(Open access funding provided by Semmelweis University)
Szakterületek:
Orvos- és egészségtudomány
In old age, decline in mobility has a significant impact on performing activities
of daily living, participating in society, and on quality of life. Mobility changes
should be measured and monitored using measures with appropriate psychometric properties.
The psychometrically sound de Morton Mobility Index (DEMMI) assesses a broad range
of mobility related activities. The aim of this study was to develop a valid and reliable,
cross-culturally adapted Hungarian version of the DEMMI scale (HU-DEMMI) among institutionalized
older people. Development of the HU-DEMMI was conducted using a cross-sectional study
design with an overall of 170 participants. Validity was tested via construct (established
by hypothesis testing) and structural validity (explored with structural equation
modeling (SEM)). Reliability was assessed using three measurement properties: internal
consistency (determined by Cronbach’s alpha), test-retest reliability (by intraclass
correlation coefficients (ICC)), and measurement error (standard error of measurement
(SEM), minimally detectable change (MDC), limits of agreement (LoA)). Linguistic and
cultural adaptation was realized successfully. As for construct validity, the HU-DEMMI
showed a strong correlation with mobility related measures and a weak correlation
with non-mobility measure. Significant differences in the DEMMI score were found across
groups being at various levels of assistive device use. Internal consistency by Cronbach’s
alpha was 0.906; the dimensionality testing revealed no violation of unidimensionality.
However, a three-dimensional structure uncovered a better fit. The inter- and intra-rater
ICC of DEMMI scores were 0.981 and 0.989, respectively. The SEM for inter-rater reliability
test was 2.924 and the MDC 90 was 6.803 points on the 100-point DEMMI scale. The 95%
LoA showed a mean inter-rater difference of 0.2115 (− 11.252; 11.675), while a mean
intra-rater difference of -1.0577 (− 9.809; 7.694). Four data points (7.69%) were
identified as outliers in both cases. Maintaining institutionalized older people’s
functional capacity and delaying its decline requires effective interventions. Valid
and reliable determination of mobility levels is necessary to address mobility decline
in a personalized way. The psychometrically robust HU-DEMMI scale developed in this
study would provide this and allow for future comparisons of Hungarian research results
with those of other countries and for contribution to international, multicenter research.
