Instruments to evaluate mobility capacity of older adults during
hospitalization: a systematic review.
aged, mobility limitation, hospitalization, validity of testes, reproducibility of tests.
Independent mobility is a key factor in predicting morbidity and determining
hospital discharge readiness for older patients. The main objective of this study was to
identify and appraise relevant mobility instruments for hospitalized geriatric patients based on
the definition of mobility of the International Classification of Functioning (ICF). A
systematic review was performed in two consecutive steps. Step 1 identified mobility
measurement instruments used to assess patients 60 years of age and over hospitalized in
acute care or intensive geriatric rehabilitation unit. The aim of the instrument, coverage of
mobility construct, applicability (format, training required, administration time and use of
assistive devices) were extracted. For each included instrument, Step 2 identified and
appraised articles reporting about their measurement properties. The Consensus-based
Standards for the selection of health status Measurement Instruments (COSMIN) were used
by two independent reviewers to critically appraise and compare the measurement properties.
Step 1 resulted in 6350 articles, of which 28 articles reported about 17 different instruments.
Step 2 retained 11 instruments with 70 articles reporting about their measurement properties
in various settings. Our results showed that 3 instruments (DEMMI, SPPB and Tinetti scale)
had the most extensive and robust measurement properties. From those, DEMMI (judgmentbased)
and SPPB (performance-based) covered the mobility construct more broadly and both
are applicable for hospitalized older adults. Conclusion DEMMI and SPPB present the best
balance between mobility coverage, measurement properties and applicability to acute care or
intensive geriatric rehabilitation unit. We recommend a combination of measures (judgment
and performance-based) to best assess mobility in hospitalized older adults.