Fischer Barbara L, Hoyt William T, Maucieri Lawrence, Kind Amy J, Gunter-Hunt Gail, Swader Teresa Chervenka, Gangnon Ronald E, Gleason Carey E
2500 Overlook Terrace, GRECC, Wm. S. Middleton Memorial VA Hospital, Madison, WI 53705.
J Rehabil Res Dev. 2014;51(2):263-74. doi: 10.1682/JRRD.2013.03.0075.
Falling is a serious hazard for older veterans that may lead to severe injury, loss of independence, and death. While the American Geriatrics Society (AGS) provides guidelines to screen individuals at risk for falls, the guidelines may be less successful with specific subgroups of patients. In a veteran sample, we examined whether the Timed Up and Go (TUG) test, including a modified version, the TUG-Cognition, effectively detected potential fallers whose risk was associated with cognitive deficits. Specifically, we sought to determine whether TUG tasks and AGS criteria were differentially associated with executive dysfunction, whether the TUG tasks identified potential fallers outside of those recognized by AGS criteria, and whether these tasks distinguished groups of fallers. Participants included 120 mostly male patients referred to the Memory Assessment Clinic because of cognitive impairment. TUG-Cognition scores were strongly associated with executive dysfunction and differed systematically between fallers grouped by number of falls. These findings suggest that the TUG-Cognition shows promise in identifying fallers whose risk is related to or compounded by cognitive impairment. Future research should study the predictive validity of these measures by following patients prospectively.
跌倒对于老年退伍军人来说是一个严重的危险因素，可能导致重伤、失去独立生活能力甚至死亡。虽然美国老年医学会（AGS）提供了筛查跌倒风险个体的指南，但这些指南在特定患者亚组中可能效果欠佳。在一个退伍军人样本中，我们研究了定时起立行走测试（TUG），包括其改良版本TUG-认知测试，是否能有效检测出因认知缺陷而存在跌倒风险的潜在跌倒者。具体而言，我们试图确定TUG任务和AGS标准与执行功能障碍之间是否存在差异关联，TUG任务能否识别出AGS标准未涵盖的潜在跌倒者，以及这些任务能否区分不同类型的跌倒者群体。参与者包括120名主要为男性的患者，他们因认知障碍被转诊至记忆评估诊所。TUG-认知测试得分与执行功能障碍密切相关，且在按跌倒次数分组的跌倒者之间存在系统性差异。这些发现表明，TUG-认知测试在识别因认知障碍而导致或加重跌倒风险的跌倒者方面具有潜力。未来的研究应通过对患者进行前瞻性跟踪来研究这些测量方法的预测效度。
