Alexandre Tiago S, Meira Débora M, Rico Natália C, Mizuta Simone K
Universidade de São Paulo, São Paulo, SP, Brazil.
Rev Bras Fisioter. 2012 Sep-Oct;16(5):381-8. doi: 10.1590/s1413-35552012005000041. Epub 2012 Aug 2.
To determine the accuracy of the Timed Up and Go Test (TUGT) for screening the risk of falls among community-dwelling elderly individuals.
This is a prospective cohort study with a randomly by lots without reposition sample stratified by proportional partition in relation to gender involving 63 community-dwelling elderly individuals. Elderly individuals who reported having Parkinson's disease, a history of transitory ischemic attack, stroke and with a Mini Mental State Exam lower than the expected for the education level, were on a wheelchair and that reported a single fall in the previous six months were excluded. The TUGT, a mobility test, was the measure of interested and the occurrence of falls was the outcome. The performance of basic activities of daily living (ADL) and instrumental activities of daily living (IADL) was determined through the Older American Resources and Services, and the socio-demographic and clinical data were determined through the use of additional questionnaires. Receiver Operating Characteristic Curves were used to analyze the sensitivity and specificity of the TUGT.
Elderly individuals who fell had greater difficulties in ADL and IADL (p<0.01) and a slower performance on the TUGT (p=0.02). No differences were found in socio-demographic and clinical characteristics between fallers and non-fallers. Considering the different sensitivity and specificity, the best predictive value for discriminating elderly individuals who fell was 12.47 seconds [(RR=3.2) 95%CI: 1.3-7.7].
The TUGT proved to be an accurate measure for screening the risk of falls among elderly individuals. Although different from that reported in the international literature, the 12.47 second cutoff point seems to be a better predictive value for Brazilian elderly individuals.
确定定时起立行走测试(TUGT)筛查社区居住老年个体跌倒风险的准确性。
这是一项前瞻性队列研究,通过随机抽签进行,不重新定位样本,按性别比例分层,纳入63名社区居住老年个体。排除报告患有帕金森病、短暂性脑缺血发作史、中风且简易精神状态检查表得分低于教育水平预期值、使用轮椅以及报告在过去六个月内有单次跌倒的老年个体。TUGT作为一项移动性测试,是感兴趣的测量指标,跌倒的发生情况为结果。通过美国老年资源与服务量表确定日常生活基本活动(ADL)和日常生活工具性活动(IADL)的表现,并通过使用额外问卷确定社会人口统计学和临床数据。采用受试者工作特征曲线分析TUGT的敏感性和特异性。
跌倒的老年个体在ADL和IADL方面有更大困难(p<0.01),TUGT表现更慢(p=0.02)。跌倒者和未跌倒者在社会人口统计学和临床特征方面未发现差异。考虑到不同的敏感性和特异性,区分跌倒老年个体的最佳预测值为12.47秒[(RR=3.2)95%CI:1.3 - 7.7]。
TUGT被证明是筛查老年个体跌倒风险的准确指标。尽管与国际文献报道不同,但12.47秒的截断点似乎对巴西老年个体是更好的预测值。