Assessing physical and cognitive function of older adults in continuing care retirement communities: who are we recruiting?

PURPOSE: In partnership with six Continuing Care Retirement Communities (CCRCs), the current study focused on the feasibility of recruiting a representative sample of residents and then assessing their functional health. MATERIAL AND METHODS: With our guidance, each of the six CCRCs recruited a volunteer (V-Group) and random (R-Group) sample of independent living residents. We provided face-to-face training and ongoing remote electronic support to the CCRC staff on the testing battery and the Web-based data entry system. The testing battery was consisted of demographic, physical function, and psychosocial assessments. RESULTS: After training, CCRC staff were receptive to the study goals and successfully used the data entry Website. In the V-Group (N=189), 76% were already participating in CCRC wellness programs. We attempted to recruit a random, unbiased (R-Group) sample of 20% (n=105) of eligible residents; however, only 30 consented to be tested and 70% of this group (21/30) were also already participating in a wellness program. Mean age of all participants was 82.9 years. The V-Group had a higher Short Physical Performance Battery (SPPB) total score (least squares mean [SE], 9.4 [0.2] vs 8.2 [0.4], p=0.014) and SPPB gait speed component score (3.5 [0.1] vs 3.0 [0.2], p=0.007) and spent more time doing moderate-to-vigorous physical activity (300 [21] vs 163 [49] min/week, p=0.013) compared to the R-Group. IMPLICATIONS: While it is feasible to recruit, assess and transmit data on residents' functional health in partnership with CCRCs, population validity was severely compromised. Attention needs to be given to the development of more effective methods to recruit less interested residents.

The Virtual Short Physical Performance Battery.

BACKGROUND: Performance-based and self-report instruments of physical function are frequently used and provide complementary information. Identifying older adults with a mismatch between actual and perceived function has utility in clinical settings and in the design of interventions. Using novel, video-animated technology, the objective of this study was to develop a self-report measure that parallels the domains of objective physical function assessed by the Short Physical Performance Battery (SPPB)-the virtual SPPB (vSPPB). METHODS: The SPPB, vSPPB, the self-report Pepper Assessment Tool for Disability, the Mobility Assessment Tool-short form, and a 400-m walk test were administered to 110 older adults (mean age = 80.6±5.2 years). One-week test-retest reliability of the vSPPB was examined in 30 participants. RESULTS: The total SPPB (mean [±SD] = 7.7±2.8) and vSPPB (7.7±3.2) scores were virtually identical, yet moderately correlated (r = .601, p < .05). The component scores of the SPPB and vSPPB were also moderately correlated (all p values <.01). The vSPPB (intraclass correlation = .963, p < .05) was reliable; however, individuals with the lowest function overestimated their overall lower extremity function while participants of all functional levels overestimated their ability on chair stands, but accurately perceived their usual gait speed. CONCLUSION: In spite of the similarity between the SPPB and vSPPB, the moderate strength of the association between the two suggests that they offer unique perspectives on an older adult's physical function.