Researchers Identify and Classify Tools for Assessing Older Adults' Health

Advances in medical science and improvements in public health services over recent decades have led to a steady increase in life expectancy worldwide. Consequently, the population aged 60 and older is growing at an unprecedented rate. According to international projections, this age group is expected to exceed two billion people by 2050. This demographic shift poses significant challenges to healthcare systems, social structures and national economies, particularly in developing countries.

Against this backdrop, the concept of healthy aging has become increasingly important. It involves maintaining individual capabilities, independence in daily activities and a satisfactory quality of life in older age. Achieving this goal requires a thorough understanding and continuous monitoring of the various dimensions of older adults' health.

Healthy aging is a multidimensional concept encompassing physical activity and physical functioning, social relationships and participation, cognitive abilities such as memory and thinking, emotional well-being, including psychological stability and freedom from anxiety and depression, and overall life satisfaction.

Despite the importance of accurately assessing these dimensions to prevent disability, muscle loss or sarcopenia, and neurological disorders such as dementia, a wide range of assessment tools is currently available. Selecting the most appropriate instruments has therefore become a major challenge for healthcare professionals and researchers. The lack of a comprehensive overview can lead to the use of unsuitable questionnaires, difficulties in comparing research findings and, ultimately, inadequate planning of elderly care services.

To address this issue, Razieh Taheri and two academic colleagues from the Department of Sports Rehabilitation at Bu-Ali Sina University's Faculty of Sport Sciences conducted a study to identify, review and classify tools and tests used to assess the health of older adults, providing a clearer overview of the scientific instruments available in this field.

The researchers employed a scoping review methodology, a systematic approach designed to map the breadth of existing knowledge and identify key dimensions of a research topic. They conducted systematic searches across major international and Iranian databases, including Scopus, Web of Science, PubMed, IranDoc and Magiran. The review covered studies published in Persian and English between 1991 and January 2025 that assessed the health of adults aged 60 and older. Data were independently extracted and analyzed by two researchers.

Following an assessment of 72 eligible studies, the findings revealed that the largest number of identified assessment instruments focused on cognitive and emotional functioning, with 26 tools. Physical functioning ranked second, with 22 instruments. The review also identified 11 tools for assessing well-being, seven for physical activity and six for social functioning.

The study concluded that although numerous instruments are available for assessing older adults' health and most demonstrate acceptable measurement accuracy, several challenges remain. These include insufficient information on validity, inadequate cultural adaptation to local populations and a lack of clarity regarding their clinical applications. The researchers therefore emphasized the need for further studies to strengthen the scientific properties of these instruments and develop specialized questionnaires tailored to the diverse needs of older adults.

Further analysis showed that health assessment instruments for older adults generally fall into two categories: self-report questionnaires and performance-based tests. Questionnaires are widely used because they are easy to administer, relatively inexpensive and suitable for large populations. However, their results may be affected by memory problems or subjective judgments. Performance-based tests, by contrast, directly evaluate balance, muscle strength and mobility through practical tasks, providing objective measures of physical capabilities.

The findings also highlighted that social and psychological concepts are strongly influenced by cultural factors. Therefore, foreign questionnaires cannot be reliably applied to older Iranian populations without appropriate localization and cultural adaptation. Furthermore, most existing instruments assess only one or two dimensions of health, while comprehensive tools capable of evaluating all aspects of aging remain largely unavailable.

The research article reporting these findings has been published in the Journal of Community Health Research, affiliated with Mazandaran University of Medical Sciences, and is now available to researchers and professionals working in the field of aging.