Journal of health research in community

Introduction
Population aging is a global phenomenon, and the United Nations indicates that the number of individuals aged 60 years and older is expected to exceed 2 billion by 2050. This rapid demographic transition heightens the need for comprehensive health assessment in older adults to promote healthy aging, enable early detection of functional decline, and prevent disability. The World Health Organization emphasizes maintaining functional ability across physical, cognitive, social, and emotional domains, along with subjective well-being, as central to quality of life in later life. 
Five domains are widely recognized as particularly important: (1) physical activity (bodily movements that result in energy expenditure), (2) physical functioning (the capacity to perform daily tasks, including mobility, balance, strength, and endurance), (3) social functioning (interpersonal relationships, participation, support networks, and the prevention of isolation), (4) cognitive-emotional functioning (memory, executive function, attention, mood, anxiety, and depressive symptoms), and (5) well-being (psychological, social, and overall life satisfaction). Despite their importance, available assessment tools remain heterogeneous, are often limited to single domains, and frequently demonstrate inconsistent psychometric reporting. Multidimensional instruments that integrate multiple domains remain relatively uncommon. This fragmentation limits standardized assessment, comparability across studies, and the translation of evidence into clinical practice and policymaking. 
Accordingly, this scoping review aimed to systematically identify and classify validated quantitative health assessment tools used in older adult populations (typically defined as individuals aged ≥60 years) across these five core domains. 

Methods
This scoping review was conducted in accordance with the Joanna Briggs Institute guidance and the Arksey and O’Malley framework, and its reporting complied with the PRISMA extension for Scoping Reviews (PRISMA-ScR). A systematic literature search was performed in Scopus, Web of Science , PubMed, IranDoc, and Magiran for studies published between January 1991 and January 2025. Search strategies combined terms related to older adults, assessment instruments, and the five health domains using Boolean operators. Inclusion criteria comprised peer-reviewed English- or Persian-language articles reporting the development, psychometric evaluation, or application of quantitative assessment tools in older adult populations. Reviews, editorials, conference abstracts, study protocols, grey literature, and qualitative or non-quantitative studies were excluded to ensure the availability and quality of psychometric information. Following duplicate removal, title and abstract screening, and full-text review, 72 eligible studies were included. Data extraction captured the instrument name, target domain(s), number of items, administration format (self-report or performance-based), reported psychometric properties (e.g., reliability and validity), and characteristics of the validation samples. 

Results
A total of 72 distinct assessment tools were identified across the five domains. Cognitive and emotional functioning was the most frequently assessed domain (26 instruments), including the Montreal Cognitive Assessment (MoCA), the Clock Drawing Test, Hospital Anxiety and Depression Scale (HADS), and the Geriatric Anxiety Inventory. These instruments generally demonstrated reliability, with Cronbach’s alpha or ICC values ranging from 0.74 to 0.98 across diverse populations, including healthy older adults and those with mild cognitive impairment, dementia, or Parkinson’s disease. 
Physical functioning was assessed using 22 tools, predominantly performance-based measures, including the Timed Up and Go (TUG) test, the Short Physical Performance Battery (SPPB), the Berg Balance Scale, the 6-minute walk test, and the 30-second chair stand test . These instruments were commonly reported to be reliable, with ICC values ranging from 0.64 to 0.97, and were widely applied in both community and clinical settings, particularly for fall-risk assessment. Well-being was assessed using 11 tools, such as the Ryff Psychological Well-Being Scales, the WHOQOL-OLD, and the Warwick–Edinburgh Mental Well-Being Scale. These instruments were primarily self-report measures encompassing psychological, social, and, in some cases, spiritual dimensions, with reported reliability values commonly exceeding 0.70.
Physical activity was the least represented domain, comprising 7 mainly self-report instruments (for example, CHAMPS, IPAQ, PASE, and RAPA), with reported test-retest reliability values ranging from 0.60 to 0.96. Validation was largely limited to healthy, community-dwelling older adults. Across domains, reliability indices were reported most frequently, whereas evidence regarding construct and criterion validity, responsiveness, and cross-cultural adaptation was inconsistently and often incompletely described. Assessment tools integrating multiple domains within a single instrument were rare. Social functioning was assessed using 6 instruments, including the Lubben Social Network Scale and the Perceived Social Isolation Scale, reflecting some conceptual overlap with functional domains. Reliability coefficients ranging from 0.63 to 0.97, with notable cultural variability in definitions and operationalization. 
Of the 72 included studies, approximately one quarter reported some form of construct, criterion, or content validity; the remaining studies provided only reliability indices. 

Conclusion
This scoping review provides a relatively comprehensive mapping of quantitative health assessment tools available for older adults across five essential health domains. Overall, a greater number of instruments and stronger psychometric evidence were observed for physical functioning and cognitive-emotional assessments, while notable gaps persist in the availability of culturally adapted instruments, particularly Persian-language versions; integrated, multidimensional tools; and comprehensive validity reporting. These findings offer practical guidance for researchers, clinicians, and policymakers in selecting appropriate assessment instruments and highlight priorities for future research, including cross-cultural validation, the development of unified multi-domain measures, and standardized psychometric reporting to support comprehensive geriatric assessment and healthy aging policies. 

Ethical Considerations
Compliance with ethical guidelines
This is a scoping review and does not involve human participants; therefore, ethical approval was not required.

Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Authors contributions
All authors contributed equally to the conception and design of the study, data collection and analysis, interpretation of the results, and drafting of the manuscript. Each author approved the final version of the manuscript for submission.

Conflicts of interest
The authors declared no conflict of interest.

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