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Related Experiment Videos

Predicting elderly patients' mobility using fall history and physician assessment.

W A Hale1, M J Delaney, W C McGaghie

  • 1Family Practice Center, Moses H. Cone Family Practice Residency Program, Greensboro, NC 27401.

Family Medicine
|September 1, 1990
PubMed
Summary

Clinician assessment of mobility better predicts elderly patient performance on mobility tests than fall history. This allows targeted mobility testing for older adults at higher risk of poor outcomes.

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Area of Science:

  • Geriatrics
  • Clinical Assessment
  • Mobility Testing

Background:

  • Predicting functional decline in ambulatory elderly patients is crucial for timely interventions.
  • Fall history and clinician judgment are potential predictors of mobility impairment.

Purpose of the Study:

  • To evaluate the predictive accuracy of a patient's fall history and an office clinician's general assessment for identifying elderly individuals likely to perform poorly on mobility testing.

Main Methods:

  • A cohort of ambulatory patients aged 65+ undergoing routine visits completed a fall history questionnaire and mobility testing.
  • Attending physicians estimated patient mobility test scores post-visit.
  • Correlation and predictive values (sensitivity, specificity) were analyzed.

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Main Results:

  • 23% of patients reported falls, and 13.5% reported fall injuries in the prior year.
  • Both fall history and physician estimates correlated with measured mobility scores.
  • Physician estimates demonstrated high sensitivity (94.4%) and specificity (82.4%) for identifying poor mobility performance.

Conclusions:

  • Office clinician's general assessment of patient mobility is a clinically useful predictor of poor performance on objective mobility tests.
  • This assessment enables targeted application of mobility testing to at-risk elderly patients, optimizing clinical resources.