Dataset Information

Self- vs proxy-reported mobility using the mobility assessment tool-short form in elderly preoperative patients.

ABSTRACT:

Background

Mobility is fundamental to maintenance of an independent lifestyle and can predict clinical outcomes after health events among older individuals. However, certain clinical situations do not accommodate physical or self-assessments. This investigation examines whether proxy-reported assessments of function using the Mobility Assessment Tool-short (MAT-sf) form is a reliable alternative.

Methods

Sixty-six older persons (≥ age 70) and their proxies were enrolled. Proxies rated patients' mobility using the MAT-sf as did the patients.

Results

The mean age of patients was 78.4 yr. (±6.2); 44% were female and 86% were white. Spouses made up 55% of the proxies, while 39% were children/in-laws. The correlation coefficient between patient and proxy MAT-sf scores was 0.81 (p < 0.01); a comparison of the slope of the regression line relating patient- and proxy-reported MAT-sf to a line of identity showed disagreement (p < 0.01), with proxy reports underreporting patient responses by 8.3% in lower mobility patients. The intra-class correlation characterizing agreement between repeated proxy reports 0.81.

Conclusion

Proxy reports of mobility in older patients have good reliability. However, in patients with poor mobility, the proxies tend to report a lower mobility than the patients.

SUBMITTER: Kim S

PROVIDER: S-EPMC5918991 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Publications

Self- vs proxy-reported mobility using the mobility assessment tool-short form in elderly preoperative patients.

Kim Sunghye S Miller Michael E ME Lin Marina M Rejeski W Jack WJ Kritchevsky Stephen B SB Marsh Anthony P AP Groban Leanne L

European review of aging and physical activity : official journal of the European Group for Research into Elderly and Physical Activity 20180426

<h4>Background</h4>Mobility is fundamental to maintenance of an independent lifestyle and can predict clinical outcomes after health events among older individuals. However, certain clinical situations do not accommodate physical or self-assessments. This investigation examines whether proxy-reported assessments of function using the Mobility Assessment Tool-short (MAT-sf) form is a reliable alternative.<h4>Methods</h4>Sixty-six older persons (≥ age 70) and their proxies were enrolled. Proxies r ...[more]

PMID: 29721102

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Project description:BackgroundHeart failure (HF) patients often experience cognitive impairment that negatively impacts self-management ability, predisposing these individuals to worse post-hospitalization outcomes. Patient proxies may have more insight into a patient's self-management capability especially in the context of patient cognitive impairment. Here, we incorporate proxy input to evaluate associations between patient- and proxy-reported capacity for instrumental activities of daily living (IADL) stratified along a patient's cognitive function in an older hospitalized heart failure population.MethodsWe conducted a quality improvement study in older HF inpatients with cognitive impairment determined by Mini-Cog. Functional activity performance has been previously assessed using the Assessment of Living Skills and Resources Revision 2 (ALSAR), a validated index where higher numerical scores associate with increasing dependence in completing IADL and risk for needing a more structured living environment, nursing home placement, hospitalization, and death. We assessed ALSAR with patient self-report and proxy-report (range 0-44 lower scores equate to better performance) and calculated the absolute difference (ALSAR difference, lower scores show stronger agreement between patients and proxies). Patients' Montreal Cognitive Assessment (MoCA) scores, among which scores less than 26 suggest clinically significant cognitive impairment, were correlated with ALSAR difference.ResultsMedian patient age was 74 years. Forty-two percent were female among our sample of 30 hospitalized HF patients with cognitive impairment. Median patient ALSAR score of 4 (range 2-7) differed from median proxy ALSAR score of 7 (range 4-12) (p<0.01). Lower MoCA correlated with higher ALSAR difference (r=-0.58, p<0.01).ConclusionsAssessing ALSAR difference in clinical practice is feasible and it correlates to MoCA score in hospitalized HF patients with cognitive impairment, consistent with prior work. These results support the notion that proxy-input of patient IADL assessment could improve patient needs detection among HF patients with cognitive impairment. This information may enhance risk assessment, disease management and discharge planning when targeting and proactively involving proxies. Prospective studies should evaluate this novel metric and its association with patient-centered outcomes.

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Dataset Information

Self- vs proxy-reported mobility using the mobility assessment tool-short form in elderly preoperative patients.

Background

Methods

Results

Conclusion

Publications

Self- vs proxy-reported mobility using the mobility assessment tool-short form in elderly preoperative patients.

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