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Relative and absolute reliability of functional performance measures for adults with dementia living in residential aged care

Published online by Cambridge University Press:  03 July 2014

Benjamin Fox Open the ORCID record for Benjamin Fox [Opens in a new window] ,
Timothy Henwood ,
Christine Neville  and
Justin Keogh
Benjamin Fox*
Affiliation:
University of Queensland, School of Nursing and Midwifery, Herston, Queensland, Australia
Timothy Henwood
Affiliation:
University of Queensland, School of Nursing and Midwifery, Herston, Queensland, Australia Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
Christine Neville
Affiliation:
University of Queensland, School of Nursing and Midwifery, Herston, Queensland, Australia
Justin Keogh
Affiliation:
Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia Human Potential Centre, AUT University, Auckland, New Zealand Cluster for Health Improvement, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Maroochydore, Queensland, Australia
*
Correspondence should be addressed to: Benjamin Fox, PhD Candidate, University of Queensland/Blue Care Research and Practice Development Centre, 56 Sylvan Road, Toowong, Queensland 4066, Australia. Phone: +617-3720-5617. Email: [email protected].
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Abstract

Background:

This pilot investigation aimed to assess the relative and absolute test–retest reliability of commonly used functional performance measures in older adults with dementia residing in residential aged care facilities.

Methods:

A total of 12 participants were tested on the Short Physical Performance Battery (SPPB), the Balance Outcome Measure for Elder Rehab (BOOMER), hand grip strength, anthropometric measures and Bio-electric Impedance Analysis (BIA). This study utilized a seven-day test–retest evaluation. Intra-class Correlation Coefficients (ICC) were used to assess relative reliability, Typical Error of Measurement (TEM) was used to assess the absolute reliability, and Bland–Altman plots were used to assess group and individual levels of agreement.

Results:

With the exception of Standing Balance (ICC = 0.49), 2.4-m walk (ICC = 0.68), functional reach (ICC = 0.38), and static timed standing (ICC = 0.47), all measures demonstrated acceptable (>0.71) ICCs. However, only the anthropometric measures demonstrated acceptable levels of absolute reliability (>10% TEM). Bland–Altman analysis showed non-significant (p > 0.05) mean differences, and eight out of the 17 measures showing wide Limits of Agreement (LoA).

Conclusions:

Current measures of functional performance are demonstrably inappropriate for use with a population of older adults with dementia. Authors suggest aligning current measurement strategies with Item Response Theory as a way forward.

Keywords

dementiaAlzheimer’sreliabilitypsychometricsmobilitybalancestrengthmeasurement
Type
Research Article
Information
International Psychogeriatrics , Volume 26 , Issue 10 , October 2014 , pp. 1659 - 1667
Copyright
Copyright © International Psychogeriatric Association 2014 

