Reliable and valid measures for the clinical assessment of balance and gait in older adults with dementia: a systematic review

Abstract

Purpose To systematically review the literature and determine clinical balance or gait tests appropriate for use in older adults with dementia. Materials and Methods Databases PubMed, EMBASE and CINAHL were searched (inception-April 2020). Inclusion criteria: participants were diagnosed with dementia and reliability or validity was evaluated for clinical balance or gait tests. Exclusion criteria: not published in English or unable to extract data. Results Twenty-two studies evaluating 35 clinical balance or gait tests were included. For community-dwelling individuals, the Modified Clinical Test of Sensory Interaction in Balance, gait velocity, Step Test and the Timed Up and Go had good relative and absolute reliability. For institutional-dwelling individuals the Berg Balance Scale, the Groningen Meander Walk Test, and 6-Meter Walk Test had excellent relative and absolute reliability. The Groningen Meander Walk Test was the only recommended test that has been validated. Conclusions Reliable clinical tests of balance and gait for use in people with dementia exist, yet few have been validated. Additionally, to comprehensively assess balance, clinicians must utilise multiple tests. Future research should evaluate the psychometric properties of clinical balance and gait tests so as to identify those appropriate for use in people with dementia across setting, severity and dementia type.