Good afternoon. Depending on what specifically you are measuring, there are some very nice instruments that have been validated for use with the geriatric patient. I have used the following in a recently completed geriatric study. The POMA is a little long but you get a lot of information from it. In my experience the Berg is not sensitive enough to use with community dwelling adults that are fairly ambulatory.

The Berg Balance Scale (BBS) is a functional test that assesses a patient’s ability to maintain balance, either statically or while performing various functional movements, and is considered to be the gold standard among functional balance tests. The maximum score of 56 denotes good balance and a score of 45 is required for safe independent living. The test has an interrater reliability intraclass correlation coefficients of 0.98; intrarater reliability intraclass correlation coefficient 0.99  

The Timed Get up and Go (TGUG) is a sensitive and specific timed functional gait and balance test for identifying community dwelling and frail adults who are at risk for falls. It involves the patient getting up from a chair without using their arms, walking 3 meters, turning and walking back to the chair and sitting down. Mobility impairments are directly related to the time needed to complete the test. The mean (95% confidence interval) TUG time for individuals at least 60 years of age is 9.4 (8.9 - 9.9) seconds [44]. Individuals whose TUG time exceeds this may warrant interventions directed at improving their strength, balance, and/or mobility.

The Performance-oriented mobility assessment (POMA), also known as the Tinetti balance and gait scale, is one of the most widely used assessments of balance, gait, and falls risk in older adults. The POMA includes an evaluation of balance under static and dynamic conditions and an evaluation of gait characteristics. A score of less than 19 out of 28 has a sensitivity of 68% and a specificity of 88% for predicting an individual who will have two or more falls.

From: Enix DE, et al. Methodology and Demographics of a Single Blinded, Randomized Controlled Trial of Chiropractic Compared to Physical Therapy for Balance Impairments in Community Dwelling Geriatric Patients with or without Low Back Pain. Chiropr Man Ther. 2014, 22:31. 

amer dizziness diagnostic scale (adds) for patients with vestibular disorder function assessment among elderly .This scale is of benefit to both clinicians and patients, because it avoids unwanted and expensive diagnostic procedures and saves consider- able time.Diagnostic Scale (ADDS), usually used to evaluate and differentially diagnose vestibular disorder function assessment among elderly and the ADDS strongly correlated with “true-positive” and “true-negative” responses for determining the probability of a vestibular disorder (r =0.95). A stepwise linear regression was conducted and the results indicate that the ADDS was a significant predictor of “true-positive” and “true-negative” responses in vestibular disorders (R2 =0.90). Approximately 90% of the variability in the vestibular gold standard test was explained by its relationship to the ADDS. Moreover, the ADDS was found to have a sensitivity of 96% and a speci- ficity ,the Amer Dizziness Diagnostic Scale has high sensitivity and specificity and that it can be used as a method of differential diagnosis for patients with vestibular function assessment.   

The Short Physical Performance battery (SPPB) is validated in several populations, reliable, fast and manageable.

The Short Physical performance battery of course, and the gait speed can be used as screening test alone.

Good morning. The Pool Activity Level (PAL) Instrument is a reliable and valid  measure of cognitive performance for occupational performance of functional activities. (Wenborn, Jennifer, Challis, David, Pool, Jackie, Burgess,

Jane, Elliott, Nicola and Orrell, Martin (2008) 'Assessing the validity and reliability of

the Pool Activity Level (PAL) Checklist for use with older people with dementia', Aging & Mental Health, 12:2, 202 - 211) 

It is currently being used to guide Therapists in the application of Cognitive Rehabilitation in a major NIHR funded programme which you can find more about by visiting the University web site: http://great.bangor.ac.uk/

This paper will give you the study background and protocol: Clare et al.: Goal-oriented cognitive rehabilitation in early-stage dementia: study protocol for a multi-centre single-blind randomised controlled trial (GREAT). Trials 2013 14:152. You can access this paper on the ResearchGate site

You received already great responses. It's true, it depends on whom and what you want to measure.  Here are a few links & references that may help:

http://cirrie.buffalo.edu/encyclopedia/en/article/44/

http://www.rehabmeasures.org/Lists/RehabMeasures/DispForm.aspx?ID=889

http://emedicine.medscape.com/article/317865-overview

Surg Clin North Am. 2015 Feb;95(1):173-90. doi: 10.1016/j.suc.2014.09.004. Epub 2014 Oct 18. Rehabilitation of the geriatric surgical patient: predicting needs and optimizing outcomes. Biffl WL1, Biffl SE2.

