Assessment of Functional Performance in Acute Geriatric Psychiatry

Abstract

Objectives:

The aim of this study was to investigate the feasibility and reliability of functional performance tests in people living with dementia and depression.

Method:

A cross-sectional study was conducted in a geriatric psychiatry hospital. People living with dementia, depression, and healthy older adults were included. Feasibility of the timed up and go test (TUG), the short physical performance battery (SPPB), and the multisurface obstacle test for older adults (MSOT) was assessed based on valid test executions. Test-retest reliability was evaluated by mean difference (MD), coefficient of variation (CV), standardized MD, intraclass correlation coefficient (ICC), and correlation coefficient (r_s ).

Results:

A total of 53 people in acute geriatric psychiatry and 21 healthy older adults were included. In people living with dementia (n = 23), feasibility was 65.2% (MSOT), 8.7% (TUG), and 8.7% (SPPB). In people living with depression (n = 30), feasibility was 83.3% (MSOT), 80.0% (TUG), and 46.7% (SPPB). Intraclass correlation coefficients and r_s for the MSOT were high (ICC > 0.70) in both groups. Coefficient of variations of the MSOT were between 10.7% and 18.0% (dementia) and 7.1% and 17.0% (depression). Reliability of the TUG and SPPB was not analyzed in people living with dementia, due to low feasibility. In people living with depression, ICCs and r_s were between 0.86 and 0.87 with CVs of 7.2% (TUG) and 0.69 and 0.95 with CVs of 7.8% and 15.1% (SPPB).

Conclusion:

Feasibility and reliability of established functional performance tests in acute geriatric psychiatry are limited, especially in people living with dementia. New strategies, for example, sensor-based approaches, may allow measurement of functional performance apart from standardized instruction-based test procedures in this clinical population.

Keywords

feasibility timed up and go test dementia depression reliability mobility

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References

Riedel-Heller

Busse

Angermeyer

. The state of mental health in old-age across the “old” European Union - a systematic review. Acta Psychiatr Scand. 2006;113(5):388–401. doi:10.1111/j.1600-0447.2005.00632.x.

Hauer

Oster

. Measuring functional performance in persons with dementia. J Am Geriatr Soc. 2008;56(5):949–950. doi:10.1111/j.1532-5415.2008.01649.x.

Rockwood

Awalt

Carver

MacKnight

. Feasibility and measurement properties of the functional reach and the timed up and go tests in the canadian study of health and aging. J Gerontol A Biol Sci Med Sci. 2000;55(2):M70–M73. doi:10.1093/GERONA/55.2.M70.

Tappen

Roach

Buchner

Barry

Edelstein

. Reliability of physical performance measures in nursing home residents with alzheimer’s disease. J Gerontol Ser A Biol Sci Med Sci. 1997;52A(1):M52–M55. doi:10.1093/gerona/52A.1.M52.

Nordin

Rosendahl

Lundin-Olsson

. Timed “up & go” test: reliability in older people dependent in activities of daily living—focus on cognitive state. Phys Ther. 2006;86(5):646–655. doi:10.1093/ptj/86.5.646.

Van Iersel

Benraad

CEM

Olde Rikkert

MGM

. Validity and reliability of quantitative gait analysis in geriatric patients with and without dementia. J Am Geriatr Soc. 2007;55(4):632–634. doi:10.1111/j.1532-5415.2007.01130.x.

Ries

Echternach

Nof

Gagnon Blodgett

. 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. Phys Ther. 2009;89(6):569–579. doi:10.2522/ptj.20080258.

Suttanon

Hill

Dodd

Said

. Retest reliability of balance and mobility measurements in people with mild to moderate alzheimer’s disease. Int Psychogeriatrics. 2011;23(07):1152–1159. doi:10.1017/S1041610211000639.

Blankevoort

Van Heuvelen

MJG

Scherder

EJA

. Reliability of six physical performance tests in older people with dementia. Phys Ther. 2013;93(1):69–78. doi:10.2522/ptj.20110164.

10.

Fox

Henwood

Neville

Keogh

. Relative and absolute reliability of functional performance measures for adults with dementia living in residential aged care. Int Psychogeriatrics. 2014;26(10):1659–1667. doi:10.1017/S1041610214001124.

11.

