WHAT IS MSAD
The Mobility Staging Tool for Advanced Dementia (MSAD) was developed at Toronto Rehabilitation Institute – University Health Network, Toronto, Canada for staging severity of mobility impairment in individuals with dementia. The information included in the MSAD tool was derived from a comprehensive review of mobility assessment tools, and a consensus exercise involving academic and clinical experts in mobility and dementia who identified key factors that impact on mobility in people with dementia (Van Ooteghem et al 2018, 2019).
HOW IT WORKS
The MSAD tool is designed to be largely observational, to capture how someone is moving naturally in their environment. It helps to spend some time observing the individual as they mobilize. These observations may be supplemented with clinical knowledge of the individual, for example, with information about his/her fall history.
MOBILITY IMPAIRMENT
Part 1 of the tool is designed to categorize the functional ability of the individual with dementia into one of four levels, by examining two facets of mobility – the extent to which the individual requires assistance with walking and postural transitions (Independence in Mobility), and the individual’s ability to move easily through different environments or settings (Mobility Performance).
MODIFIERS
Part 2 of the staging tool considers factors that modify or impact functional mobility impairment. It has been designed to account for the many different ways that mobility is impaired in dementia. For example, an individual could be highly independent, yet very impulsive; or they may be very limited in their mobility-related functional capacity, but be highly restless.
GLOBAL MOBILITY RATING
The global mobility rating score or mobility stage is represented by the numeric score obtained in Part 1 + the alpha-score obtained in Part 2. If an individual moves primarily by wheelchair, this rating is appended with a “W”.
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