Reliability of 4-m and 6-m walking speed tests in elderly people with cognitive impairment

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Abstract

The purpose of this study was to evaluate the interrater and test–retest reliability of 4-m and 6-m walking speed tests in elderly people with cognitive impairment. 50 subjects aged 65 and over with cognitive impairment were selected from an adult day-care centre and a nursing home. To examine interrater reliability, 21 people were evaluated independently by two researchers who administered the 4-m and 6-m walking tests in each evaluation. For test–retest reliability, two observers administered the tests to the same 29 subjects, with a time interval of one week. Intraclass correlation coefficients (ICCs) were calculated to examine interrater and test–retest reliability. The ICCs for interrater reliability reached values of 0.96 and 0.88 for the 4-m and 6-m walking tests, respectively. In the test–retest study, the time interval was 7.4 ± 1.17 days. The ICCs were 0.91 for the 4-m test and 0.86 for the 6-m test. The results support the use of walking 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.

Section snippets

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.

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