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Defining and Measuring Preclinical Mobility Limitation: An Expert Consensus Exercise Informed by a Scoping Review
Julie Richardson1,2, Marla Beauchamp1, Jonathan Bean3,4
1School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.
Summary
Preclinical mobility limitation (PCML) is an early functional change in older adults, identified by modified mobility tasks without perceived disability. Standardized measurement of PCML is crucial for timely interventions to prevent further decline.
Area of Science:
- Gerontology
- Rehabilitation Science
- Public Health
Background:
- Early functional changes in older adults, termed preclinical disability (PCD), are understudied.
- PCD presents a critical window for intervention to prevent further functional decline.
- A standardized research approach for PCD, including definitions and measurements, is needed.
Purpose of the Study:
- To establish a consensus definition and measurement approach for preclinical disability in older adults.
- To identify the optimal terminology and assessment methods for early functional changes.
- To inform future research and clinical practice for proactive health interventions.
Main Methods:
- A two-stage process involving a scoping review of existing literature.
- A web-enabled consensus meeting with content experts to refine findings.
- Utilizing expert consensus to define and operationalize preclinical mobility limitation.
Main Results:
- The term preclinical mobility limitation (PCML) is supported for early functional changes.
- PCML should be measured using patient-reported and performance-based assessments.
- Key mobility tasks for PCML assessment include walking, stairs, and transfers, with modified frequency or method.
Conclusions:
- PCML accurately describes functional changes preceding overt disability.
- Current standardized assessments for PCML are limited.
- Further research on the reliability, validity, and responsiveness of PCML outcome measures is essential.
