Performance-based physical function in older community-dwelling persons: a systematic review of instruments

Background: Identification of older persons at risk for the loss of independence, onset of (co)-morbidity or functional limitations through screening/assessment is of interest for the public health-care system. To date several different measurement instruments for overall physical function are frequently used in practice, but little information about their psychometric properties is available. Objectives and Methods: Our aim was to assess instruments with an overall score related to functional status and/or physical performance on content and psychometric properties. Electronic databases (Medline, EMBASE, AMED, Cochrane Library and CINAHL) were searched, using MeSH terms and relevant keywords. Studies, published in English, were included if their primary or secondary purpose was to evaluate the measurement properties of measurement instruments for overall physical function in community-dwelling older persons aged 60 years and older. Reliability, validity, responsiveness and practicability were evaluated, adhering to a specified protocol. Results: In total 78 articles describing 12 different functional assessment instruments were included and data extracted. Seven instruments, including their modified versions, were evaluated for reliability. Nine instruments, including their modified versions, were evaluated with regard to validity. Conclusion: In conclusion, the Short Physical Performance Battery can be recommended most highly in terms of validity, reliability and responsiveness, followed by the Physical Performance Test and Continuous Scale Physical Functional Performance.