Self- vs proxy-reported mobility using the mobility assessment tool-short form in elderly preoperative patients

Background

Mobility is fundamental to maintenance of an independent lifestyle and can predict clinical outcomes after health events among older individuals. However, certain clinical situations do not accommodate physical or self-assessments. This investigation examines whether proxy-reported assessments of function using the Mobility Assessment Tool-short (MAT-sf) form is a reliable alternative.

Methods

Sixty-six older persons (≥ age 70) and their proxies were enrolled. Proxies rated patients’ mobility using the MAT-sf as did the patients.

Results

The mean age of patients was 78.4 yr. (±6.2); 44% were female and 86% were white. Spouses made up 55% of the proxies, while 39% were children/in-laws. The correlation coefficient between patient and proxy MAT-sf scores was 0.81 (p?<?0.01); a comparison of the slope of the regression line relating patient- and proxy-reported MAT-sf to a line of identity showed disagreement (p?<?0.01), with proxy reports underreporting patient responses by 8.3% in lower mobility patients. The intra-class correlation characterizing agreement between repeated proxy reports 0.81.

Conclusion

Proxy reports of mobility in older patients have good reliability. However, in patients with poor mobility, the proxies tend to report a lower mobility than the patients.

     

Hormone profiles,body mass index and aging male symptoms: results of the Androx Vienna Municipality study

Aging in the male is accompanied by steroid hormonal decline, and men may develop symptoms associated with hypogonadism. Increased awareness of ‘andropause’ in recent years has led to greater demand for hormonal assessments, resulting in a rising burden for health economics. We conducted a cross-sectional study to define men at risk for hypogonadism, in whom further hormonal investigation should be performed.

We examined 664 blue-collar workers aged 40–60 years at their workplace and determined hormonal status and body mass index (BMI). Men with an abnormal urogenital status and those on medication that might affect endocrine status were excluded from the study. All participants completed the validated Aging Male Symptom (AMS) questionnaire and obtained scores for psychological symptoms, somatovegetative symptoms, and sexual symptoms.

Multiple logistic regression analyses revealed a significantly increased risk (represented by the odds ratio) of psychological symptoms for men with low levels of testosterone and/or bioavailable testosterone (BAT). Increased BMI as well as low testosterone levels and/or low BAT levels raised the risk of somatovegetative symptoms. Each decrease of BAT by 1?ng/ml caused an approximately 1.8-fold increase of the risk (odds ratio?=?1.832, p?=?0.005). Additional independent risk factors were increased age and low luteinizing hormone (LH) level. Men aged 55 years with BMI >?28?kg/m² and with somatovegetative symptoms and moderate or severe psychological symptoms had a 7.2-fold increase in the risk of a BAT level <?1.5?ng/ml compared to men without these risk factors (p <?0.001). Sensitivity and specificity were 75% and 71%, respectively.

The AMS score combined with age and BMI provides an easy and convenient method to identify men with probable androgen deficiency who require hormonal assessment.     

Development of a lateral mobility task to identify individuals at risk for mobility disability and functional decline

Lateral mobility is integral to many activities of daily living involving transfer from one position to another. The objective of this study was to develop and evaluate the validity and test-retest reliability of a lateral-mobility (LATMOB) task for older adults. Measurements of lateral mobility, balance, and strength and self-reported and performance-based physical functioning were obtained in 63 women and 77 men > or = 50 years of age. The LATMOB task was significantly correlated with age, knee-extensor strength, grip strength, functional reach, and one-leg-stance time. Test-retest reliability of the task was excellent. The LATMOB task was highly correlated with the car task. Balance was significantly correlated with time to get into and out of a car and performance on the LATMOB task. The LATMOB task was significantly correlated with the Short Physical Performance Battery score. The LATMOB task is valid and reliable, but additional work is needed to assess its sensitivity to change and predictive validity.