The Physical and Cognitive Performance Test for Residents in Assisted Living Facilities

Abstract

OBJECTIVE The aim of this study is to develop and evaluate the psychometric properties of a new performance-based instrument (the Physical and Cognitive Performance Test for Assisted Living Facilities; PCPT ALF) designed to assess the physical and cognitive skills associated with the performance of activities of daily living (ADL) and instrumental activities of daily living (IADL). DESIGN There were three stages in this study: development of instrument items and validity testing, a feasibility pilot study and a cross-sectional trial to establish construct and criterion validity and reliability. SETTING One 116-bed ALF. PARTICIPANTS Following a pilot test with 10 residents, a cross-sectional trial was conducted with 55 additional residents. MEASUREMENTS The Barthel Index and the Functional Independence Measure were used to estimate criterion validity. Construct validity was examined using exploratory factor (EFA) analyses. RESULTS Disattenuated correlations between the PCPT ALF and other tools were all above 0.72 supporting criterion validity. Internal consistency (physical ability, α = 0.95; cognitive support, α = 0.92) and one week test-retest reliability (PCPT ALF, p=0.93) were high as was inter-rater reliability (0.99=physical ability; 1.00 =cognitive support). In two EFAs, one each for the physical ability and cognitive support subscales, a one factor solution accounted for 64.1% of the variance and 63.5% of the variance, respectively. CONCLUSION The findings provide early evidence of the PCPT ALF instrument’s score validity and reliability. If confirmed, this study’s findings may be used in future work to assess the success of interventions to prevent or slow decline in the skills associated with ADL/IADL performance in ALFs.

Noticing Acute Changes in Health in Long-Term Care Residents

“…Second, assessments should capture multiple health domains given the complexity of the patient population. For example, assessments capturing changes across physical (e.g., gait, balance, and ADLs) and cognitive health domains (memory and executive function) may aid in differentiating between acute health status changes and complications because of chronic conditions (Bowen et al, 2017). Finally, study findings suggest some healthcare staff are unclear on the processes and procedures for reporting suspected changes in acute health status and to whom to report these changes.…”

Changes in Motor Behavior Predict Falls and Identify Acute Events

“…The Physical and Cognitive Performance Test (PCPT) was measured monthly on each resident to account for intra-individual changes in physical and cognitive ability which may affect motor behaviors. The PCPT is a valid and reliable performance-based measure of activities of daily living (ADL) and how these may be affected by changes in cognition in a population of institutionalized older adults with known ADL and cognitive deficits (Bowen et al, 2017). The PCPT physical abilities scale ranges from 0-27; the cognitive abilities scale ranges from 8-24 (total range = 0-51) with higher total scores indicative of increased physical and cognitive ability.…”

A research proposal testing a new model of ambulation activity among long-term care residents with dementia/cognitive impairment: the study protocol of a prospective longitudinal natural history study

“…We will also assess new medical diagnoses and medications each week by medical chart review to capture changes. FS will be measured by the Physical and Cognitive Performance Test for Assisted Living Facilities (PCPT ALF) [44] and the Barthel Index [45]. FS instruments will be administered at a consistent clock hour and day for each resident to reduce variability that occurs across the daytime period among residents with CI/dementia.…”

“…PCPT ALF = test–retest reliability (≥ 0.60) [44] Spearman correlation with the Barthel, the Functional Independence Measure and the MDS Resident Assessment Instrument (≥ 0.70; unpublished data)…”