Abstract
BackgroundMobility is a key outcome in older patients with cognitive impairment. The de Morton Mobility Index (DEMMI) is an established measure of older people’s mobility that is promising for use in older patients with cognitive impairment. The aim of this study was to examine the DEMMI’s psychometric properties in older patients with dementia, delirium or other cognitive impairment.MethodsThis cross-sectional study was performed in a geriatric hospital and includes older acute medical patients with cognitive impairment indicated by a Mini Mental State Examination (MMSE) score ≤ 24 points. A Rasch analysis was performed to check the DEMMI’s unidimensionality. Construct validity was assessed by testing 13 hypotheses about expected correlations between the DEMMI and outcome measures of similar or related constructs, and about expected differences of DEMMI scores between groups differing in mobility related characteristics. Administration times were recorded.ResultsA sample of 153 patients with mild (MMSE 19–24 points; 63%) and moderate (MMSE: 10–18 points; 37%) cognitive impairment was included (age range: 65–99 years; mean MMSE: 19 ± 4, range: 8–24 points; diagnosis of dementia and delirium: 40% and 18%, respectively). Rasch analysis indicated unidimensionality with an overall fit to the model (P = 0.107). Internal consistency reliability was excellent (Cronbach’s alpha = 0.92). Eleven out of 13 (85%) hypotheses on construct validity were confirmed. The DEMMI showed good feasibility, and no adverse events occurred. The mean administration time of 5 min (range: 1–10) was not influenced by the level of cognitive impairment. In contrast to some other comparator instruments, no floor or ceiling effects were evident for the DEMMI.ConclusionsResults indicate sufficient psychometric properties of the DEMMI in older patients with cognitive impairment.Trial registrationGerman Clinical Trials Register (DRKS00005591). Registered February 2, 2015.
Highlights
Mobility is a key outcome in older patients with cognitive impairment
Cognitive impairment is common in older people admitted to the acute hospital, with prevalence for dementia estimated to be between 13 and 63% [1, 2], and for delirium to be between 20 and 27% [3, 4]
This study provides first evidence for the de Morton Mobility Index (DEMMI) to be a feasible, unidimensional and construct valid measurement instrument of mobility in older individuals with cognitive impairment, without floor and ceiling effects
Summary
Mobility is a key outcome in older patients with cognitive impairment. The de Morton Mobility Index (DEMMI) is an established measure of older people’s mobility that is promising for use in older patients with cognitive impairment. The aim of this study was to examine the DEMMI’s psychometric properties in older patients with dementia, delirium or other cognitive impairment. Cognitive impairment can further complicate the assessment of mobility, e.g. due to complex test instructions [9, 10] To overcome such limitations of existing instruments [7], the de Morton Mobility Index (DEMMI) was developed [11]. This performance-based bedside-test has a broad scale width and is quick and simple to administer [11, 12]. The aim of this study was to examine the DEMMI’s psychometric properties in older acute medical patients with cognitive impairment
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
