The Value Of Timed Up And Go Test In The Elderly Fall Prediction And Risk Assessment

Objective:The aim of the present study was to conduct a prospective investigation to evaluate the accuracy of the Timed Up and Go Test(TUGT),4-meter walking test,and grip strength test to screen for the risk of falls and to determine a cut-off point to be used clinically.After combining with other risk factors for falls,determine falls risk profiles to derive a falls risks prediction score and establish a simple and practical clinical screening tool for Chinese community-dwelling elderly individuals.In that way,it would help us protect elderly from falls,improve their quality of life.Methods:First,this is a prospective study include 541 participants in Hangu,Tianjin,which were over 60 years old,the average age was 67.4 ± 5.6 years old and 307 females and 234 males are included.We collected the relative information about the questionnaire,such as age,sex,marital status,smoking,drinking and the history of chronic disease.The criteria for diagnosis of chronic disease include self-reported and physician's diagnosis.The subjects were not diagnosed according to their blood biochemistry and other clinical auxiliary diagnosis as well as the doctor's diagnosis,if necessary,the subjects were asked to do two times the auxiliary examination.The mobility,balance and muscle strength were assessed by walking speed,TUGT and grip strength.Physical ability test by a trained graduate student.In order to reduce the error,the same person was measured in follow-up.We did data collection at baseline via comprehensive geriatric assessment;after the follow-up,we performed the same data collection as the initial assessment.Second,falls were ascertained at a 2-year follow-up appointment.Sociodemographic information,medical history and physical performance data were collected.With other fall risk factors,screening of a comprehensive,integrated fall prediction model.Result:In the first study,our study's subjects' incidence of falls was 20.8%.The Recurrent falls group had a fall rate of 6.8% during the follow-up year.We use the standard areas under the curve(AUC)of our screening tool is greater than 0.70,that the tool can be used for clinical.After adding age and gender to the predictive model for any falls,the AUC of TUGT was 0.642,so it can not be a predictive tool for any falls.However,the full model(TUGT,age and gender)for recurrent falls,the TUGT's AUC improved to 0.733 and the 15.96 second cut-off seems to be a better predictive value.In the second study,The mean age was 67.4 years;57.7% were women.Female sex(Odds Ratios(OR)1.82;95% CI 1.17–2.82),diabetes(OR 2.13;95% CI 1.13–3.98),TUGT?10.49s(OR 1.51;95% CI 1.23–1.94),a history of falls(OR 3.15;95% CI 1.72–5.79),and depression(Geriatric Depression Scale(GDS)?11,OR 2.51;95% CI 1.36–4.63)were the strongest predictors.These predictors were used to establish a risk score.The area under the curve(AUC)of the score was 0.748.From a clinical point of view the most appropriate cutoff value was 7(97.5% specificity,70.7% positive predictive value(PPV),and 83.6% negative predictive value(NPV)).For this cutoff,the fraction correctly classified was 82.5%.Conclusion:Future falls were best predicted by the TUGT in recurrent fallers at baseline.For any fall,TUGT still can not meet the clinical criteria.But the findings highlighted the use TUGT to prevent elderly people fall on the importance of Chinese residential community,it can be as basic health care and hospital frequently fall risk screening test.And for any fall,although separate TUGT no predictive value,but we proved simple and easy to operate TUGT associated with gender,history of diabetes,falls,depression of the predictive value of screening model,affirmed the TUGT joint the value of other factors may be used in Chinese community-dwelling elderly individuals as an initial step to screen those at low risk for falls.In clinical practice,the cut off score of 7,may be more help in saving costs at the same time,better predict the elderly fall.In addition,this model has not yet been validated in other populations.To validate the risk profile,its predictive ability has to be examined prospectively.And,this risk profile cannot be applied to institutionalised or frailer older populations.Few high-quality trials have been conducted,and studies with retrospective fall data,which are known to be prone to recall bias and therefore have compromised internal and external validity were included.