A head-to-head comparison of the de Morton Mobility Index (DEMMI) and Elderly Mobility Scale (EMS) in an older acute medical population

Abstract

Purpose: To compare the clinimetric properties of the de Morton Mobility Index (DEMMI®) and the Elderly Mobility Scale (EMS). Method: A head-to-head comparison of the EMS and DEMMI® with 120 consecutive older acute medical patients. The DEMMI® and EMS were administered within 48 h of hospital admission and discharge. Results: At admission, 6% and 15% of participants scored the lowest scale score for the DEMMI® and EMS, respectively. For the DEMMI®, 17% of participants scored within the minimal detectable change of the lowest scale score compared to 20% for the EMS at admission. At hospital discharge, DEMMI® scores were normally distributed and the EMS had a ceiling effect. Similar evidence of convergent, discriminant and known groups validity were obtained for the DEMMI® and EMS. There was no significant difference in responsiveness to change between the DEMMI® and EMS. The EMS was significantly quicker to administer compared to the DEMMI®. Conclusion: The DEMMI® and EMS are both valid measures of mobility for older acute medical patients. The DEMMI® has a broader scale width than the EMS with interval level measurement and therefore provides a more accurate method for measuring and monitoring changes in mobility for older acute medical patients.

Implications for Rehabilitation

• Mobility of older acute medical patients.

• Hospitalised older acute medical patients are at “high risk” of mobility decline.

• Accurate measurement of mobility is essential for preventing and treating mobility decline.

• Many existing mobility measures have significant measurement limitations.

• The DEMMI® is a more accurate measure of mobility than the EMS in an older acute medical population.

• de Morton Mobility Index
• Elderly mobility Scale
• hospital
• measurement
• mobility
• older persons
• physical ability

Acknowledgements

The authors would like to acknowledge the support of the physiotherapy department at Flinders Medical Centre, South Australia. This research was presented by Mr Michael O’Brien at the Australian Physiotherapy Association National Gerontology Conference, Sydney, Australia, October 2009.

Declaration of interest

This research was funded by the National Health and Medical Research Council of Australia (NHMRC Post-Doctoral Fellowship for Dr. Natalie de Morton, Grant no. 519555).