title: Self-Reported Versus Performance-Based Assessments of a Simple Mobility Task Among Older Adults in the Emergency Department.
abstract: OBJECTIVE
  Accurate information about the mobility of independently living older adults is essential in determining whether they may be safely discharged home from the emergency department (ED). We assess the accuracy of self-reported ability to complete a simple mobility task among older ED patients.
  
  
  METHODS
  This was a cross-sectional study of cognitively intact patients aged 65 years and older who were neither nursing home residents nor critically ill, conducted in 2 academic EDs. Consenting participants were asked whether they could get out of bed, walk 10 feet, turn around, and get back in bed without assistance, and if not, whether they could perform this task with a cane, walker, or assistance. Each participant was then asked to perform the task and was provided with a mobility device or assistance as needed.
  
  
  RESULTS
  Of 272 patients who met eligibility criteria and answered the physical task question, 161 (59%) said they could do the task unassisted, 45 (17%) said they could do it with a cane or walker, 21 (8%) said they could do it with assistance, and 45 (17%) said they would be unable to do it even with assistance. Among those who said they could do the task either with or without assistance and who were subsequently willing to attempt the task (N=172), discrepancies between self-reported ability and actual performance were common. Of those who said they could perform the task without assistance, 12% required some assistance or were unable to complete the task. Of those who said they could perform the task with a cane or walker, 48% required either assistance or were unable to perform the task. Of those who said they could perform the task with assistance, 24% were unable to perform the task even with assistance.
  
  
  CONCLUSIONS
  In this sample of older adults receiving care in the ED, the accuracy of their self-reported ability to perform a simple mobility task was poor, particularly for those who reported some need for assistance. For older adults being considered for discharge who report a need for assistance with mobility, direct observation of the patient's mobility by a member of the emergency care team should be considered.
authors.affiliation: School of Medicine, University of North Carolina, Chapel Hill, NC.
authors.forename: Kyle M
authors.initials: KM
authors.lastname: Roedersheimer
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
authors.forename: Greg F
authors.initials: GF
authors.lastname: Pereira
authors.affiliation: Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, NJ.
authors.forename: Christopher W
authors.initials: CW
authors.lastname: Jones
authors.affiliation: Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, NJ.
authors.forename: Valerie A
authors.initials: VA
authors.lastname: Braz
authors.affiliation: Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.
authors.forename: Sowmya A
authors.initials: SA
authors.lastname: Mangipudi
authors.affiliation: Department of Emergency Medicine, University of North Carolina, Chapel Hill, NC. Electronic address: tplattsm@med.unc.edu.
authors.forename: Timothy F
authors.initials: TF
authors.lastname: Platts-Mills
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D004636:Emergency Service, Hospital; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D057566:Self Report; D012656:Self-Help Devices / Q000706:statistics & numerical data; D014481:United States