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Background: A recent review of the literature reveals an absence of standardized measures to assess mobility in persons with
advanced dementia. Persons with moderate to severe dementia have significant difficulty adhering to instructions. The aim of
the study was to develop a standardized measure of gait and balance for use with persons with dementia. We chose to modify
the �Tinetti Assessment Tool for Balance and Gait� because many of the items are based on observation. Modification of test
items requires analysis of reliability prior to establishing validity.
Objective: To determine the inter-rater and test-retest reliability of �Tinetti Assessment Tool for Balance and Gait-Dementia�
Methods: Inter-rater reliability: Participants were observed and scored simultaneously by two raters familiar with the written
instructions (physiotherapy, occupational therapy or nursing staff). Test-retest reliability: The test was re-administered after
10 to 30 minutes.
Results: A total of n=20 participants were recruited and included. The mean age of participants was 75 with the majority being
female (n=11, 55%). All were diagnosed with dementia or cognitive impairment. Secondary diagnoses include heart disease,
diabetes and Parkinson�s disease. The mean cognitive assessment (SMMSE) score was 8.5/30 (n=12). Inter-rater reliability of
the total score was high (r=0.90) as was test-retest reliability (r=0.92).
Discussion: These results are comparable to established reliability of the original Tinetti tool (r>0.8). The results indicate that
the modified measure has sufficient reliability to commence validity testing. Developing a measure that assesses functional
changes in this population is important for determining the impact of mobilization and least restraint programs for people
with dementia in long term care. Further study will establish validity of the cut score for predicting falls risk.
Biography
Alison Douglas is affiliated with St Joseph’s Healthcare Hamiltonin the Senior Mental Health Behavioral Unit. She is also affiliated with McMaster University Department of Psychiatry and Behavioral Neurosciences and is the Editor-in-Chief of the journal Physical and Occupational Therapy in Geriatrics.