Physical Performance Characteristics of Assisted Living Residents and Risk for Adverse Health Outcomes

Giuliani, Carol; Gruber‐Baldini, Ann L.; Park, Nan Sook; Schrodt, Lori A.; Rokoske, Franzi; Sloane, Philip D.; Zimmerman, Sheryl

doi:10.1093/geront/48.2.203

Cited by 65 publications

(64 citation statements)

References 51 publications

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“…A wide range of physical performance measures have been used to predict health and function especially in older populations 123 . Among these, aspects of walking such as speed and related metrics (e.g.…”

Section: Introductionmentioning

confidence: 99%

One walk a year to 1000 within a year: Continuous in-home unobtrusive gait assessment of older adults

et al. 2012

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Physical performance measures predict health and function in older populations. Walking speed in particular has consistently predicted morbidity and mortality. However, single brief walking measures may not reflect a person’s typical ability. Using a system that unobtrusively and continuously measures walking activity in a person’s home we examined walking speed metrics and their relation to function. In 76 persons living independently (mean age, 86) we measured every instance of walking past a line of passive infra-red motion sensors placed strategically in their home during a four-week period surrounding their annual clinical evaluation. Walking speeds and the variance in these measures were calculated and compared to conventional measures of gait, motor function and cognition. Median number of walks per day was 18 ± 15. Overall mean walking speed was 61 ± 17 cm/sec. Characteristic fast walking speed was 96 cm/sec. Men walked as frequently and fast as women. Those using a walking aid walked significantly slower and with greater variability. Morning speeds were significantly faster than afternoon/evening speeds. In-home walking speeds were significantly associated with several neuropsychological tests as well as tests of motor performance. Unobtrusive home walking assessments are ecologically valid measures of walking function. They provide previously unattainable metrics (periodicity, variability, range of minimum and maximum speeds) of everyday motor function.

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Section: Introductionmentioning

confidence: 99%

One walk a year to 1000 within a year: Continuous in-home unobtrusive gait assessment of older adults

et al. 2012

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“…Therefore, walking speed is an important indicator of health status and function and can be used as a 'vital sign' (Fritz and Lusardi 2009;Studenski et al 2011;Taekema et al 2012). It has been shown that walking speed associates with aspects of poor health status or outcomes in older adults, such as mortality (Abellan van Kan et al 2009;Cesari et al 2005;Newman et al 2006;Toots et al 2013), mobility impairment (Newman et al 2006;Purser et al 2005;Rolland et al 2004), falls (Abellan van Kan et al 2009;Montero-Odasso et al 2005), presence of cognitive impairment (Auyeung et al 2008;Camicioli et al 1998), cardiopulmonary diseases (Dumurgier et al 2010;Ilgin et al 2011;Newman et al 2006;Rosano et al 2011), hospitalization, and nursing home placement (van Abellan et al 2009;Cesari et al 2005;Giuliani et al 2008;MonteroOdasso et al 2005). Cut-off values for walking speed are used for the prediction of aforementioned health outcomes and underpin clinical decision making.…”

Section: Introductionmentioning

confidence: 99%

Walking speed in elderly outpatients depends on the assessment method

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Stijntjes

et al. 2014

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Walking speed is shown to be an important indicator of the health status and function in older adults and part of the comprehensive geriatric assessment in clinical practice. The present study aimed to assess the influence of different assessment methods on walking speed and its association with the key aspects of poor health status, i.e., the presence of low cognitive performance and cardiopulmonary disease. In 288 community-dwelling elderly (mean age 82.2±7.1 years) referred to a geriatric outpatient clinic, walking speed was assessed with the 4-m, 10-m, and 6-min walking tests. The mean walking speed assessed with the 10-m walking test was higher compared to the 4-m and 6-min walking tests (mean difference (95 % CI) 0.11 m/s (0.10; 0.13) and 0.08 m/s (0.04; 0.13), respectively). No significant difference was found in the walking speed assessed with the 4-m compared to the 6-min walking test (mean difference (95 % CI) −0.03 m/s (−0.08; 0.03)). ICCs showed excellent agreement of the 4-m with the 10-m walking test and fair to good agreement of the 6-min with the 4-m as well as 10-m walking test. The presence of low cognitive performance was negatively associated with walking speed, with the highest effect size for the 4-m walking test. The presence of cardiopulmonary disease was negatively associated with walking speed as well, with the highest effect size for the 6-min walking test. In conclusion, in the clinically relevant population of elderly outpatients, walking speed and its interpretation depends on the assessment method, which therefore cannot be used interchangeably in clinical practice.

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“…In addition, training of muscle strength, flexibility and balance as well as management of fall risk should be included [6]. Physical performance, especially walking speed, chair rise and balance, is strongly associated with the ability to perform ADL and risk of injury from falls [7]. Fear of falling and avoidance due to fear of falling are common in older people, both in fallers and non-fallers [8].…”

Section: Introductionmentioning

confidence: 99%

“…We wanted to focus on the frailest residents, who are dependent in ADL and seldom get involved in specific training. In addition, balance is strongly associated with ADL and mobility [7]. …”

Section: Introductionmentioning

confidence: 99%

Effects of Individually Tailored Physical and Daily Activities in Nursing Home Residents on Activities of Daily Living, Physical Performance and Physical Activity Level: A Randomized Controlled Trial

et al. 2012

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Background: Nursing home residents are extremely inactive and deterioration in health and an increasing dependence in activities of daily living (ADL) are common. Physical activity and exercise play a major role in the preservation of physical function and quality of life late in life. However, evidence for the benefit of rehabilitation in nursing home residents is conflicting and inconclusive. Objective: To evaluate the effect of an individually tailored intervention program of 3 months, for nursing home residents, on ADL, balance, physical activity level, mobility and muscle strength. Methods: In this single-blind randomized clinical trial with parallel groups, nursing home residents >64 years of age from three Nordic countries were included. The intervention group (IG) was assigned to individually tailored physical and daily activities, while the control group (CG) received ordinary care. Primary outcomes were ADL and balance, and secondary outcomes physical activity level, mobility and muscle strength. Results: At baseline, 322 nursing home residents were included, of whom 266 were assessed after 3 months of intervention. Following the intervention, a significant difference was found between participants in the IG and CG on measures of balance, physical activity and transfers. The IG significantly improved walking/wheelchair speed and functional leg muscle strength. The CG had significantly deteriorated in ADL, balance and transfers. Persons who had taken part in the intervention for more than 150 min/week significantly improved their balance and physical activity level. Participation in more than 10 weeks of intervention significantly improved physical activity and walking/wheelchair speed, while a deterioration was seen in those who had participated less. Conclusion: Individually tailored intervention in nursing home residents focusing on physical and daily activities is effective in improving transfers, balance and physical activity level compared to usual care. The effect of the intervention is dependent on the total activity time.

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Physical Performance Characteristics of Assisted Living Residents and Risk for Adverse Health Outcomes

Abstract: Simple performance measures identify modifiable functional deficits and suggest targeted interventions to prolong independent mobility and aging in place in RC/AL facilities.

Cited by 65 publications

References 51 publications

One walk a year to 1000 within a year: Continuous in-home unobtrusive gait assessment of older adults

One walk a year to 1000 within a year: Continuous in-home unobtrusive gait assessment of older adults

Walking speed in elderly outpatients depends on the assessment method

Effects of Individually Tailored Physical and Daily Activities in Nursing Home Residents on Activities of Daily Living, Physical Performance and Physical Activity Level: A Randomized Controlled Trial

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