Assessment von Mobilität – geriatrisches Assessment zur Erfassung lokomotorischer Mobilitätseinschränkungen und Perspektiven der Instrumentierung

Hobert, Markus A.; Jamour, Michael

doi:10.1007/s00391-022-02040-8

Cited by 4 publications

(5 citation statements)

References 51 publications

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“…The methods and instruments reported for capturing contextual factors in the field of physical function, cognitive capacity, and social aspects coincide with the tools used in previous studies ( 27 , 50 , 51 ).…”

Section: Discussionmentioning

confidence: 88%

“…These factors causing mobility or immobility add up to a holistic understanding of mobility. Research on the range of factors influencing mobility and corresponding assessment tools has already been called for in the current literature in the field of mobility research ( 26 , 27 ). The results regarding contextual factors are discussed below.…”

Section: Discussionmentioning

confidence: 99%

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Definition and Contextual Factors of Nursing Home Residents’ Mobility in a Holistic View: A Delphi Study

Vogel

Otto

Zimmel

et al. 2022

Innovation in Aging

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Background and Objectives Current definitions of older adults’ mobility do not cover the full range of influencing factors and do not consider nursing home residents. The present study reports expert ratings from a Delphi study regarding factors influencing the mobility of long-term nursing home residents. Research Design and Methods We invited 129 professionals with expertise in a field relevant to research on mobility in older adults such as health care, medicine, or human movement science to participate in a Delphi study comprising three rounds of online questionnaires. Up to 40 experts participated in each round. In the first round, we used open-ended questions to solicit possible definitions, contextual factors, and assessment tools. In the second round the participants used Likert scales (1-10) to rate their suitability. In the final round, we presented a definition based on consensus as well as the top-rated contextual factors and assessment tools from the first 2 rounds for a final rating of agreement. Results The experts showed broad agreement on the final version of the mobility definition, with 8.9 ± 1.4 (mean ± standard deviation) out of 10 points. The experts also showed broad consensus on the selected contextual factors, with 8.4 ± 1.8 points to 8.9 ± 1.2 points (out of 10 points). This was also the case for the top 3 assessment tools selected from results of previous rounds, which showed an agreement of 7 or more points (out of 10 points) by 81.6% to 100% of all experts in the different categories. Discussion and Implications Given that an interdisciplinary group of experts considered various hitherto neglected contextual factors as relevant, the Delphi survey and its results imply the need for an updated interdisciplinary and holistic understanding of mobility in nursing home residents and can provide a basis for putting it into practice.

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Definition and Contextual Factors of Nursing Home Residents’ Mobility in a Holistic View: A Delphi Study

Vogel

Otto

Zimmel

et al. 2022

Innovation in Aging

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“…Our results show that it is used in a standardized way at different time points in many centers. The DEMMI is also recommended by the S1 guideline for level 2 CGA and is suitable for a differentiated assessment of mobility, also in non-ambulatory patients, as it comprises numerous tasks that do not require walking ability and has almost no floor effects [ 64 ]. Particularly for patients with previous falls, the S1 guideline for level 2 CGA recommends the use of assessment instruments for fear of falling, such as the FES-I [ 65 ], which has been used very rarely so far in the centers surveyed.…”

Section: Discussionmentioning

confidence: 99%

“…Multiple responses were possible. CCI = Charlson Comorbidity Index, CIRS = Cumulative Illness Rating Scale, MAGIC = Manageable geriatric assessment tasks that do not require walking ability and has almost no floor effects [64]. Particularly for patients with previous falls, the S1 guideline for level 2 CGA recommends the use of assessment instruments for fear of falling, such as the FES-I [65], which has been used very rarely so far in the centers surveyed.…”

Section: Motor Functionmentioning

confidence: 99%

Which Comprehensive Geriatric Assessment (CGA) instruments are currently used in Germany: a survey

Kudelka,

Ollenschläger,

Dodel

et al. 2024

BMC Geriatr

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Background The Comprehensive Geriatric Assessment (CGA) records geriatric syndromes in a standardized manner, allowing individualized treatment tailored to the patient’s needs and resources. Its use has shown a beneficial effect on the functional outcome and survival of geriatric patients. A recently published German S1 guideline for level 2 CGA provides recommendations for the use of a broad variety of different assessment instruments for each geriatric syndrome. However, the actual use of assessment instruments in routine geriatric clinical practice and its consistency with the guideline and the current state of literature has not been investigated to date. Methods An online survey was developed by an expert group of geriatricians and sent to all licenced geriatricians (n = 569) within Germany. The survey included the following geriatric syndromes: motor function and self-help capability, cognition, depression, pain, dysphagia and nutrition, social status and comorbidity, pressure ulcers, language and speech, delirium, and frailty. Respondents were asked to report which geriatric assessment instruments are used to assess the respective syndromes. Results A total of 122 clinicians participated in the survey (response rate: 21%); after data cleaning, 76 data sets remained for analysis. All participants regularly used assessment instruments in the following categories: motor function, self-help capability, cognition, depression, and pain. The most frequently used instruments in these categories were the Timed Up and Go (TUG), the Barthel Index (BI), the Mini Mental State Examination (MMSE), the Geriatric Depression Scale (GDS), and the Visual Analogue Scale (VAS). Limited or heterogenous assessments are used in the following categories: delirium, frailty and social status. Conclusions Our results show that the assessment of motor function, self-help capability, cognition, depression, pain, and dysphagia and nutrition is consistent with the recommendations of the S1 guideline for level 2 CGA. Instruments recommended for more frequent use include the Short Physical Performance Battery (SPPB), the Montreal Cognitive Assessment (MoCA), and the WHO-5 (depression). There is a particular need for standardized assessment of delirium, frailty and social status. The harmonization of assessment instruments throughout geriatric departments shall enable more effective treatment and prevention of age-related diseases and syndromes.

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“…Studies analyzing quantitative parameters to describe gait quality (i.e. with an instrumented assessment [ 7 ]) after ECT have not yet been published to our knowledge.…”

Section: Discussionmentioning

confidence: 99%

Depression as a major component of a gait disorder—Successful multimodal treatment including electroconvulsive therapy

et al. 2022

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This case report describes an 82-year-old patient who was treated in a gerontological psychiatric ward due to a multifactorial gait disorder with falls. The main component of the gait disorder was depression, which was accompanied by a pronounced fear of falling. Other factors were polyneuropathy, gonarthrosis and an exercise deficit after previous inactivity. An important part of the multimodal treatment was electroconvulsive therapy (ECT). A total of nine sessions of ECT in right unilateral stimulation were conducted. The treatment resulted in a significant improvement of the depression and the gait disorder, which was impressively reflected in the geriatric assessment. The presented case shows that depression and fear of falling should not be underestimated as (main) components of a gait disorder. Here, a multimodal treatment including treatment of the depression by ECT was successful. Supplementary Information The online version of this article (10.1007/s00391-022-02135-2) contains supplementary material, which is available to authorized users.

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Assessment von Mobilität – geriatrisches Assessment zur Erfassung lokomotorischer Mobilitätseinschränkungen und Perspektiven der Instrumentierung

Cited by 4 publications

References 51 publications

Definition and Contextual Factors of Nursing Home Residents’ Mobility in a Holistic View: A Delphi Study

Definition and Contextual Factors of Nursing Home Residents’ Mobility in a Holistic View: A Delphi Study

Which Comprehensive Geriatric Assessment (CGA) instruments are currently used in Germany: a survey

Depression as a major component of a gait disorder—Successful multimodal treatment including electroconvulsive therapy

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