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References

Ahlskog, J. E., Geda, Y. E., Graff-Radford, N. R. and Petersen, R. C. (2011). Physical exercise as a preventive or disease-modifying treatment of dementia and brain aging. Mayo Clinic Proceedings, 86, 876–884.Google Scholar
Atkinson, H. H. et al. (2007). Cognitive function, gait speed decline, and comorbidities: the health, aging and body composition study. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 62, 844–850.Google Scholar
BEAN, J. F. et al. (2002). The relationship between leg power and physical performance in mobility-limited older people. Journal of the American Geriatrics Society, 50, 461–467.Google Scholar
Binder, E. F., Miller, J. P. and Ball, L. J. (2001). Development of a test of physical performance for the nursing home setting. The Gerontologist, 41, 671–679.Google Scholar
Blankevoort, C. G., Van Heuvelen, M. J., Boersa, F., Luning, H., De Jong, J. and Scherder, E. J. (2010). Review of effects of physical activity on strength, balance, mobility and ADL performance in elderly subjects with dementia. Dementia and Geriatric Cognitive Disorders, 30, 392–402.Google Scholar
Blankevoort, C. G., Van Heuvelen, M. J. and Scherder, E. J. (2012). Reliability of six physical performance tests in older people with dementia. Physical Therapy, 93, 69–78.Google Scholar
Ble, A. et al. (2005). Executive function correlates with walking speed in older persons: the InCHIANTI study. Journal of the American Geriatrics Society, 53, 410–415.Google Scholar
Bohannon, R. W. (2006). Reference values for the timed up and go test: a descriptive meta-analysis. Journal of Geriatric Physical Therapy, 29, 64–68.Google Scholar
Brill, P. A., Drimmer, A. M., Morgan, L. A. and Gordon, N. F. (1995). The feasibility of conducting strength and flexibility programs for elderly nursing home residents with dementia. Gerontologist, 35, 263–266.Google Scholar
Cesari, M. et al. (2005). Prognostic value of usual gait speed in well-functioning older people – results from the Health, Aging and Body Composition Study. Journal of the American Geriatrics Society, 53, 1675–1680.CrossRefGoogle ScholarPubMed
Coelho, F. G. D. et al. (2013). Multimodal exercise intervention improves frontal cognitive functions and gait in Alzheimer's disease: a controlled trial. Geriatrics & Gerontology International, 13, 198–203.Google Scholar
Conradsson, M. et al. (2007). Berg balance scale: intrarater test–retest reliability among older people dependent in activities of daily living and living in residential care facilities. Physical Therapy, 87, 1155–1163.Google Scholar
Disch, J. (1987). Recent developments in measurement and possible applications to the measurement of psychomotor behavior: a response. Research Quarterly for Exercise and Sport, 58, 210–212.CrossRefGoogle Scholar
Domholdt, E. (2000). Physical Therapy Research: Principles and Applications. Philadelphia, PA: Saunders.Google Scholar
Embretson, S. E. and Reise, S. P. (2000). Item Response Theory for Psychologists. Mahweh, NJ: Lawrence Erlbaum Associates Publishers.Google Scholar
Guralnik, J. M. (2012). Assessing Physical Performance in the Older Patient. Baltimore, MD: National Institute on Aging.Google Scholar
Guralnik, J. M. et al. (1994). A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. Journals of Gerontology, 49, M85–94.Google Scholar
Guralnik, J. M., Ferrucci, L., Simonsick, E. M., Salive, M. E. and Wallace, R. B. (1995). Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. New England Journal of Medicine, 332, 556–561.CrossRefGoogle ScholarPubMed
Haines, T., Kuys, S. S., Morrison, G., Clarke, J., Bew, P. and Mcphail, S. (2007). Development and validation of the balance outcome measure for elder rehabilitation. Archives of Physical Medicine and Rehabilitation, 88, 1614–1621.Google Scholar
Hands, B., Sheridan, B. and Larkin, D. (1999). Creating performance categories from continuous motor skill data using a Rasch measurement model. Journal of Outcome Measurement, 3, 216–232.Google Scholar
Hauer, K. and Oster, P. (2008). Measuring functional performance in persons with dementia. Journal of the American Geriatrics Society, 56, 949–950.CrossRefGoogle ScholarPubMed
