Functional mobility limitations and falls in assisted living residents with dementia: physical performance assessment and quantitative gait analysis

McGough, Ellen L., Logsdon, Rebecca G., Kelly, Valerie E. and Teri, Linda (2013) Functional mobility limitations and falls in assisted living residents with dementia: physical performance assessment and quantitative gait analysis. Journal of Geriatric Physical Therapy, 36 2: 78-86. doi:10.1519/JPT.0b013e318268de7f

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Author McGough, Ellen L.
Logsdon, Rebecca G.
Kelly, Valerie E.
Teri, Linda
Title Functional mobility limitations and falls in assisted living residents with dementia: physical performance assessment and quantitative gait analysis
Journal name Journal of Geriatric Physical Therapy   Check publisher's open access policy
ISSN 1539-8412
2152-0895
Publication date 2013-04-01
Sub-type Article (original research)
DOI 10.1519/JPT.0b013e318268de7f
Volume 36
Issue 2
Start page 78
End page 86
Total pages 9
Place of publication Philadelphia, PA, United States
Publisher Lippincott Williams & Wilkins
Collection year 2014
Language eng
Formatted abstract
Background and Purpose: The prevalence of functional mobility limitations and falls is higher in people with dementia compared with cognitively healthy older adults, and both are associated with gait and motor impairments. The aims of this study were to examine concurrent validity of physical performance assessments and spatiotemporal gait measures in older adults with advanced dementia and to prospectively examine their relationship to functional mobility limitations and falls over a 4-month period.

Methods
: Thirty-one older adults living in dementia-specific assisted living residences participated. Correlations were examined between a modified Berg Balance Scale (mod-Berg), the Short Physical Performance Battery (SPPB), and spatiotemporal gait measures using the GAITRite Walkway system. Over 4-months, functional mobility limitations were rated, and falls were recorded by nursing supervisors. Differences in functional mobility limitations and falls were examined in relation to baseline balance and gait measures.

Results: Partial correlations between spatiotemporal gait measures and the mod-Berg as well as the SPPB were statistically significant (P < .05) after adjusting for age and Mini-Mental State Examination scores. Participants with low functional mobility ratings had significantly lower scores on the mod-Berg (P ≤ .001) and SPPB (P ≤ .001). They also demonstrated slower gait speed, lower cadence, higher stride time variability, and a greater percentage of gait cycle in double support (P ≤ .01). Participants with at least 1 fall, compared with those who did not fall, had lower scores on the mod-Berg (P = .02), lower cadence (P = .048), and greater stride length variability (P = .035).

Discussion: The mod-Berg and SPPB were strongly correlated with reliable gait measures associated with instability and increased fall risk. The modified Berg Balance Scale demonstrates potential as a predictor of falls in older adults living in dementia-specific assisted living.

Conclusion: The results of this study provide support for the application of brief physical performance assessments by physical therapists to identify functional mobility limitations and fall risk in older adults with advanced dementia.
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Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Nursing, Midwifery and Social Work Publications
 
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Created: Tue, 10 Dec 2013, 23:10:56 EST by Vicki Percival on behalf of School of Nursing, Midwifery and Social Work