Geriatric Assessment: The Tools Every Praan Health Coach Uses

Functional assessment is the foundation of evidence-based senior healthcare. Before designing any exercise or nutrition program, a PHA coach conducts a systematic evaluation of the patient's current functional status — their "functional age" — using validated, standardised tools.

Why Standardised Assessment Matters

Without baseline assessment, progress cannot be measured. Without measurement, the effectiveness of an intervention cannot be evaluated. Standardised tools also allow comparison with population norms, identifying patients who are at high risk for adverse outcomes.

The Short Physical Performance Battery (SPPB)

The SPPB is one of the most widely used and validated tools in geriatric medicine. It consists of three tests:

1. Balance test: Standing with feet together, in semi-tandem, and in tandem position for 10 seconds each 2. Gait speed: Time to walk 4 metres at usual pace 3. Chair stand test: Time to stand from a chair 5 times without using arms

Each test is scored 0–4, giving a total score of 0–12. An SPPB score below 9 is associated with increased risk of disability, hospitalisation, and mortality. A score below 7 indicates high frailty risk.

Grip Strength

Grip strength — measured with a hand dynamometer — is one of the most powerful biomarkers of overall health in elderly adults. It predicts mortality, cardiovascular disease, cognitive decline, and disability more accurately than many traditional risk factors.

Normal grip strength values for elderly Indians: men >26 kg, women >18 kg. Values below these thresholds indicate sarcopenia and warrant targeted intervention.

The Timed Up and Go (TUG) Test

The TUG test measures the time taken to stand from a chair, walk 3 metres, turn, walk back, and sit down. It assesses mobility, balance, and fall risk. A TUG time above 12 seconds in elderly adults indicates increased fall risk; above 20 seconds indicates high fall risk requiring intensive intervention.

The 6-Minute Walk Test (6MWT)

The 6MWT measures the distance a patient can walk in 6 minutes at their own pace. It is a reliable indicator of cardiovascular fitness and functional exercise capacity. Normal values for elderly Indians: men 400–500m, women 350–450m.

Cognitive Screening

PHA coaches use the Mini-Cog (a 3-minute cognitive screening tool) to identify patients who may have cognitive impairment affecting their ability to follow exercise instructions or manage their own health. Patients who screen positive are referred for formal cognitive assessment.

Integrating Assessment into Practice

PHA coaches conduct a full assessment at baseline, then repeat key measures every 4–6 weeks to track progress and adjust the program. This data-driven approach — tracking functional age, not just chronological age — is what makes the PHA model genuinely evidence-based.