Abstract
BackgroundRecommendations for assessing motor performance in individuals with dementia (IWD) are rare, and most existing assessment tools previously applied in IWD were initially developed for healthy older adults. However, IWD and their healthy counterparts differ in motor and cognitive capabilities, which needs to be considered when designing studies for this population. This article aims to give recommendations for motor assessments for IWD and to promote standardisation based on a structured discussion of identified assessment tools used in previous trials.MethodsAppropriateness and standardisation of previously applied motor assessments for IWD were intensively discussed using a qualitative approach during an expert panel. Furthermore, the use of external cues and walking aids, as well as psychometric properties were considered. Starting with a comprehensive overview of current research practice, the discussion was gradually specified and resulted in the elaboration of specific recommendations.ResultsThe superior discussion emphasised the need for tailoring motor assessments to specific characteristics of IWD and attaching importance to standardised assessment procedures. Specific recommendations include the use of sequential approaches, which incorporate a gradual increase of complexity from simple to more difficult tasks, a selection of motor assessments showing sufficient relative reliability and appropriateness for IWD, as well as allowing external cues and walking aids when restricted to repeated instructions and commonly used devices, respectively.ConclusionsThese are the first recommendations for assessing motor performance in IWD based on a comprehensive qualitative approach. Due to limited evidence, it was not possible to address all existing questions. It is therefore important to evaluate these recommendations in studies with IWD. Besides tailoring and evaluating available assessments, future research should focus on developing specific tools for IWD. Moreover, further progress in standardisation is necessary to enhance comparability between different trials. This article provides initial approaches for overcoming existing limitations in trials with IWD by giving recommendations and identifying future research questions, and therefore contributes to enhancing evidence regarding efficacy and effectiveness of physical activity interventions.
Highlights
Recommendations for assessing motor performance in individuals with dementia (IWD) are rare, and most existing assessment tools previously applied in IWD were initially developed for healthy older adults
The initial group invited to this expert panel comprised 27 international researchers, who were chosen based on existing relations with the Karlsruhe Institute of Technology (KIT) and a literature screening aimed to identify researchers located within geographical proximity who were interested in motor assessments in IWD
The present article conveys a consensus of recommendations for assessing motor performance in IWD, which was reached during an expert panel with two interrelated one-day meetings at the KIT in December 2014 and February 2015
Summary
Recommendations for assessing motor performance in individuals with dementia (IWD) are rare, and most existing assessment tools previously applied in IWD were initially developed for healthy older adults. Despite increasing research in this area [1], there still is insufficient evidence, which can be explained by methodological limitations, unspecific interventions, or inappropriate assessments [2,3,4] This emphasises the need for further high quality studies guided by suggestions for optimised interventions and sensitive assessment tools. Considering significant differences in cognitive and motor performance [6,7,8,9,10], it is not possible to directly translate study designs developed for healthy older adults to IWD. This is important for clinical practice considering prognostic, diagnostic, and therapeutic reasons [12, 13]
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