A Pilot Study to Determine Baseline Performance of Well Older Adults on the Interactive Metronome Long Form Assessment

PURPOSE: Life expectancy has increased in the United States. In 2014, 14.5%, or one in seven, Americans were age 65 yr or older. By 2060, the elderly population is expected to double in size. Aging is associated with decline in motor and processing skills, which is exacerbated by physical inactivity leading to lower functional ability and quality of life and increased health care costs. The demographic shift with rising health costs has resulted in a transition toward a value-based system with changes in reimbursement. It requires clinicians to use evidence-based technology and interventions to maintain an individual’s functional independence. Using objective and direct measures and research to identify the factors associated with activity and function in older adults will stimulate interventions to facilitate independence.

IM is a treatment tool used to improve neurological functions of motor planning and sequencing including timing, processing speed, balance, and coordination. IM is used to assess or facilitate function and movement in a variety of ages and conditions. Normative data and research related to the performance of the elderly on the IM is lacking. Establishing benchmark performance data as a reference point for the well elderly on the IM is essential for determining whether IM can be an effective tool for assessment and intervention with the elderly. The purpose of this study was to establish benchmark performance data for the well elderly population on the IM Long Form Assessment (LFA).

DESIGN AND METHODS: A convenience sample of 95 well elderly individuals age 65 yr and older were recruited from four metropolitan area YMCAs. They participated in a one-time session completing 14 subtests of the IM LFA protocol. The IM LFA collects participants’ real-time feedback response in milliseconds (ms), which can then be compared statistically. A self-designed demographic questionnaire was used to screen participants for exclusion and determine factors that may influence participant performance.

RESULTS: Cronbach’s alpha indicated that the IM LFA’s 14 subtests have excellent internal consistency (Cronbach’s α = .931). Kruskal–Wallis H test showed a significant difference in performance scores among the three age groups, χ²(2) = 11.608, p = .003, with a mean rank performance score of 36.39 for ages 65–70, 53.08 for ages 71–76, and 57.67 for ages 77–93. Mann–Whitney U tests indicated participants ages 65–70 (n = 38) had lower performance scores compared with participants ages 71–76 (n = 24, p = .015) and ages 77–93 (n = 33, p = .002). This may indicate a decline in response time and processing speed with aging.

There were significant differences in three IM LFA subtests and total unadjusted score between the 65–70 and 71–76 groups. There were significant differences in six IM LFA subtests and the total unadjusted score between the 65–70 and 77–93 groups. There were no significant differences in performance between the 71–76 and 77–93 age groups, which may indicate a degree of stability in response time for these 14 subtests after the age of 71.

Physical activity level did not appear to have a significant effect on performance scores, although age does affect performance. This may indicate that regardless of physical activity level, there appears to be a gradual decline in response time with aging. Conversely, this may indicate that the participants’ performance results are consistent and representative of normal aging.

CONCLUSION: Results indicate a gradual decline in response time with aging, regardless of physical activity level. IM could be used as an assessment to determine the impact of aging on functional performance. Further research is warranted to determine the use of the IM as an intervention to improve or maintain response time.

References

Interactive Metronome. (2009). IM certification provider training manual. Sunrise, FL: Author.

Murtagh, E. M., Murphy, M. H., Murphy, N. M., Woods, C., Nevill, A. M., & Lane, A. (2015). Prevalence and correlates of physical inactivity in community-dwelling older adults in Ireland. PLoS ONE, 10(2), e0118293. https://doi.org/10.1371/journal.pone.0118293

U.S. Department of Health and Human Services. (2014). A profile of older Americans: 2014. Retrieved from http://www.aoa.acl.gov/Aging_Statistics/Profile/2014/docs/2014-Profile.pdf