Fox

Henwood

Keogh

Neville

. Psychometric viability of measures of functional performance commonly used for people with dementia. JBI Database Syst Rev Implement Rep. 2016;14(8):115–171. doi:10.11124/JBISRIR-2016-003064.

12.

Aizen

Lubosky

Sobeh

Ibrahim

Pressburger

Oliven

. Rehabilitation of mobility and motor function in nursing home residents with dementia. Harefuah. 2018;157(4):214–218.

13.

Alenazi

Alshehri

Alothman

, et al. Functional reach, depression scores, and number of medications are associated with number of falls in people with chronic stroke. PM R. 2018;10(8):806–816. doi:10.1016/J.PMRJ.2017.12.005

14.

Lam

Huang

Liao

Chung

Kwok

Pang

. Physical exercise improves strength, balance, mobility, and endurance in people with cognitive impairment and dementia: a systematic review. J Physiother. 2018;64(1):4–15. doi:10.1016/j.jphys.2017.12.001.

15.

Morat

Kroeger

Mechling

. The multisurface obstacle test for older adults (MSOT): development and reliability of a novel test for older adults. Eur Rev Aging Phys Act. 2013. doi:10.1007/s11556-013-0121-0.

16.

World Health Organization. International Statistical Classification of Diseases and Related Health Problems. 10th Rev. Geneva: World Health Organization; 2011.

17.

Inouye

Van Dyck

Alessi

Balkin

Siegal

Horwitz

. Clarifying confusion: the confusion assessment method: a new method for detection of delirium. Ann Intern Med. 1990;113(12):941–948.

18.

Folstein

McHugh

. “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189–198.

19.

Nedopil

Aldenhoff

Amelung

, et al. Competence to give informed consent to clinical studies. statement by the taskforce on. Pharmacopsychiatry. 1999;32(05):165–168.

20.

Shulman

. Clock-drawing: is it the ideal cognitive screening test? Int J Geriatr Psychiatry. 2000;15(6): 548–561. doi:10.1002/1099-1166(200006)15:6<548:: AID-GPS242>3.0.CO;2-U.

21.

Podsiadlo

Richardson

. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142–148.

22.

Büsching

. Short physical performance battery test – ein muss in der geriatrie. physiopraxis. 2015;13(1):42–43. doi:10.1055/s-0034-1399816.

23.

Guralnik

Simonsick

Ferrucci

, et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994;49(2):M85–M94.

24.

Hopkins

. Spreadsheets for analysis of validity and reliability. Sportscience. 2015;19:36–42.

25.

Atkinson

Nevill

. Statistical methods for assessing measurement error (reliability) in variables relevant to sports medicine. Sport Med. 1998;26(4):217–238. doi:10.2165/00007256-199826040-00002.

26.

Koo

. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropract Med. 2016;15(2):155–163.

27.

Hopkins

. Measures of reliability in sports medicine and science. Sport Med. 2000;30(1):1–15.

28.

Hopkins

Schabort

Hawley

. Reliability of power in physical performance tests. Sport Med. 2001;31(3):211–234.

29.

Scientific Advisory Committee of the Medical Outcomes Trust. Assessing health status and qualitiy-of-life instruments: attributes and review citeria. Qual Life Res. 2002;11:193–205.

30.

Giannouli

Bock

Mellone

Zijlstra

. Mobility in old age: capacity is not performance. Biomed Res Int. 2016;11:1–8. doi:10.1155/2016/3261567.

31.

Zhang

Regterschot

GRH

Geraedts

Baldus

Zijlstra

. Chair rise peak power in daily life measured with a pendant sensor associates with mobility, limitation in activities, and frailty in old people. IEEE J Biomed Heal Informatics. 2017;21(1):211–217. doi:10.1109/JBHI.2015.2501828.

32.

Fleiner

Haussermann

Mellone

Zijlstra

. Sensor-based assessment of mobility-related behavior in dementia: feasibility and relevance in a hospital context. Int Psychogeriatrics Int Psychogeriatr Assoc. 2016;28(10):1687–1694. doi:10.1017/S1041610216001034.

Assessment of Functional Performance in Acute Geriatric Psychiatry – Time for New Strategies?

Abstract

Objectives:

Method:

Results:

Conclusion:

Keywords

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References