Assessment Strategies for the Older Adult
Assessment Strategies for the Older Adult
This domain tests safe, reliable measurement: screening first, then baseline function, then reassessment. The exam favors practical field tests and clear referral triggers over maximal lab testing.
Core rules
- Screen with PAR-Q+, medical history, medications, fall history, pain, and goals before testing.
- Measure resting HR and BP when appropriate; use RPE and talk test during effort.
- Use the Senior Fitness Test battery: 30-second chair stand, 30-second arm curl, 6-minute walk or 2-minute step, chair sit-and-reach, back scratch, and 8-foot up-and-go.
- Add gait speed and Timed Up and Go: gait speed <0.8 m/s and TUG ≥12 seconds suggest elevated fall risk and need for targeted balance work.
- Standardize instructions, seat height, and rest intervals; test the more affected side first for unilateral tasks.
- Reassess every 4–8 weeks and after changes in health or medication.
Worked example
A 78-year-old completes the 8-foot up-and-go in 13 seconds and usual gait speed at 0.7 m/s. She reports one fall in six months. You do not label her “unsteady” as a diagnosis; you document results, prioritize balance and lower-body strength, and recommend a clinician review for falls. Reassessment in 6 weeks uses the same tests and conditions.
Traps
Maximal testing, Valsalva, testing during acute illness, changing test protocols between sessions, and ignoring medications that affect balance or heart rate. Do not use a single test to declare fall risk.