 52 s, and Color-Form 89 s were based on sensitivity and specificity for differentiating older patients with MCI with controls. The cut-off point for Color was 62.50 s, for Form 111 s, and Color-Form 197.50 s based on sensitivity and specificity measures for differentiating older patients with dementia and MCI.Conclusion: The findings of this study showed that A Quick Test of Cognitive Speed (AQT) is a suitable tool for assessing cognitive function in older adults.

Older Adults’ Attitudes About Future Mobility Changes and the Usefulness of Mobility Assessment Materials

2020 ◽  
pp. 073346482094792
Author(s):  
Bethany A. West ◽  
Gwen Bergen ◽  
Briana Moreland
Keyword(s):  
Older Adults ◽  
Confidence Intervals ◽  
Telephone Survey ◽  
Mobility Assessment

Objectives: To understand older adults’ attitudes about future mobility and usefulness of mobility assessment materials. Methods: Data came from a telephone survey of 1,000 older adults aged 60–74 years. After answering baseline questions, respondents received mobility assessment materials, then completed follow-up interviews. Respondents were asked about future mobility challenges. During baseline and follow-up, subjects were asked four questions about their mobility as they aged which measured thinking about mobility, thinking about protecting mobility, confidence in protecting mobility, and motivation to protect mobility. Differences in percent of respondents’ attitudes between baseline and follow-up and 95% confidence intervals were calculated. Results: Driving (42%) was the most commonly reported challenge. Significant increases from baseline to follow-up in thinking about mobility (25%), thinking about protecting mobility (39%), and confidence in protecting mobility (29%) were reported. Discussion: Brief mobility assessment materials can encourage older adults to consider future mobility. Planning for changes can prolong safe mobility.

The Case for Mobility Assessment in Hospitalized Older Adults: American Geriatrics Society White Paper Executive Summary

2018 ◽  
Vol 67 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Heidi L. Wald ◽  
Ravishankar Ramaswamy ◽  
Michael H. Perskin ◽  
Lloyd Roberts ◽  
Michael Bogaisky ◽  
...  
Keyword(s):  
Older Adults ◽  
White Paper ◽  
American Geriatrics Society ◽  
Executive Summary ◽  
Mobility Assessment ◽  
Hospitalized Older Adults

Cognitive performances better identify fallers than mobility assessment among older adults with fear of falling

2019 ◽  
Author(s):  
Antoine Langeard ◽  
Laurence Desjardins-Crépeau ◽  
Marianne Lemay ◽  
Marie-Christine Payette ◽  
Louis Bherer ◽  
...  
Keyword(s):  
Older Adults ◽  
Fear Of Falling ◽  
Mobility Assessment

scholarly journals Sensitivity and Specificity of Portable Hearing Screening in Middle-Aged and Older Adults

2013 ◽  
Vol 18 (01) ◽  
pp. 021-026 ◽  
Author(s):  
Carolina Cardoso ◽  
Ângelo Bós ◽  
Andréa Gonçalves ◽  
Maira Olchik ◽  
Leticia Flores ◽  
...  
Keyword(s):  
Older Adults ◽  
Sensitivity And Specificity ◽  
Hearing Screening ◽  
Middle Aged

scholarly journals Walking Speed Threshold for Classifying Walking Independence in Hospitalized Older Adults

2010 ◽  
Vol 90 (11) ◽  
pp. 1591-1597 ◽  
Author(s):  
James E. Graham ◽  
Steve R. Fisher ◽  
Ivonne-Marie Bergés ◽  
Yong-Fang Kuo ◽  
Glenn V. Ostir
Keyword(s):  
Older Adults ◽  
Sensitivity And Specificity ◽  
Walking Speed ◽  
Community Dwelling ◽  
Community Based ◽  
Convenience Sample ◽  
Cut Point ◽  
Risk Threshold ◽  
Risk Thresholds ◽  
Hospitalized Older Adults

Background Walking speed norms and several risk thresholds for poor health outcomes have been published for community-dwelling older adults. It is unclear whether these values apply to hospitalized older adults. Objective The purpose of this study was to determine the in-hospital walking speed threshold that best differentiates walking-independent from walking-dependent older adults. Design This was a cross-sectional study. Methods This study recruited a convenience sample of 174 ambulatory adults aged 65 years and older who had been admitted to a medical-surgical unit of a university hospital. The participants' mean (SD) age was 75 (7) years. Fifty-nine percent were women, 66% were white, and more than 40% were hospitalized for cardiovascular problems. Usual-pace walking speed was assessed over 2.4 m. Walking independence was assessed through self-report. Several methods were used to determine the threshold speed that best differentiated walking-independent patients from walking-dependent patients. Approaches included a receiver operating characteristic (ROC) curve, sensitivity and specificity, and frequency distributions. Results The participants' mean (SD) walking speed was 0.43 (0.23) m/s, and 62% reported walking independence. Nearly 75% of the patients walked more slowly than the lowest community-based risk threshold, yet 90% were discharged home. Overall, cut-point analyses suggested that 0.30 to 0.35 m/s may be a meaningful threshold for maintaining in-hospital walking independence. For simplicity of clinical application, 0.35 m/s was chosen as the optimal cut point for the sample. This threshold yielded a balance between sensitivity and specificity (71% for both). Limitations The limitations of this study were the small size of the convenience sample and the single health outcome measure. Conclusions Walking speeds of older adults who are acutely ill are substantially slower than established community-based norms and risk thresholds. The threshold identified, which was approximately 50% lower than the lowest published community-based risk threshold, may serve as an initial risk threshold or target value for maintaining in-hospital walking independence.

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