Predicting falls with the cognitive timed up-and-go dual task in frail older patients

Abstract

Background: The cognitive timed up-and-go dual task (CogTUG) has been proposed to improve the performance of the timed up-and-go (TUG) test for predicting falls in older patients and as a screening tool for early detection of frailty. We aimed to determine whether the CogTUG score is associated with a history of falls in frail older outpatients with gait disorders.

Methods: This retrospective study involved outpatients >75 years old with or without previous falls who were admitted from 2012 to 2014 to a geriatric day hospital for gait disorders. Patients took the TUG and CogTUG tests on the day of comprehensive geriatric assessment.

Results: Among the 161 patients included (157 analyzed; mean age 84.4±6.2 years; 72% women), 84 (53.5%) had fallen in the previous year: 105 (66.9%) were considered pre-frail and 52 (33.1%) frail. As compared with non-fallers, fallers had lower Tinetti balance scores (P=0.0004) and handgrip strength (P=0.03), more lost weight (P=0.04), and they took longer to perform the TUG test (P=0.04). Fallers and non-fallers did not differ in time taken to perform the CogTUG test (30.7±11.2 vs. 28.5±10.2s, P=0.20). History of falls was associated with only weight loss (odds ratio 3.43; 95% CI 1.13-11.30, P=0.03) and handgrip strength (0.88; 0.78-0.97, P=0.02) on multivariate analysis.

Conclusion: Unlike TUG scores, the CogTUG score was not associated a history of falls in frail older outpatients with gait disorders. Our results underline that weight loss and low muscle strength are related to falls.

Keywords: Dual task TUG; Falls; Frailty; Handgrip strength; Malnutrition; Older age; TUG.