Does the timed up and go test predict future falls among British community-dwelling older people? Prospective cohort study nested within a randomised controlled trial
Background Falling is common among older people. The Timed-Up-and-Go Test (TUG) is recommended as a screening tool for falls but its predictive value has been challenged. The objectives of this study were to examine the ability of TUG to predict future falls and to estimate the optimal cut-off po...
| Main Authors: | , , , , , , |
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| Format: | Article |
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BioMed Central
2015
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| Online Access: | https://eprints.nottingham.ac.uk/30539/ |
| _version_ | 1848794005400190976 |
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| author | Kojima, Gotaro Masud, Tahir Kendrick, Denise Morris, Richard W. Gawler, Sheena Treml, Jonathan Iliffe, Steve |
| author_facet | Kojima, Gotaro Masud, Tahir Kendrick, Denise Morris, Richard W. Gawler, Sheena Treml, Jonathan Iliffe, Steve |
| author_sort | Kojima, Gotaro |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Background
Falling is common among older people. The Timed-Up-and-Go Test (TUG) is recommended as a screening tool for falls but its predictive value has been challenged. The objectives of this study were to examine the ability of TUG to predict future falls and to estimate the optimal cut-off point to identify those with higher risk for future falls.
Methods
This is a prospective cohort study nested within a randomised controlled trial including 259 British community-dwelling older people ≥65 years undergoing usual care. TUG was measured at baseline. Prospective diaries captured falls over 24 weeks. A Receiver Operating Characteristic curve analysis determined the optimal cut-off point to classify future falls risk with sensitivity, specificity, and predictive values of TUG times. Logistic regression models examined future falls risk by TUG time.
Results
Sixty participants (23%) fell during the 24 weeks. The area under the curve was 0.58 (95% confidence interval (95% CI) = 0.49-0.67, p = 0.06), suggesting limited predictive value. The optimal cut-off point was 12.6 seconds and the corresponding sensitivity, specificity, and positive and negative predictive values were 30.5%, 89.5%, 46.2%, and 81.4%. Logistic regression models showed each second increase in TUG time (adjusted for age, gender, comorbidities, medications and past history of two falls) was significantly associated with future falls (adjusted odds ratio (OR) = 1.09, 95% CI = 1.00-1.19, p = 0.05). A TUG time ≥12.6 seconds (adjusted OR = 3.94, 95% CI = 1.69-9.21, p = 0.002) was significantly associated with future falls, after the same adjustments.
Conclusions
TUG times were significantly and independently associated with future falls. The ability of TUG to predict future falls was limited but with high specificity and negative predictive value. TUG may be most useful in ruling in those with a high risk of falling rather than as a primary measure in the ascertainment of risk. |
| first_indexed | 2025-11-14T19:09:19Z |
| format | Article |
| id | nottingham-30539 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T19:09:19Z |
| publishDate | 2015 |
| publisher | BioMed Central |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-305392020-05-04T17:07:07Z https://eprints.nottingham.ac.uk/30539/ Does the timed up and go test predict future falls among British community-dwelling older people? Prospective cohort study nested within a randomised controlled trial Kojima, Gotaro Masud, Tahir Kendrick, Denise Morris, Richard W. Gawler, Sheena Treml, Jonathan Iliffe, Steve Background Falling is common among older people. The Timed-Up-and-Go Test (TUG) is recommended as a screening tool for falls but its predictive value has been challenged. The objectives of this study were to examine the ability of TUG to predict future falls and to estimate the optimal cut-off point to identify those with higher risk for future falls. Methods This is a prospective cohort study nested within a randomised controlled trial including 259 British community-dwelling older people ≥65 years undergoing usual care. TUG was measured at baseline. Prospective diaries captured falls over 24 weeks. A Receiver Operating Characteristic curve analysis determined the optimal cut-off point to classify future falls risk with sensitivity, specificity, and predictive values of TUG times. Logistic regression models examined future falls risk by TUG time. Results Sixty participants (23%) fell during the 24 weeks. The area under the curve was 0.58 (95% confidence interval (95% CI) = 0.49-0.67, p = 0.06), suggesting limited predictive value. The optimal cut-off point was 12.6 seconds and the corresponding sensitivity, specificity, and positive and negative predictive values were 30.5%, 89.5%, 46.2%, and 81.4%. Logistic regression models showed each second increase in TUG time (adjusted for age, gender, comorbidities, medications and past history of two falls) was significantly associated with future falls (adjusted odds ratio (OR) = 1.09, 95% CI = 1.00-1.19, p = 0.05). A TUG time ≥12.6 seconds (adjusted OR = 3.94, 95% CI = 1.69-9.21, p = 0.002) was significantly associated with future falls, after the same adjustments. Conclusions TUG times were significantly and independently associated with future falls. The ability of TUG to predict future falls was limited but with high specificity and negative predictive value. TUG may be most useful in ruling in those with a high risk of falling rather than as a primary measure in the ascertainment of risk. BioMed Central 2015-04-03 Article PeerReviewed Kojima, Gotaro, Masud, Tahir, Kendrick, Denise, Morris, Richard W., Gawler, Sheena, Treml, Jonathan and Iliffe, Steve (2015) Does the timed up and go test predict future falls among British community-dwelling older people? Prospective cohort study nested within a randomised controlled trial. BMC Geriatrics, 15 (38). pp. 1-7. ISSN 1471-2318 Timed up and go test; Falls; Older people http://www.biomedcentral.com/1471-2318/15/38 doi:10.1186/s12877-015-0039-7 doi:10.1186/s12877-015-0039-7 |
| spellingShingle | Timed up and go test; Falls; Older people Kojima, Gotaro Masud, Tahir Kendrick, Denise Morris, Richard W. Gawler, Sheena Treml, Jonathan Iliffe, Steve Does the timed up and go test predict future falls among British community-dwelling older people? Prospective cohort study nested within a randomised controlled trial |
| title | Does the timed up and go test predict future falls among British community-dwelling older people? Prospective cohort study nested within a randomised controlled trial |
| title_full | Does the timed up and go test predict future falls among British community-dwelling older people? Prospective cohort study nested within a randomised controlled trial |
| title_fullStr | Does the timed up and go test predict future falls among British community-dwelling older people? Prospective cohort study nested within a randomised controlled trial |
| title_full_unstemmed | Does the timed up and go test predict future falls among British community-dwelling older people? Prospective cohort study nested within a randomised controlled trial |
| title_short | Does the timed up and go test predict future falls among British community-dwelling older people? Prospective cohort study nested within a randomised controlled trial |
| title_sort | does the timed up and go test predict future falls among british community-dwelling older people? prospective cohort study nested within a randomised controlled trial |
| topic | Timed up and go test; Falls; Older people |
| url | https://eprints.nottingham.ac.uk/30539/ https://eprints.nottingham.ac.uk/30539/ https://eprints.nottingham.ac.uk/30539/ |