Physiotherapy Department, Healthy Aging Research Laboratory, Federal University of São Carlos, São Carlos/SP, Brazil.
Physiotherapy Department, Rheumatology and Hand Rehabilitation Research Laboratory, Federal University of São Carlos, São Carlos/SP, Brazil.
Phys Ther. 2022 Feb 1;102(2). doi: 10.1093/ptj/pzab263.
The purpose of this study was to analyze the relative and absolute reliability of assessment tests addressing body structure and function and activity in older adults with dementia.
Medline, Embase, Web of Science, The Cochrane Library, and Scielo were searched from inception until March 2021. Two independent reviewers performed the selection process based on titles, abstracts, and full text. Reliability studies of assessment tests in older adults with dementia were included. Methodological quality of the studies was evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments Risk of Bias checklist. Relative reliability was analyzed using the intraclass correlation coefficient (ICC) interpreted based on Munro classification. Absolute reliability was analyzed using the minimal detectable change (MDC) and standard error of measurement.
Fifteen studies involving a total of 560 older adults with dementia were included. Nineteen assessment tests were identified: 13 addressing body structure and function (muscle strength, postural balance, cardiorespiratory fitness) and 6 addressing activity (walking and mobility). Studies determined test-retest and interrater reliability. Fifteen studies evaluated relative reliability using the ICC, with values ranging from no or small correlation to very high correlations. Ten studies evaluated absolute reliability using the MDC or standard error of measurement or both.
Relative reliability of the assessment tests for body structure and function and activity was high to very high based on ICCs, demonstrating good reproducibility. Regarding absolute reliability, the analysis of the MDC values revealed the need for substantial change to determine that a real change had occurred. Future investigations should consider the type of dementia and standardization of verbal encouragement during the assessment.
This review identified the good reproducibility of assessment tests of body structure and function (muscle strength, postural balance, cardiorespiratory fitness) and activity (walking and mobility) domains in older adults with dementia. Clinically important values may differ when older adults with dementia of diverse etiologies are analyzed together and older adults specifically with Alzheimer disease. Identifying the type of dementia, analyzing types of dementia separately, and standardizing verbal commands during the execution of tests is of considerable clinical importance for this population of older adults.
本研究旨在分析针对患有痴呆症的老年人的身体结构和功能以及活动的评估测试的相对和绝对可靠性。
从建库到 2021 年 3 月，我们检索了 Medline、Embase、Web of Science、The Cochrane Library 和 Scielo。两名独立的审查员根据标题、摘要和全文进行了选择过程。纳入了针对患有痴呆症的老年人的评估测试的可靠性研究。使用共识基础的健康测量仪器选择标准（COnsensus-based Standards for the selection of health Measurement INstruments，COSMIN）风险偏倚检查表评估研究的方法学质量。使用基于 Munro 分类的组内相关系数（intraclass correlation coefficient，ICC）分析相对可靠性。使用最小可检测变化（minimal detectable change，MDC）和测量标准误差分析绝对可靠性。
纳入了 15 项共涉及 560 名患有痴呆症的老年人的研究。确定了 19 项评估测试：13 项评估身体结构和功能（肌肉力量、姿势平衡、心肺适应性），6 项评估活动（行走和移动能力）。研究确定了测试-再测试和观察者间可靠性。15 项研究使用 ICC 评估了相对可靠性，其值范围从无相关或小相关到高度相关。10 项研究使用 MDC 或测量标准误差或两者均评估了绝对可靠性。
基于 ICC，评估身体结构和功能以及活动的测试的相对可靠性为高到非常高，表明具有良好的可重复性。关于绝对可靠性，MDC 值的分析表明需要进行实质性的变化才能确定实际发生了变化。未来的研究应考虑痴呆症的类型和评估过程中口头鼓励的标准化。
本综述确定了针对患有痴呆症的老年人的身体结构和功能（肌肉力量、姿势平衡、心肺适应性）和活动（行走和移动能力）领域的评估测试具有良好的可重复性。当一起分析具有不同病因的痴呆症老年人以及特定的阿尔茨海默病老年人时，以及当分析特定的阿尔茨海默病老年人时，临床重要值可能会有所不同。对于这一老年人群体，确定痴呆症的类型、分别分析不同类型的痴呆症以及在执行测试时标准化口头命令具有重要的临床意义。