Kemoun, G. et al. (2010). Effects of a physical training programme on cognitive function and walking efficiency in elderly persons with dementia. Dementia and Geriatric Cognitive Disorders, 29, 109–114.CrossRefGoogle ScholarPubMed
Lin, M. R., Hwang, H. F., Hu, M. H., Wu, H. D., Wang, Y. W. and Huang, F. C. (2004). Psychometric comparisons of the timed up and go, one-leg stand, functional reach, and Tinetti balance measures in community-dwelling older people. Journal of the American Geriatrics Society, 52, 1343–1348.Google Scholar
Littbrand, H., Stenvall, M. and Rosendahl, E. (2011). Applicability and effects of physical exercise on physical and cognitive functions and activities of daily living among people with dementia: a systematic review. American Journal of Physical Medicine and Rehabilitation, 90, 495–518.Google Scholar
Ries, J. D., Echternach, J. L., Nof, L. and Gagnon, B. M. (2009). Test–retest reliability and minimal detectable change scores for the timed “up & go” test, the six-minute walk test, and gait speed in people with Alzheimer disease. Physical therapy, 89, 569–579.Google Scholar
Rockwood, K., Awalt, E., Carver, D. and Macknight, C. (2000). Feasibility and measurement properties of the functional reach and the timed up and go tests in the Canadian study of health and aging. The Journals of Gerontology: Series A, Biological Sciences and Medical Sciences, 55, M70–M73.Google Scholar
Safrit, M. J. (1987). The applicability of item response theory to tests of motor behavior. Research Quarterly for Exercise and Sport, 58, 213–215.Google Scholar
Santana-Sosa, E., Barriopedro, M. I., Lopez-Mojares, L. M., Perez, M. and Lucia, A. (2008). Exercise training is beneficial for Alzheimer's patients. International Journal of Sports Medicine, 29, 845–850.Google Scholar
Schwenk, M., Gogulla, S., Englert, S., Czempik, A. and Hauer, K. (2012). Test–retest reliability and minimal detectable change of repeated sit-to-stand analysis using one body fixed snesor in geriatric patients. Physiological Measurement, 33, 1931–1946.Google Scholar
Sheridan, P. L., Solomont, J., Kowall, N. and Hausdorff, J. M. (2003). Influence of executive function on locomotor function: divided attention increases gait variability in Alzheimer's disease. Journal of the American Geriatrics Society, 51, 1633–1637.CrossRefGoogle ScholarPubMed
Spray, J. A. (1987). Recent developments in measurement and possible applications to the measurement of psychomotor behavior. Research Quarterly for Exercise and Sport, 58, 203–209.CrossRefGoogle Scholar
Suttanon, P., Hill, K. D., Dodd, K. J. and Said, C. M. (2011). Retest reliability of balance and mobility measurements in people with mild to moderate Alzheimer's disease. International Psychogeriatrics, 23, 1152–1159.CrossRefGoogle ScholarPubMed
Taekema, D. G., Gussekloo, J., Maier, A. B., Westendorp, R. G. and De Craen, A. J. (2010). Handgrip strength as a predictor of functional, psychological and social health. A prospective population-based study among the oldest old. Age Ageing, 39, 331–337.Google Scholar
Tappen, R. M., Roach, K. E., Buchner, D., Barry, C. and Edelstein, J. (1997). Reliability of physical performance measures in nursing home residents with Alzheimer's disease. The Journals of Gerontology: Series A, Biological Sciences and Medical Sciences, 52, M52–M55.Google Scholar
Thomas, V. and Hageman, P. (2002). A preliminary study on the reliability of physical performance measures in older dayare center clients with dementia. International Psychogeriatrics, 14, 17–23.Google Scholar
Thomas, J. R. and Nelson, J. K. (2001). Research Methods in Physical Activity. Champaign, IL: Human Kinetics.Google Scholar
Van Iersel, M. B., Benraad, C. and Rikkert, M. (2007). Validity and reliability of quantitative gait analysis in geriatric patients with and without dementia. Journal of the American Geriatrics Society, 55, 632–633.CrossRefGoogle ScholarPubMed
Venturelli, M., Scarsini, R. and Schena, F. (2011). Six-month walking program changes cognitive and ADL performance in patients with Alzheimer. American Journal of Alzheimers Disease and Other Dementias, 26, 381–388.CrossRefGoogle ScholarPubMed
Zhu, W. (2006). Constructing tests using Item Response Theory. In Wood, T. M. and Zhu, W. (eds.), Measurement Theory and Practice in Kinesiology (pp. 53–76). Champaign, IL: Human Kinetics.Google Scholar