Reliability, validity and minimal detectable change of 2-minute walk test, 6-minute walk test and 10-meter walk test in frail older adults with dementia

Abstract

Background: Walk tests are commonly used to evaluate walking ability in frail older adults with dementia but their psychometric evidence in this population is lacking. Objectives: 1) To examine test-retest and inter-rater reliability, construct and known-group validity, and minimal detectable change at 95% level of confidence (MDC95) of walk tests in frail older adults with dementia, and 2) to examine the feasibility and consistency of a cueing system in facilitating participants in completing walk tests. Design: Psychometric study with repeated measures. Setting: Day care and residential care facilities. Participants: Thirty-nine frail older adults with a mean age 87.1 and a diagnosis of dementia or Alzheimer's disease who were able to walk independently for at least 15 meters. Methods: The participants underwent a 2-minute walk test (2MWT), 6-minute walk test (6MWT) and 10-meter walk test (10MeWT) on six separate occasions under 2 independent assessors using a cueing system. Functional status was measured using the Elderly Mobility Scale (EMS), Berg Balance Scale (BBS) and Modified Barthel Index (MBI). Results: Excellent test-retest (ICC=.91-.98) and inter-rater reliability (ICC=.86-.96) were shown in the 2MWT, 6MWT and 10MeWT. The walk tests were strongly correlated with each other (ρ =.85-.94). The correlations between the walk tests and the functional measures were moderate in general (ρ =.34-.55). All the walk tests were able to distinguish between those who could walk outdoor and indoor only (p≤.036). The MDC95 were 9.1m in the 2MWT, 28.1m in the 6MWT, 3 and .16m/s in the 10MeWT. The cues provided by the assessors in the walk tests were generally consistent (ICC=.62-.89). Conclusions: The 2MWT, 6MWT and 10MeWT are reliable and valid measures in evaluating walking ability in frail older adults with dementia. The MDC95 of the walk tests has been established. The cueing system is feasible and reliable to facilitate the administration of the walk tests in this population group.

Relationship Between Balance, Gait, and Activities of Daily Living in Older Adults With Dementia

“…Regarding the associations between cognition and ADLs and between balance and walking speed, the results of this study were consistent with the results of the previous studies. [24][25][26] A significant decline of cognition function was shown together with ADLs in this study. We suggest that cognition impairment is closely associated with the inability to perform ADLs in people with dementia.…”

“…They reported findings of r ¼ 0.49 (10MWT measured in 2-min walk test) and r ¼ 0.35 (10MWT measured in 6-min walk test) between walking speed and balance. 26 This results demonstrated that strong association between balance and walking speed suggests that older adults with dementia walk shorter distances over a longer period of time when a loss of balance performance occurs.…”

Changes in Cognitive Function and in the Levels of Glycosylated Haemoglobin (HbA1c) in Older Women with Type 2 Diabetes Mellitus Subjected to a Cardiorespiratory Exercise Programme

“…Moreover, it has been reported that the 6MWT is easy to perform and reliable for the evaluation of cardiorespiratory fitness in patients with DM2 [41]. Likewise, a significant correlation has been observed between the results of this test and the values of HbA1c [42]; it has even provided reliable and valid results to evaluate the walking capacity in fragile older individuals with dementia [43]. The 6MWT was carried out in homogenous groups of 10 participants in a 400-metre flat track, marked every 50 metres.…”

The maximal gait speed is a simple and useful prognostic indicator for functional recovery after total hip arthroplasty

“…Gait speed has been shown to predict morbidity and mortality in various populations [24,25]. In addition, the evaluation of gait speed is reliable and accurately measures even frail older adults with cognitive dysfunction, which is common comorbidity in the elderly population [26]. Importantly, several studies have indicated that the single measurement of gait speed outperformed other multicomponent frailty scales in predicting outcomes [27,28].…”