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Does the timed up and go test predict future falls among British community-dwelling older people? Prospective cohort study nested within a randomised controlled trial

Kojima, Gotaro; Masud, Tahir; Kendrick, Denise; Morris, Richard W.; Gawler, Sheena; Treml, Jonathan; Iliffe, Steve

Authors

Gotaro Kojima

Tahir Masud

DENISE KENDRICK denise.kendrick@nottingham.ac.uk
Professor of Primary Care Research

Richard W. Morris

Sheena Gawler

Jonathan Treml

Steve Iliffe



Abstract

Background

Falling is common among older people. The Timed-Up-and-Go Test (TUG) is recommended as a screening tool for falls but its predictive value has been challenged. The objectives of this study were to examine the ability of TUG to predict future falls and to estimate the optimal cut-off point to identify those with higher risk for future falls.

Methods

This is a prospective cohort study nested within a randomised controlled trial including 259 British community-dwelling older people ≥65 years undergoing usual care. TUG was measured at baseline. Prospective diaries captured falls over 24 weeks. A Receiver Operating Characteristic curve analysis determined the optimal cut-off point to classify future falls risk with sensitivity, specificity, and predictive values of TUG times. Logistic regression models examined future falls risk by TUG time.

Results

Sixty participants (23%) fell during the 24 weeks. The area under the curve was 0.58 (95% confidence interval (95% CI) = 0.49-0.67, p = 0.06), suggesting limited predictive value. The optimal cut-off point was 12.6 seconds and the corresponding sensitivity, specificity, and positive and negative predictive values were 30.5%, 89.5%, 46.2%, and 81.4%. Logistic regression models showed each second increase in TUG time (adjusted for age, gender, comorbidities, medications and past history of two falls) was significantly associated with future falls (adjusted odds ratio (OR) = 1.09, 95% CI = 1.00-1.19, p = 0.05). A TUG time ≥12.6 seconds (adjusted OR = 3.94, 95% CI = 1.69-9.21, p = 0.002) was significantly associated with future falls, after the same adjustments.

Conclusions

TUG times were significantly and independently associated with future falls. The ability of TUG to predict future falls was limited but with high specificity and negative predictive value. TUG may be most useful in ruling in those with a high risk of falling rather than as a primary measure in the ascertainment of risk.

Journal Article Type Article
Publication Date Apr 3, 2015
Journal BMC Geriatrics
Electronic ISSN 1471-2318
Publisher Humana Press
Peer Reviewed Peer Reviewed
Volume 15
Issue 38
APA6 Citation Kojima, G., Masud, T., Kendrick, D., Morris, R. W., Gawler, S., Treml, J., & Iliffe, S. (2015). Does the timed up and go test predict future falls among British community-dwelling older people? Prospective cohort study nested within a randomised controlled trial. BMC Geriatrics, 15(38), doi:10.1186/s12877-015-0039-7
DOI https://doi.org/10.1186/s12877-015-0039-7
Keywords Timed up and go test; Falls; Older people
Publisher URL http://www.biomedcentral.com/1471-2318/15/38
Related Public URLs http://creativecommons.org/licenses/by/4.0/
Copyright Statement Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0

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Copyright Statement
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0





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