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

Ellen L McGough, Rebecca G Logsdon, Valerie E Kelly, Linda Teri
Journal of Geriatric Physical Therapy 2013, 36 (2): 78-86

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.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"