Performances on the Timed Up and Go Test and subtasks between fallers and non-fallers in older adults with cognitive impairment

Ansai, Juliana Hotta; Andrade, Larissa Pires de; Nakagawa, Theresa Helissa; Rebelatto, José Rubens

doi:10.1590/0004-282X20180055

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ARTICLE • Arq. Neuro-Psiquiatr. 76 (6) • June 2018 • https://doi.org/10.1590/0004-282X20180055 copy

Performances on the Timed Up and Go Test and subtasks between fallers and non-fallers in older adults with cognitive impairment

Performances no teste Timed Up and Go e subtarefas em idosos com comprometimento cognitivo, caidores e não caidores

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

This work aimed to compare performances on the Timed Up and Go (TUG) test and its subtasks between faller and non-faller older adults with mild cognitive impairment (MCI) and mild Alzheimer’s disease (AD). A prospective study was conducted, with 38 older adults with MCI and 37 with mild AD. Participants underwent an assessment at baseline (the TUG and its subtasks using the Qualisys ProReflex system) and the monitoring of falls at the six-month follow up. After six months, 52.6% participants with MCI and 51.3% with AD fell. In accordance with specific subtasks, total performance on the TUG distinguished fallers from non-fallers with AD, fallers from non-fallers with MCI and non-fallers with MCI from non-fallers with AD. Although no other difference was found in total performances, non-fallers with MCI and fallers with AD differed on the walking forward, turn and turn-to-sit subtasks; and fallers with MCI and non-fallers with AD differed on the turn-to-sit subtask.

aged; Alzheimer’s disease; accidental falls; cognitive disfunction

Variable, Md (IQR)	Non-fallers with MCI (n = 18)	Fallers with MC (n = 20)	Non-fallers with mild AD (n = 18)	Fallers with mild AD (n = 19)	p-value
Age (years)	72.5 (68.7–79.5)	77.0 (71.2–82.0)	78.0 (72.7–81.0)	79.0 (73.0–84.0)	0.253
Female gender, n (%)	16 (88.9)	16 (80.0)	11 (61.1)	10 (52.6)	0.058
Body mass index (kg/m²)	30.4 (27.6–32.8)	29.0 (25.1–31.1)	27.7 (22.1–32.3)	27.3 (22.7–30.4)	0.168
Years of schooling	4.0 (4.0–10.0)	4.0 (2.0–4.7)	4.0 (2.0–6.2)	4.0 (4.0–8.0)	0.474
Diseases (number)	2.0 (2.0–3.2)	3.0 (2.0–4.0)	3.0 (2.0–4.0)	4.0 (3.0–5.0)	0.070
Medication (number)	4.0 (2.7–6.5)	5.0 (3.0–7.0)	5.0 (2.7–6.0)	5.0 (4.0–6.0)	0.659
Minnesota	1,287.2 (355.0–2,314.0)	743.4 (174.6–1724.3)	353.8 (95.6–1018.4)	289.8 (0.0–1161.1)	0.138

Variable, Md (IQR)	Non-fallers with MCI (n = 18)	Fallers with MCI (n = 20)	Non-fallers with mild AD (n = 18)	Fallers with mild AD (n = 19)	p-value
TUG, total time (s)	12.4 (11.2–14.3)^#,+	14.4 (11.8–17.2)^#	17.9 (13.7–21.5)^+,$	14.0 (12.4–17.8)^$	0.003
Sit-to-stand, time (s)	0.8 (0.7–1.0)	0.9 (0.8–1.0)	0.9 (0.8–1.2)	0.9 (0.7–1.0)	0.390
Walking forward, gait speed (m/s)	0.5 (0.4–0.6)^#,+,$	0.4 (0.3–0.5)^#	0.4 (0.2–0.5)⁺	0.4 (0.3–0.5)^$	0.034
Turn, time (s)	1.7 (1.2–2.3)^#,+,$	2.2 (1.9–2.8)^#	2.5 (2.1–2.8)⁺	2.6 (2.1–2.8)^$	0.027
Walking back, gait speed (m/s)	0.7 (0.6–0.8)^#,+	0.6 (0.4–0.7)^#	0.5 (0.4–0.6)⁺	0.6 (0.5–0.7)	0.007
Turn-to-sit, time (s)	1.8 (1.6–2.3)⁺	2.0 (1.8–2.7)^#	3.0 (2.1–3.9)^+,$,#	2.0 (1.8–2.5)^$	0.026

Variable, Md (IQR)	Non-fallers with MCI (n = 18)	Fallers with MCI (n = 20)	Non-fallers with mild AD (n = 18)	Fallers with mild AD (n = 19)	p-value
TUG
Steps (number)	17.0 (14.2–18.0)	18.0 (16.0–21.0)	20.5 (15.5–24.0)	17.5 (15.0–22.2)	0.185
Sit-to-stand
V of trunk, F/E (º/s)	42.6 (40.4–51.0)⁺	41.9 (32.4–50.8)	35.6 (27.6–40.7)⁺	41.0 (37.1–48.6)	0.012
Walking forward
First step - time (s)	0.6 (0.5–0.6)	0.6 (0.6–0.7)	0.7 (0.6–0.7)	0.7 (0.6–0.7)	0.142
First step - length (m)	0.2 (0.2–0.3)	0.2 (0.1–0.3)	0.1 (0.1–0.3)	0.2 (0.1–0.2)	0.139
Steps (number)	4.7 (4.0–5.0)	5.0 (5.0–7.0)	5.8 (4.9–7.7)	5.3 (5.0–6.0)	0.073
Turn
V of trunk, R (º/s)	76.0 (63.9–89.3)^#,+,$	62.4 (50.8–72.6)^#	56.1 (44.6–65.0)⁺	58.8 (54.2–70.0)^$	0.003
Steps (number)	3.3 (3.0–4.3)^#,+,$	5.0 (3.6–5.0)^#	5.0 (3.6–5.0)⁺	5.0 (4.3–5.0)^$	0.007
Walking back
First step - time (s)	0.6 (0.6–0.8)	0.6 (0.6–0.7)	0.6 (0.6–0.8)	0.6 (0.5–0.8)	0.553
First step - length (m)	0.3 (0.2–0.4)	0.2 (0.2–0.3)	0.2 (0.2–0.3)	0.3 (0.2–0.4)	0.254
Steps (number)	4.0 (3.0–4.9)	5.0 (4.0–6.0)	5.0 (3.9–6.0)	4.3 (3.6–5.3)	0.146
Turn-to-sit
V of trunk, F/E (º/s)	38.3 (30.1–45.8)^+,$	31.6 (25.1–37.5)	26.3 (19.2–35.1)⁺	30.1 (23.6–37.0)^$	0.013
V of trunk, R (º/s)	41.1 (34.6–49.2)⁺	40.7 (35.5–43.8)^#	29.3 (26.6–36.6)^+,$,#	38.9 (33.1–44.8)^$	0.014
Steps (number)	3.8 (3.0–4.0)^+,$	4.0 (3.7–4.7)	4.5 (4.0–5.8)⁺	4.0 (4.0–4.8)^$	0.016

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[1] Correspondence: Juliana Hotta Ansai; Departamento de Fisioterapia da UFMS, Instituto Integrado de Saúde; Cidade Universitária, 79070-900; Campo Grande MS, Brasil; E-mail: juliana.h.ansai@ufms.br