Falls Risk Assessments and a Possible Link to Cognitive Health

There are a few tests which are used to assess mobility and falls risk in older adults, such as the “Timed Up and Go” test (TUG), the Berg Balance Test (BBT), and the Dynamic Gait Index (DGI). An article in Gerontology compares these three assessments, and suggests that the TUG may be more useful in the assessment of physically healthier individuals and is also related to cognitive function.

Researchers have used the BBT, DGI, and TUG to identify individuals at risk for falls, but each differs somewhat in their administration and scoring. Previous studies have suggested that the BBT and DGI may suffer from the “ceiling effect,” or inability to find differences between individuals at the higher end of the scoring range. This suggests that these tests might be less useful in finding change in mobility and falls risk in healthier individuals. In contrast, the TUG has been found to be sensitive to interventions with mobile, healthy older adults.

This study administered the BBT, DGI and TUG, as well as a set of cognitive tests, to a population of 265 healthy older adults. The researchers also collected data on any falls occurring to participants in the 12 months after the tests. They found that there were ceiling effects for the BBT and DGI, but that the results from the TUG were normally distributed. The three tests were only moderately correlated with one another, and the TUG had a small negative correlation with Mini Mental Status Exam scores, verbal fluency, and the backward digit span (which tests working memory and concentration). In this study sample, neither the BBT nor DGI were significantly related to falls during the follow-up period, while participants who had two or more falls had significantly slower performance on the TUG. 

The authors suggest a few reasons that the TUG scores were associated with cognitive function. Tests of balance and mobility involve the combination and coordination of several physical tasks, which place some demand on cognitive function. Due to this and its useful statistical properties, the TUG may be a useful indicator of falls risk, limited mobility, and possibly even cognitive function.  

Source:

Herman, T.; Giladi, N.; and Hausdorff, J.M. (2011). “Properties of the ‘Timed Up and Go’ Test: More than Meets the Eye.” Gerontology 57(3).

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