Reliability of 4-m and 6-m walking speed tests in elderly people with cognitive impairment
Introduction
Walking speed tests are the most widely used objective physical performance-based tests to evaluate mobility in elderly people (Imms and Edholm, 1981, Buchner et al., 1995, Guralnik and Ferrucci, 2003, Wang et al., 2009). Longitudinal studies have demonstrated that walking speed tests are useful to predict important adverse results such as: hospitalization, dependence, frailty and mortality (Cesari et al., 2005, Onder et al., 2005, Ostir et al., 2007, Kim et al., 2009); however, numerous studies have reported high values for test–retest and interrater reliability (Hoeymans et al., 1997, Jette et al., 1999, Ostchega et al., 2000, Cabrero-García et al., 2007). Tests over 4 m and 6 m are most commonly used in studies with elderly people (Muñoz-Mendoza et al., 2010). Although they are both short-distance tests, Guralnik et al. (2000) consider that 4 m is an adequate distance to evaluate walking speed; furthermore, it is more viable for use both in the home context and at the clinic. In the literature, few studies evaluate the reliability of walking tests in subjects with cognitive impairment. Tappen et al. (1997) reported reliability values between 0.57 and 0.97 for the 25-feet test (7.5 m) and Thomas and Hageman (2002) obtained an ICC of 0.92 for the 6-m test. Evidence of reliability for this type of population is still scarce. Therefore, the purpose of this study was to evaluate the reliability of 4-m and 6-m walking speed tests on elderly people with cognitive impairment.
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Participants
The sample included people aged 65 and over with different degrees of cognitive impairment, selected from a population of 119 people belonging to the Gerontological Complex “La Milagrosa”, which includes an adult day-care centre and a nursing home (A Coruña, Spain). So as not to burden the subjects, they were divided randomly into two groups, one to examine interrater reliability and the other to determine test–retest reliability. People with cardiac or respiratory pathologies which could be
Results
Of the 119 subjects admitted to the adult day-care centre or nursing home, 55 met the eligibility criteria. Of these, 21 took part in the interrater reliability study and 29 completed the test–retest reliability study. The reasons for losses during the data gathering process were: hospitalization (n = 2), immobility (n = 1), refusal to take part (n = 1) and leaving the centre (n = 1).
Table 1 summarizes the baseline characteristics of the two samples. The mean age of the participants in the interrater
Discussion
This study has examined interrater and test–retest reliability on this population. The values for interrater and test–retest reliability were high for both the 4-m and 6-m test, according to the quality standards of the SACMOT (2002) and Terwee et al. (2007), which give a value of 0.70 for the minimum reliability required to make group decisions. The 4-m test achieved values higher than those recommended for individual decisions (0.90).
Although one limitation of this study is the small sample
Conflicts of interest statement
None.
Acknowledgement
Our sincere thanks go to the Gerontological Complex “La Milagrosa” for giving us access to their elderly residents.
References (28)
- et al.
Clinical validity of the “Mini-Mental State” for Spanish speaking communities
Neuropsychologia
(2001) - et al.
Mini-Mental State: a practical method for grading the cognitive state of patients for the clinician
J. Psychiatr. Res.
(1975) - et al.
Assessing the building blocks of function: utilizing measures of functional limitation
Am. J. Prev. Med.
(2003) - et al.
Quality criteria were proposed for measurement properties of health status questionnaires
J. Clin. Epidemiol.
(2007) - et al.
Índice de Barthel: instrumento válido para la valoración funcional de pacientes con enfermedad cerebrovascular
Rev. Esp. Geriatr. Gerontol.
(1993) - et al.
Statistical methods for assessing agreement between two methods of clinical measurement
Lancet
(1986) - et al.
The clinical assessment of gait, balance and mobility in older adults
- et al.
Reproducibilidad de la batería EPESE de desempeño físico en atención primaria
Anal. Modif. Conduct.
(2007) - et al.
Prognostic value of usual gait speed in well-functioning older people: results from the health aging and body composition study
J. Am. Geriatr. Soc.
(2005) - 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)
Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery
J. Gerontol. A: Biol. Sci. Med. Sci.
Measuring functional performance in persons with dementia
J. Am. Geriatr. Soc.
Reproducibility of performance-based and self-reported measures of functional status
J. Gerontol. A: Biol. Sci. Med. Sci.
Studies of gait and mobility in the elderly
Age Ageing
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