Accuracy of Timed Up and Go Test for screening risk of falls among community-dwelling elderly

Abstract

Objective: To determine the accuracy of the Timed Up and Go Test (TUGT) for screening the risk of falls among community-dwelling elderly individuals. Method: This is a prospective cohort study with a randomly by lots without reposition sample stratified by proportional partition in relation to gender involving 63 community-dwelling elderly individuals. Elderly individuals who reported having Parkinson´s disease, a history of transitory ischemic attack, stroke and with a Mini Mental State Exam lower than the expected for the education level, were on a wheelchair and that reported a single fall in the previous six months were excluded. The TUGT, a mobility test, was the measure of interested and the occurrence of falls was the outcome. The performance of basic activities of daily living (ADL) and instrumental activities of daily living (IADL) was determined through the Older American Resources and Services, and the sociodemographic and clinical data were determined through the use of additional questionnaires. Receiver Operating Characteristic Curves were used to analyze the sensitivity and specificity of the TUGT. Results: Elderly individuals who fell had greater difficulties in ADL and IADL (p<0.01) and a slower performance on the TUGT (p=0.02). No differences were found in socio-demographic and clinical characteristics between fallers and non-fallers. Considering the different sensitivity and specificity, the best predictive value for discriminating elderly individuals who fell was 12.47 seconds [(RR=3.2) 95%CI: 1.3-7.7]. Conclusions: The TUGT proved to be an accurate measure for screening the risk of falls among elderly individuals. Although different from that reported in the international literature, the 12.47 second cutoff point seems to be a better predictive value for Brazilian elderly individuals.Keywords: elderly; falls; TUGT; sensitivity; specificity; physical therapy. ResumoObjetivo: Determinar a acurácia do Timed Up and Go Test (TUGT) para rastrear risco de quedas em idosos da comunidade. Método: Tratase de um estudo de coorte prospectivo com amostra sorteada aleatoriamente, sem reposição e estratificada por partilha proporcional em relação ao sexo de 63 idosos da comunidade. Excluíram-se idosos com doença de Parkinson, ataque isquêmico transitório, acidente vascular encefálico, Miniexame do Estado Mental inferior ao considerado normal de acordo com a escolaridade, movimentação exclusiva por cadeira de rodas e relato de uma queda nos seis meses anteriores à primeira entrevista. O TUGT, um teste de mobilidade, foi a medida testada, e o desfecho, a ocorrência de queda. Mensuraram-se atividades básicas (ABVD) e instrumentais de vida diária (AIVD) pela Older American Resources and Services e dados sociodemográficos e clínicos por questionário complementar. Para analisar a sensibilidade e a especificidade do TUGT, utilizou-se a Receiver Operating Characteristic Curves (ROC). Resultados: Os idosos que caíram tinham maior dificuldade na execução de ABVD e AIVD (p<0,01) e desempenho mais lento no TUG...

Análise de métodos para detectar sarcopenia em idosas independentes da comunidade

“…In the same study, the percentage altered to more than 50% among individuals aged 80 years or more, demonstrating that the prevalence of sarcopenia is positively correlated with age. 17 In total, 70.27% of the participants did not exhibit sarcopenia in C1 and C2, corroborating the results of a recent study in the Japanese city of Kashiwa. In this study, independent elderly individuals (65+) were assessed for sarcopenia using the same diagnostic criteria as the present study: muscle mass, measured by BIA; muscle strength, measured by HGS; and physical performance, based on GS.…”

“…This could be attributed to a moderately active physical activity profile, based on previous results from this research group. 38 Conversely, the performance in the TUG test did not classify the participants as a risk for falls, given that they recorded mean values of less than 12.4 s. 17 It is possible to hypothesize that the performance in the TUG test was worse among the 60-69 years age group, when compared with the 70-79 years age group, due to the existence of more comorbidities. In a recent study, the association of low muscle mass and chronic illnesses contributed to a greater impairment of physical performance in elderly individuals, when compared to isolated factors.…”

“…Both the GS test and the TUG test are valid and can be used clinically (and in research) to assess sarcopenia, survival, functional mobility and the risk of falls in community-dwelling elderly individuals. 17,30 The prevalence of sarcopenia varies depending on the methods used to define the diagnosis. Bijlsma et al 31 used seven different diagnostic criteria for sarcopenia, based on measurements of muscle mass (BIA or DXA) and HGS.…”

“…These values were used in the present study. 17 It is also important to consider that reductions in muscle mass and function may be accompanied by an increase in fat mass during the aging process. This condition is currently known as sarcopenic obesity.…”

“…The test was performed twice: the first attempt was used to familiarize the participants with the task, and the second was used to record the time (in seconds). 17 The following reference scores were used to analyze their performance in the TUG test: 8.1 s (60-69 years); 9.2 s (70-79 years) and 11.3s (80-99 years). 18 …”