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Prognostic validity of the Timed Up-and-Go test: a modified Get-Up-and-Go test, staff's global judgement and fall history in evaluating fall risk in residential care facilities
Umeå University, Department of Community Medicine and Rehabilitation, Physiotherapy.
Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
Luleå University of Technology, Department of Health Sciences, Health and Rehab.
Umeå University, Department of Community Medicine and Rehabilitation, Physiotherapy.
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2008 (English)In: Age and Ageing, ISSN 0002-0729, E-ISSN 1468-2834, Vol. 37, no 4, p. 442-448Article in journal (Refereed) Published
Abstract [en]

Objectives: to evaluate and compare the prognostic validity relative to falls of the Timed Up-and-Go test (TUG), a modified Get-Up-and-Go test (GUG-m), staff's judgement of global rating of fall risk (GLORF) and fall history among frail older people. Design: cohort study, 6-month prospective follow-up for falls. Participants: 183 frail persons living in residential care facilities in Sweden, mean age 84 years, 73% women. Methods: the occurrence of falls during the follow-up period were compared to the following assessments at baseline: the TUG at normal speed; the GUG-m, a rating of fall risk scored from 1 (no risk) to 5 (very high risk); the GLORF, staff's rating of fall risk as 'high' or 'low'; a history of falls in the previous 6 months. These assessment tools were evaluated using sensitivity, specificity and positive and negative likelihood ratios (LR+ to rule in and LR- to rule out a high fall risk). Results: 53% of the participants fell at least once. Various cut-off values of the TUG (12, 15, 20, 25, 30, 35, 40 s) and the GUG-m showed LR+ between 0.9 and 2.6 and LR- between 0.1 and 1.0. The GLORF showed an LR+ of 2.8 and an LR- of 0.6 and fall history showed an LR+ of 2.4 and an LR- of 0.6. Conclusions: in this population of frail older people, staff judgement of their residents' fall risk as well as previous falls both appear superior to the performance-based measures TUG and GUG-m in ruling in a high fall risk. A TUG score of less than 15 s gives guidance in ruling out a high fall risk but insufficient information in ruling in such a risk. The grading of fall risk by GUG-m appears of very limited value.

Place, publisher, year, edition, pages
2008. Vol. 37, no 4, p. 442-448
National Category
Physiotherapy
Research subject
Physiotherapy
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URN: urn:nbn:se:ltu:diva-6248DOI: 10.1093/ageing/afn101ISI: 000257238000016Scopus ID: 2-s2.0-47049113778Local ID: 472dfd70-9b9d-11dd-94de-000ea68e967bOAI: oai:DiVA.org:ltu-6248DiVA, id: diva2:979125
Note
Validerad; 2008; 20081016 (eriros)Available from: 2016-09-29 Created: 2016-09-29 Last updated: 2018-07-10Bibliographically approved

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