Clinical characteristics and functional assessment of elderly patients with cancer. Sekine I. Rinsho Ketsueki. 2014 May;55(5):518-25. Review. PMID: 24881916 Clin Interv Aging. 2013;8:201-11. doi: 0.2147/CIA.S32405.

Assessment scales in stroke: clinimetric and clinical considerations. Harrison JK1, McArthur KS, Quinn TJ. Clin Interv Aging. 2013;8:201-11. doi: 10.2147/CIA.S32405.

J Clin Epidemiol. 2013 Jun;66(6):619-32. doi: 10.1016/j.jclinepi.2012.12.003. New technology-based functional assessment tools should avoid the weaknesses and proliferation of manual functional assessments. Lowe SA1, Rodríguez-Molinero A, Glynn L, Breen PP, Baker PM, Sanford J, Jones BD, Ólaighin G.

Age Ageing. 2012 Nov;41(6):712-21. doi: 10.1093/ageing/afs099. Performance-based physical function in older community-dwelling persons: a systematic review of instruments.

Freiberger E1, de Vreede P, Schoene D, Rydwik E, Mueller V, Frändin K, Hopman-Rock M.

BMJ. 2011 Aug 22;343:d4681. doi: 10.1136/bmj.d4681. Functional assessment in older people.

Quinn TJ1, McArthur K, Ellis G, Stott DJ.

I have learned a lot about al the posting, 

Nothing to add, except perhaps that functional assessment obviously should include some cognitive component as well.

I am awaiting for an interdisciplinary team of geriatricians, neuropsychologists, individuals with frailty and dementia to come together with technology experts and design and evaluate a some what more objective method of measuring functionality in elderly.

Any takers? 

thanks

The following cognitive tests are frequently used in older adult populations:

• MMSE
• Trail Making Test
• Clock Drawing Test
• Stroop Color-Word Test

As pointed out, it depends who are what the functional asessment is wanting to tell you. The Lawton instrument of daily living is often recommended for older people in the community or perhaps returning to the comunity following hospitalisation. Functional Independence measure (FIM) is often used but there are limits to its usefulness in geriatrics as those with cognitive impairment and/or frailty make minimal gains over time an really there are often environmental and social supports that compensate and may be the difference between gettng home or requiring care. Seems better for rehabilitation patients so will need to consider what you mean by geraitric rehabilitation as there can be significant overlap between the care types. 

There are several and since none of them is perfect anyone of them can indicate

an "on the spot " score of function. Important is to look for dynamics.

The concept of  " frailty ' is dificult to consider since there is still no agreement about its definition and its use. It seems more an adjective than a clinical entity.

I think the answer mainly depends of your objectives and goals. For example, if you want to screen patients for frailty, the 6 meters walking test is one of the most useful. If it is for waking disorders in general, the seat test is very interesting. For screening fallers, I use the one leg balance test.

Hi Manoj, I have used the Frailty Wheel by SEEK.  Frailty is a relative term and often misused in gerontology.  The Frailty Wheel provides quant measures that I find useful. Here is an article on this topic:

Corapi, K.M., McGee, H., & Barker, M. (2006).  Screening for frailty among seniors in clinical practice.  Nature Reviews Rheumatology, 2.  476-480.  doi: 10.1038/ncprheum0288. 

Info about Frailty Wheel by SEEK:

http://www.kpchr.org/research/public/seek/seek.aspx?pageid=196

Dear Friends - as i mentioned earlier there are several functional assessment tools.

The classical and the best validated are Katz and Barthel. But if you Manoj concentrate on rehabilitation of elderly the best is FIM - Functional Independence Meassure ,

Dear Colleagues,

also agree depedende sample of our research, we are studying sarcopenia and recommended by EWGSOP are:

1 testing battery SPPB

2- Gait speed

3- Test Timed uo and Go

However to practice outpatient clinic we are using for functional screening

Katz and Lawton

Thanks

You should exactly the following items:

  Which function do you want to check? Physical? Mental, cognitive? Social?

If your goal physical performance. There are many tests to assess this area. Do you want to check the overall performance or specific areas such as balance you consider?

These tests generally can be divided into two groups.

Assessment by observation: Sppb, Berg Balance Scale

Self-reported assessment by: Lawton, Barthel index

  The exact target you can choose the kind of tools do help a lot.