Reliability and Validity of Four Step Tests in Older Adults With Dementia

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry Pub Date : 2024-11-28 DOI:10.1002/gps.70021

Wayne Lap Sun Chan, Sharon Man Ha Tsang, Lily Yuen Wah Ho

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引用次数: 0

Abstract

Objectives

To determine the test–retest and inter-rater reliability, concurrent and discriminative validity of the Four Square Step Test (FSST), the Choice Stepping Reaction Time Test (CSRTT), the Maximum Step Length Test (MSLT), and the Alternate Step Test (AST) in older adults with dementia.

Methods

Thirty-seven older adults with dementia who could walk independently for at least 10 m were recruited at community centers and day care centers for older adults. The participants completed the step tests conducted by two independent raters on three separate testing occasions within 3 weeks. In addition, the physical and cognitive function of the participants were evaluated at baseline.

Results

The FSST, CSRTT, and MSLT showed good-to-excellent test–retest reliability (intraclass correlation coefficient [ICC] = 0.83–0.91), and the AST exhibited fair test–retest reliability (ICC = 0.70). All the step tests showed good-to-excellent inter-rater reliability (ICC = 0.75–0.94). The step tests had moderate-to-strong correlations with various physical and cognitive measures (Pearson correlation coefficients = 0.34–0.72). The MSLT side step and AST could differentiate between individuals who did and did not use a walking stick to ambulate (p ≤ 0.046). The FSST, CSRTT, and AST could differentiate between individuals with and without a major neurocognitive impairment (p ≤ 0.005).

Conclusion

The FSST, CSRTT, and MSLT were reliable and valid for examining the stepping performance of older adults with dementia. Clinicians can use these tests to evaluate the physical and cognitive function of this population and identify those with significant cognitive impairment.

Trial Registration

Clinical Trial Registration number: NCT04296123

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老年痴呆患者四步测试的信度和效度

目的探讨四方步检验（FSST）、选择步反应时间检验（CSRTT）、最大步长检验（MSLT）和交替步检验（AST）在老年痴呆患者中的重测信度、信度、并发效度和判别效度。方法在社区中心和老年人日托中心招募了37名能够独立行走至少10米的老年痴呆患者。参与者在三周内完成了由两位独立评分员在三个不同的测试场合进行的步骤测试。此外，在基线时对参与者的身体和认知功能进行评估。结果FSST、CSRTT和MSLT具有优良的重测信度（类内相关系数[ICC] = 0.83 ~ 0.91）， AST具有一般的重测信度（ICC = 0.70）。所有步进检验均显示良好至优异的量表间信度（ICC = 0.75 ~ 0.94）。步进测试与各种身体和认知测量具有中强相关性（Pearson相关系数= 0.34-0.72）。MSLT侧步和AST可以区分使用和不使用手杖行走的个体（p≤0.046）。FSST、CSRTT和AST可以区分有无严重神经认知障碍的个体（p≤0.005）。结论FSST、CSRTT和MSLT对老年痴呆患者的步进能力检测是可靠有效的。临床医生可以使用这些测试来评估这一人群的身体和认知功能，并识别那些有显著认知障碍的人。临床试验注册号：NCT04296123

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来源期刊

International Journal of Geriatric Psychiatry 医学-精神病学

CiteScore

6.10

自引率

2.50%

发文量

168

审稿时长

4-8 weeks

期刊介绍： The rapidly increasing world population of aged people has led to a growing need to focus attention on the problems of mental disorder in late life. The aim of the Journal is to communicate the results of original research in the causes, treatment and care of all forms of mental disorder which affect the elderly. The Journal is of interest to psychiatrists, psychologists, social scientists, nurses and others engaged in therapeutic professions, together with general neurobiological researchers. The Journal provides an international perspective on the important issue of geriatric psychiatry, and contributions are published from countries throughout the world. Topics covered include epidemiology of mental disorders in old age, clinical aetiological research, post-mortem pathological and neurochemical studies, treatment trials and evaluation of geriatric psychiatry services.