Evaluating Physical, Functional, and Quality of Life Outcomes in Older Adults

Validated scales and tests were used to assess various client outcomes at baseline (T₀). The Phone-FITT scale [16 (link)] (frequency + duration FD summary score) was used to measure household and recreational activities, with higher total FD scores indicating greater participation in that category of physical activity. The KATZ Activities of Daily Living Index [17 (link)] was used to assess a client’s independence to perform six daily activities of living. A summative score ranged from 0–6, in which a score of 6 indicated full function, 4 indicated moderate impairment and ≤2 indicated severe functional impairment. The Iconographic Falls Efficacy Scale [18 (link)] was used to assess client’s fear of falling by using ten pictures to describe a range of activities and situations. A summative score ranged from 10–40 in which a score of 10–18 indicated low concern about falling and 19–40 indicated high concern about falling. The QoL-AD [19 (link)] has 13 items that measure quality of life in people with dementia. A summative score is in the range of 13–52, in which a higher score indicated a better quality of life. The functional mobility of clients was assessed using the Time-Up-and-Go test [20 ] at a maximal but safe speed, whereby a time ≥12 s indicated the person was at risk of falling. Lower limb functioning was evaluated using the Short Physical Performance Battery test [21 (link)] which consisted of balance tests (side-by-side stand, semi-tandem stand and tandem stand), a gait speed test (time to walk a 3-metre path, with the use of a walking aid if needed), and a chair-stand test (time to complete 5 chair stands). Each test category scored 0–4, whereby a higher score indicated better standing balance, higher gait speed and better lower limb strength, respectively. The summative score of all test categories (sum of balance test, gait speed test and chair stand test scores) ranged from 0–12, whereby a score of 12 indicated full function and <10 indicated one or more mobility limitation.
Client and/or carer rated client’s sleep quality in the past three months at baseline (T₀) on a 5-point Likert scale. A rating of “1” represented “very good” sleep quality, “3” represented “average” and “5” represented “very poor” sleep quality. Data on carer- and/or client-reported falls in the past month, whereby a fall was defined as “an event which results in a person coming to rest inadvertently on the ground or floor or other lower level” [22 ], and healthcare use in the past three months were also collected.